Let's learn more about Uterine Prolapse. Do you also have this problem?

Do you sometimes feel a heaviness or fullness in your vagina? Or do you feel like something is pressing down on you when you stand or walk? Some women can experience this kind of discomfort. Today we are going to talk about a condition that affects many people, but is sometimes a little embarrassing to talk about, called uterine prolapse.

What is Uterine Prolapse?

Simply put, a prolapsed uterus means that your uterus has dropped a little below where it should be, hanging down towards the vagina. Think of it like a small bag. This bag is located inside the pelvis. It is held there by a strong mesh of muscles and ligaments. These are called pelvic floor muscles . Over time, or when these supporting muscles weaken for other reasons, the uterus loses its firmness and begins to fall. This can happen to any woman, but it is most common in women who have gone through menopause and have had several vaginal deliveries.

Are there different scenarios for this?

Yes, doctors classify this into different stages depending on the degree to which the uterus has descended. Then it is easier to treat.

• Stage I: In this stage, the uterus may be slightly lower than the upper part of the vagina.
• Stage II: Here the uterus may have reached the lower part of the vagina.
• Stage III: The uterus is visible outside the vagina.
• Stage IV: This is the most severe stage. The entire uterus may have come out of the vagina.

By identifying the cases in this way, it is easier for the doctor to decide what type of treatment is right for you.

Who is more likely to develop this condition?

As mentioned before, this can happen to anyone, but for some people, the risk is a little higher.

• For those who have given birth to more than one child normally: especially if the baby was heavy or if the delivery was a little difficult.
• For women who have gone through menopause: This is because during this time, the hormone estrogen in the body decreases. This hormone helps keep the pelvic muscles strong. When it decreases, the muscles can become weak.
• If someone in the family has had this condition before: This means there may be a hereditary predisposition.
• For those who have had previous pelvic surgeries.

How common is this? Is it a dangerous condition?

A low uterus is a condition that is more common than you might think. The risk increases with age. It is also more likely to occur in women who have had multiple normal pregnancies.

Now let's see if this is dangerous. In most cases, this is not a life-threatening disease. However, it can make it difficult to carry out daily activities and be comfortable. Sometimes, if there are very few cases (mild cases) , you can live without any symptoms and do not need treatment. However, if the condition is severe, you may have difficulty urinating and defecating. Therefore, this is often a problem that affects the quality of life . Doctors only start treating it when the symptoms start to interfere with your daily life.

What does it feel like when the uterus prolapses? What are the symptoms?

If your uterus is slightly prolapsed, you may not experience any symptoms. But as it descends, it can put pressure on other organs in the pelvic cavity – such as the bladder and bowel. This can cause symptoms such as:

• A feeling of heaviness, fullness, or pressure in the pelvis. It may also feel like there is something like a ball in the vagina.
• Lower abdominal and back pain.
• Pain during intercourse.
• It feels like a piece of uterine tissue is coming out of the vagina. It may even be felt in the hand.
• Difficulty inserting objects such as tampons into the vagina.
• Constipation.
• Urination problems:
• Leakage of urine (incontinence) – when laughing, coughing, or sneezing.
• Frequent need to urinate (urinary frequency).
• Sudden, strong need to urinate (urinary urgency).

These symptoms can be especially severe when you stand, walk for long periods of time, cough, or sneeze, as gravity puts extra pressure on the pelvic muscles.

Why does the uterus prolapse like this? What are the reasons?

As we've discussed before, the uterus is held in place by the pelvic floor muscles and ligaments. When these become weak, the uterus begins to descend. There are several reasons why these muscles may weaken:

• Menopause causes a decrease in muscle strength: This is due to a decrease in the hormone estrogen.
• Pregnancy: These muscles are put under a lot of pressure during pregnancy.
• Vaginal childbirth: Especially if you have had multiple children, or if the baby weighs more than 4 kg (9 lbs).
• Obesity: When body weight increases, the pelvic muscles also have to bear that weight.
• Having a chronic cough or straining: This risk is higher for people with conditions like asthma, or those who have frequent, hard bowel movements.
• Chronic constipation.
• Repeated heavy lifting: Lifting weights incorrectly can also be a cause of this.

Could this situation cause other problems?

Yes, when the pelvic floor muscles weaken, not only the uterus but also the other organs around it can drop from their normal positions. This is called pelvic organ prolapse .

• Cystocele: In this case, the bladder descends into the vagina.
• Rectocele: A protrusion of part of the rectum into the vagina.
• Enterocele: A protrusion of part of the small intestine into the vagina.

How do doctors diagnose this exactly?

If you have these symptoms, the first thing a doctor will do when you see them is examine you. They will do a pelvic examination . During this, the doctor will insert a device called a speculum (which allows you to see inside the vagina) into your vagina and examine your vagina and uterus. The uterus will be lowered and he will feel for any lumps inside the vagina.

You may also be asked to cough, breathe deeply, or strain as if you are holding your urine. This will help the doctor understand how weak your pelvic muscles are.

What are the treatments for this?

There are several treatments for uterine prolapse. There are surgical and non-surgical options. Your doctor will choose the treatment that is best for you based on the severity of your condition, your general health, your age, and whether you want to have more children. This treatment is successful for most people.

