Uterine Prolapse – The Do’s and Don’ts Women Want to Know

Uterine Prolapse Self Management Help for Women prolapsed uterus

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
  • Obesity
  • 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.

Avoid:

  • 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.

Do:

  • 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:   uterine prolapse exercises

  • Cycling
  • Walking
  • Dancing – low impact types
  • Bush walking
  • Swimming

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/”>prolapse exercisesABOUT 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.

Comments

  1. I wish I could write like you as Margaret Laurence once said “When I say “work” I only mean writing. Everything else is just odd jobs.”

  2. Shann Weston says:

    How about uterine prolapse and zumba? This is very popular now. These are a lot of latin dance steps and one knee high step, alternating legs that is popular.

    • Pelvic Exercises says:

      Hi Shann,
      Thanks for your question regarding uterine prolapse and zumba. I don’t see an issue with basic low impact and single leg lift dance steps and uterine prolapse. The issues arise when the exercises or dance steps become high impact with both feet raised off the ground at once. If an exercise or dance step has at least one foor on the ground at all times, then it is low impact and usually pelvic floor-friendly in that it won’t put the pelvic floor under strain. The key to protecting a uterine prolapse and participaing in exercise classes such as zumba is to keep the steps low impact and avoid jumping dance moves. Thank you for your imput Shann, Michelle.

  3. Definitely good contribution, I basically rely on up-dates within your stuff.

  4. Do you know if the pelvic prolapse surgery including a hysterectomy is less time recovering if it is done with the davinci robotic surgery?

  5. Hello – I have just been diagnosed with Uterine prolapse and do not want to have surgery! I have osteoporosis and now feel at a loss about what I should do to address the prolapse as well as getting cardio exercise, walking is uncomfortable at times.  I do Qi Gong twice a week and have just started to learn Tai Chi.  I am 77 Years old.  Any help or suggestions would be greatly appreciated.  Thank you.

    • Uterine prolapse and exercise

      Hi Pat

      I sympathise with your dilemma as exercising for osteoporosis with a uterine prolapse can be a real challenge, especially if your prolapse is uncomfortable. I will answer your question 2 parts as I am not exactly sure whether you are aiming to exercise for your cardiovascular health specifically, or whether you are attempting to address your bone density with exercise.

      The best choices for cardiovascular fitness and to protect a uterine prolapse are low impact exercises meaning at least one foot is in contact with the ground at all times. This reduces the impact and pressure on your pelvic floor and prolapse.
      Appropriate low impact exercises with a uterine prolapse include:

      - Stationary cycling
      - Water based exercises such as water walking and swimming
      - Walking (only if comfortable – some women find that small bouts of walking during the day especially wearing good support briefs are manageable rather than one long walk).

      Unfortunately appropriate exercise for osteoporosis involves high impact activity which is completely inappropriate with a uterine prolapse that is symptomatic with walking. Resistance exercises are the other appropriate type of exercises to address bone health however these do not improve cardiovascular fitness. There are a number of resistance exercises that most women can still perform despite their uterine prolapse.

      I hope this gives you some idea about your exercise options Pat
      Kindest regards
      Michelle

  6. hi,
    While inserting copper T, my gyno said that my uterus is low and not to lift weights. Is this what you call uterine prolapse?
    My legs and thighs are obese and I've planned to reduce them through excercise. Please guide me on what to do?
     

  7. Hi, I have a prolapse of the uterus and vaginal wall. I also have an injured back from lifting my large baby. I am working on ways of lifting him correctly to reduce more problems with my prolapse and my back. I am finding both problems aren't getting better as I cannot do the core strntheing exercises to fix my back as it will make my prolapse worse. Any suggestions? Thankyou

  8. Hi,
    Have just been diagnosed with uterine prolapse and I was wondering will riding my horse (an ornery, but gaited Tennessee Walker) make the condition worse?

  9. I am 45, and after a pretty sedentary life for about fifteen years prior along with obesity, I have been doing situps, leg lifts, Chi Lel Qi Gong by Luke Chan, at home with a DVD, and plenty of outdoor work that requires lifting and other actions, that would assist anyone with weak muscles to push and strain in and around that area, and have never had a problem with a prolapsed uterus. Could be that when the lower back and lower abdominal muscles get weak, the legs and other relative body parts particularly in the areas of the anus and bladder work differently, and much harder, to compensate for those weaknesses that the problem occurs. Experience has told me that when there is weakness there is a tendency to use the wrong muscles of the body and there is jeopardy of the the uterus being pushed out of the opening. There is no denying that, when paying close attention, it can be felt when it is being put under stress and strain and that is evidence that the wrong muscles are being used. I am living proof that it is possible to do sit ups and leg lifts, mild to moderate ones, without a prolapse coming on when the correct muscles are used-not those surrounding the immediate area of the uterus so much. When it can be felt that there is pushing going on inside then it is time to learn how to use the muscles that will not do that.

