Uterine Prolapse Self Management Help for Women
Uterine prolapse is one form of vaginal prolapse in women. The risk of uterine prolapse increases in mature women however a prolapsed uterus also occurs younger women and at times this diagnosis is made immediately following childbirth.
This Pelvic Floor Physiotherapy information outlines self management strategies for uterine prolapse problems.
Read on now to learn:
- What is a uterine prolapse
- Uterine prolapse symptoms
- What causes a uterine prolapse
- How to prevent uterine prolapse from becoming worse and protect prolapse repair surgery
- Uterine prolapse exercises.
1. What is Uterine Prolapse?
Uterine prolapse is a “fallen down” uterus or womb slipped out of position. It happens when the uterus (or womb) loses its strong supports that hold it up inside your pelvis.
The uterus is held up and in position inside the pelvis by a combination of strong ligaments (imagine ropes holding it up from above), and the pelvic floor muscles (supporting your uterus from below). When these supports fail inside the uterus moves down within the pelvis, and the cervix, or strong muscle around the neck of the uterus moves down inside the vagina. This illustrates the importance of strong healthy pelvic floor muscles if your have been diagnosed with a uterine prolapse and after prolapse repair surgery.
2. Uterine Prolapse Symptoms
A prolapsed uterus may present with a number of different symptoms. When the prolapse is very mild you may have no symptoms. Uterine prolapse symptoms tend to become more apparent as the prolapse becomes worse including any of the following:
- A bulging, heavy/dragging feeling in the vagina;
- A lump coming down inside the vagina;
- A heavy feeling in the abdomen or pelvis;
- Difficulty inserting tampons;
- Difficulty emptying the bladder; and
- Low back discomfort.
3. What Causes Prolapsed Uterus?
Some common causes of uterine prolapse include:
- Pregnancy and childbirth that causing damage to the pelvic floor during birth such as prolonged pushing, multiple births and large babies. Note that injury to your pelvic floor during childbirth may not become apparent until many years later!
- Postnatal pelvic floor injury caused by constipation and/or inappropriate exercise.
- Chronic constipation and straining
- Chronic coughing and/or sneezing
- Wasting of the supportive structures in your pelvic floor during and after menopause
- Heavy lifting
- Inappropriate exercise including high impact exercise, heavy weight training and intense abdominal or core exercise.
For comprehensive guidelines for uterine prolapse exercises to avoid and choose refer to Inside Out – the essential women’s guide to pelvic support by Michelle Kenway Pelvic Floor Physiotherapist and Dr Judith Goh Urogynaecologist.
4. How to Protect after Uterine Prolapse Surgery?
There are a number of important steps you can take to manage your prolapse and protect your prolapse repair if you have taken the step of having prolapse repair surgery.
- Straining/constipation (seehow to overcome bowel movement problems to learn how to empty and avoid straining);
- Heavy lifting, pushing/pulling, bending;
- Smoking (to reduce coughing);
- High impact sports (e.g. jogging, sit-ups, horse-riding, high impact aerobics);
- Heavy resistance training;
- Intense core or abdominal exercises; and
- Becoming overweight.
- Pelvic floor muscle exercises – start pelvic floor exercises after surgery when you have your specialist’s approval to commence;
- Wear quality support briefs (underwear);
- Speak with your specialist about the possibility of being fitted with a support pessary. A pessary is a prolapse support device that sits high inside the vagina. Many women find that using a pessary device helps them exercise their pelvic floor muscles and supports their prolapse;
- Practice good bowel habits (e.g. never strain);
- Alternate activities (e.g. sitting/standing) and avoid prolonged standing especially when you are recovering from pelvic floor repair surgery;
- Do tasks early in the day;
- Split tasks (e.g. do vacuuming over a few days rather than all in one day);
- Manage your weight and lose weight if you are overweight;
- Have a rest in afternoon and elevate your legs if possible;
- Try to maintain good posture;
- Speak with your doctor to manage chronic cough, chronic hay fever and sneezing; and
- Choose low impact pelvic floor safe exercise.
5. Uterine Prolapse Exercise
You need to be very careful about the types of exercise you perform to avoid worsening your uterine prolapse and after surgical repair for a prolapsed uterus (when you have your specialist’s approval to exercise). Many everyday exercises can increase pressure on your pelvic floor and worsen your prolapse or even contribute to repeat prolapse after already having had prolapse surgery. Unfortunately many fitness instructors are unaware of the potential for this kind of injury with exercise so that you need to make sure that you are fully informed about the exercises that are appropriate for you if you are living with a prolapse.
1. Pelvic floor safe fitness exercise
Fitness exercise should be be low impact to protect your pelvic floor - this means keeping at least one foot on the ground as you exercise. Ideal low impact fitness exercises include:
- Dancing – low impact types
- Bush walking
2. Pelvic floor safe strength and abdominal exercises
Use caution when choosing strength and abdominal exercises:
- Avoid unsafe abdominal exercises and abdominal exercise machines to minimise downward pressure on your pelvic floor
- Avoid inappropriate strength exercises and use protection strategies for strength training such as leg press and wide leg squats that increase pressure on your prolapse
- Avoid heavy lifting and straining when lifting weights
- Choose seated positions for all your strength wherever possible to support your pelvic floor
- Avoid holding your breath when lifting weights and breathe out with all effort whether it be a lift/lower/push or pull.
ref=”https://www.pelvicexercises.com.au/pelvic-exercise-products/pelvic-exercise-books/prolapse-exercises/”>ABOUT THE AUTHOR, Michelle Kenway
Michelle Kenway is a Pelvic Floor Physiotherapist and author of Prolapse Exercises Inside Out. Prolapse Exercises is a complete exercise guide for women with prolapse and after prolapse surgery seeking to exercise safely and protect their pelvic floor.