Nonsurgical options

• Exercise: There are special exercises called Kegel exercises . These can strengthen the pelvic floor muscles. If the condition is not too severe, these exercises alone can help. Kegel exercises are done like this: Tighten the muscles around the vagina as if you are holding back urine. Hold for a few seconds, then relax the muscles. Do this about ten times in a row. You can do this exercise about four times a day, anywhere, at any time.
• Vaginal pessary: ​​This is a small, doughnut-shaped device made of rubber or plastic. It is inserted into the vagina, either around or under the cervix. It provides support for the uterus and helps keep it in place. A doctor will fit the pessary to your body. However, it needs to be cleaned regularly and removed before having sex.
• Diet and lifestyle changes: Sometimes these changes can help reduce symptoms like constipation. Eating more water and fiber can help reduce the urge to have a bowel movement. Also, maintaining a healthy weight for your body can help reduce the strain on your pelvic floor muscles when standing and walking.

Surgical options

• Hysterectomy and prolapse repair: Sometimes this is treated with a surgery called a hysterectomy, which involves removing the entire uterus. This surgery can be done through the vagina (vaginal hysterectomy) or through an incision in the abdomen (abdominal hysterectomy). However, a hysterectomy is a major operation. After the uterus is removed, you will not be able to have children again.
• Prolapse repair without hysterectomy: This surgery involves moving the uterus back into its original position and tightening it. The pelvic ligaments can be reattached to the lower part of the uterus to hold it in place. This surgery can also be done through the vagina or through the abdomen, depending on the method used by the doctor.

What happens if you don't get treatment?

It really depends on the severity of the prolapse. If it's very mild and doesn't have a significant impact on your quality of life, your doctor may not recommend treatment. However, prolapse can also affect other organs in your pelvis (such as the bladder and rectum). Therefore, doctors usually recommend treatment only when you start to experience discomfort from the condition.

Can't I push this lowered uterus up myself?

No, you can't push your uterus back up on your own. Only a doctor can treat a prolapsed uterus. So don't try to do anything yourself, as it could make the situation worse.

How can this situation be prevented and the risk reduced?

We can't prevent some things, such as having multiple children naturally and going through menopause. However, there are things we can do to reduce the risk of uterine prolapse.

• Maintain a healthy weight and exercise regularly.
• Keep your pelvic floor muscles strong by doing Kegel exercises. This is very important to do during pregnancy and after giving birth.
• If you smoke, stop. Smoking can cause a persistent cough. It puts unnecessary pressure on the pelvic muscles.
• Use proper technique when lifting weights.
• To prevent constipation, avoid straining to have a bowel movement. Eat foods high in fiber and drink plenty of water.

Think about these things when lifting weights

Follow these tips to avoid injury and damage to your pelvic muscles when lifting weights:

• Don't lift anything that is too heavy or awkwardly shaped for you to lift alone. Also, don't lift anything that is above waist level.
• Before lifting anything, make sure your feet are firmly planted on the ground and stable.
• When lifting something below waist level, keep your back straight and bend your knees and hips as you lower. Keep your knees straight and do not bend forward at the waist.
• Stand firmly on the ground, close to the object you are going to lift, with your legs slightly apart.
• Tighten your abdominal muscles and lift the weight with your leg muscles . Straighten your knees at the same speed. Don't lift the weight in one go.
• Stand completely straight, without twisting your body. Always put your feet forward when lifting an object.
• If you are lifting something from a table, pull it to the edge of the table and bring it close to your body. Bend your knees and get close to the item. Lift the item with your legs and stand.
• Hold the lifted object close to your body, with your arms folded. Keep your abdominal muscles tight. Walk slowly, taking small steps.
• When lowering an object, just like when lifting it, keep your legs straight, tighten your abdominal muscles, and lower it by bending your hips and knees.

Can this happen again?

Most of the time, treatment for uterine prolapse is successful. However, sometimes, the condition can recur. Especially in cases like these:

• If you have a very severe prolapse .
• If you are obese .
• If you are under 60 years old .

Therefore, even after treatment, it is very important to follow medical advice and develop good lifestyle habits.

Is it possible to fully recover from this condition?

In most cases, the outlook for uterine prolapse is very good. Treatment and lifestyle changes (maintaining a healthy weight, exercising) can help prevent the condition from recurring. If you have any concerns about this, talk to your doctor. He or she can help you develop a treatment plan that works for you, as well as help you develop good lifestyle habits to prevent this condition from recurring in the future.

When should you see a doctor?

If you have any of the symptoms below, definitely see a doctor.

• If you feel like something is stuck in your vagina or coming out .
• If there is pain when urinating or defecating.
• If you have persistent lower abdominal pain, back pain, or pelvic pressure for no other reason.

Remember, a prolapsed uterus is a common condition among women who have had several children naturally or who have gone through menopause. Symptoms may vary depending on how far the uterus has prolapsed, but it can be very uncomfortable. Therefore, if you have symptoms such as a discharge from the vagina or a feeling of heaviness in the pelvic area, see a doctor and get treatment before it affects other organs. Then you can get relief quickly.

So what are the most important things we need to remember from this?

Uterine prolapse is when the muscles that hold the uterus in place weaken, causing it to drop into the vagina. This is common among women, especially after childbirth and menopause.

• Symptoms: Vaginal heaviness, discharge, difficulty urinating and defecating, and back pain may occur.
• Causes: Things like childbirth, menopause, obesity, persistent cough or constipation, and heavy lifting can all affect it.
• There are treatments: Kegel exercises, pessary insertion, and, if necessary, surgery can successfully treat this condition.
• It can also be prevented: You can reduce your risk by maintaining a healthy weight, doing Kegel exercises, lifting weights correctly, and avoiding smoking.
• If you feel uncomfortable: Definitely seek medical advice. There is nothing to be ashamed of or afraid of. The sooner you get treatment, the sooner you can recover.

` Uterine Prolapse, Women's Health, Pelvic Support Muscles, Menopause, Childbirth, Kegel Exercises