As women get older, they may experience something called pelvic organ prolapse. Pelvic prolapse results when one of the pelvic organs (uterus, vagina, bladder, bowel, rectum or anus) slips out of its natural position, usually protruding into the vaginal canal. This happens when the pelvic muscles and connective tissues that hold your organs in place weaken or fail.

What is uterine prolapse?

For women experiencing uterine prolapse, the uterus (womb) starts to sag or slip from its normal position and into the vagina (birth canal). Women may experience an incomplete or complete uterine prolapse. An incomplete prolapse occurs when the uterus just slightly shifts out of place. A complete prolapse occurs when the uterus begins to fall down the vagina, and a bulge may appear to be coming out of the vagina.

What causes uterine prolapse?

Numerous events or injuries can cause the connective tissue and pelvic floor muscles to loosen. Pregnancy and vaginal childbirth are the primary cause of pelvic prolapse in women. Carrying and delivering a baby places considerable pressure on the pelvic floor muscles. Repeated heavy lifting, excess weight and strained bowel movements can also place enough pressure on the muscles to cause prolapse. The pelvic floor muscles naturally weaken and prolapse as a result of menopause and the aging process as well.

How is uterine prolapse treated?

Surgery is not always needed for uterine prolapse. It depends on the severity of symptoms. Your doctor may first recommend a few strategies to improve your symptoms at home, such as pelvic floor exercises (Kegels), losing weight and avoiding heavy lifting. Your doctor can also provide a pessary, a vaginal insert that provides pelvic support.

If more conservative approaches don’t work, you may need surgery to repair your uterine prolapse. A hysterectomy may be one option your doctor recommends. A hysterectomy is a surgical procedure performed to remove a woman’s uterus, and women can no longer get pregnant once the uterus is removed, as this is where a baby develops. Menopause will also occur if ovaries are removed during the hysterectomy.

If recommended by your doctor, some women also have the option to retain their uterus through uterus preserving procedures, which involves lifting the uterus and restoring the vaginal walls back to their original positions. Some of the benefits of uterine preservation over hysterectomy include shorter surgical time, faster recovery and avoiding early onset menopause. Surgery for uterine prolapse can be done through your vagina or abdomen, and your doctor may use synthetic patch to repair the prolapse through the abdomen.

Surgery is often effective, but it’s not recommended for women who are not done with having children. Pregnancy and childbirth can strain the pelvic muscles, which can undo surgical repairs of the uterus.