    • Michelle Kenway says:

      Hi Mini

      Thanks so much for your comment. Yes agreed entirely, it is possible for some women to perform exercises such as double leg raises without any trouble at all. It may well even be that some women with well functioning pelvic floor muscles become even stronger through their pelvic floor with sit up exercises, as the pelvic floor needs to contract to counteract the associated downward pressure of the exercise. But for those women whose pelvic floor muscles are not functioning well, or for those women who are at increased risk such as women with a prolapse or after previous prolapse surgery, then these women may sustain pelvic floor injury with these types of exercises.

      It is great to hear this input asit is important that women know that the same exercises are not necessarily indicated for everyone. Different exercises are suited to different women’s bodies that’s for sure.

      Cheers
      Michelle

  10. Hi I have a uterine prolapse but keep putting off the hysterectomy as I cannot afford four weeks in bed due to work and family commitments. Sometimes it feels as if all my insides are falling out through my vagina. Do you think an op can be avoided or will the situation only get worse? I am 45 year old with two kids. Thanks for the useful info and comments,
    Sand

    • Michelle Kenway says:

      Hi Sand
      This will largely depend on the severity of your prolapse, and symptoms do not always indicate the severity i.e. a woman with a mild prolapse may actually experience quite a degree of discomfort. Seeing a trained pelvic Floor Physiotherapist would be a good start for you to help assess the severity of your prolapse, identify and address those factors potentially worsening your symptoms, and to assist with pelvic floor rehabilitation. Another alternative to consider is a vaginal pessary to support your uterus. There are many pessaries on the market to suit different prolapses, and different needs – a good start would be to speak with a gynaecologist about the possibility of using a pessary. In Australia some Pelvic Floor Physiotherapists are starting to fit pessaries too. Another factor to consider in menopause at which time your oestrogen levels fall, weakening the pelvic floor and it wil be important to attend to good pelvic floor strengthening.

      There has been some recent research supporting the fact that pelvic floor exercises can alleviate prolapse symptoms, so this is worth pursueing. In fact it really is a win-win situation as this type of rehab. may very well improve prolapse surgery outcomes also buy minimising the risk of recurrent prolapse. Unfortunately some women don’t anticipate the fact that recurrent prolapse is a risk post-op.

      I hope this information helps to provide you with some alternatives Sand, Michelle

  11. Margaret Rowe says:

    Hi Michelle,

    I have rectocele, and some urinary continence issues, mostly stress. But I love running. I was diagnosed at 39 with second degree prolapse.I had two very large babies. I have used the neurotrac machine and I have been to the physical therapist. I did notice some improvement.I am 41. I don’t want surgery. But equally I don’t want this to get any worse. But I love exercise. I am very upset that can’t do most of the things I love. Coupled with every present anxiety every time I lift my son, or move to quickly. I also just had a D&C, after miscarriage, which I assume could make things worse, I think it may have. My question is, is there any more I can do, apart from surgery? And my second question, which you may not be able to answer, is based on my frustration, and my upset at finding my self in this situation.Not knowing it was so common or so likely for a woman who delivers a large baby vaginally. Why are we not told ? warned in the hospital ? the emotional shift is huge when this happens. I live in Ireland. Perhaps things are better communicated in other countries. But from what I can see online it seems fairly universal. Is that changing in your experience ? I would hate for my daughter to experience this, certainly without the benefit of being forewarned and hopefully forearmed.

    • Michelle Kenway says:

      Hi Margaret
      You can rest assured that things are no different in other countries to the best of my knowledge. While there are increasing attempts to be proactive about pelvic floor rehab after delivery in Australia, in my professional and personal experience warnings about the potential for prolapse after vaginal delivery are lacking indeed.

      Apart from surgery there is much that can and should be done to manage prolapse:
      - pelvic floor muscle rehabilitation
      - modification of lifestyle factors including good bowel management as a priority
      - trial of pessary
      - general physical conditioning
      - pelvic floor safe exercise
      - understadning of the potential for worsening with menopause and strategies for this
      - and more …this prolapse link will help you find more information https://www.pelvicexercises.com.au/prolapse/

      I am sorry to read about your miscarriage. Remember that pregnancy hormones will cause some pelvic floor laxity (continuing short term after pregnancy too) and once again pelvic floor exercises will usually help to manage and overcome this issue, it shouldn’t be longstanding especially if miscarriage was early stages.

      I hope this information helps you along a little Margaret
      Regards
      Michelle

  12. Hi,
    So I suppose this means martial arts is out??? I started training a few months ago and it’s wonderful exercise and I am already slimming down. This is one of the few things going well for me right now and I would hate to give it up. I have no idea how bad my prolapse is since I haven’t seen a gyne yet.
    Thanks.

    • Michelle Kenway says:

      Hi Micki
      As for many exercises, the safety for your pelvic floor comes down to the individual capacity of the pelvic floor and the type/intensity of exercises. Watching my sons do martial arts I notice that there is quite a bit of intense core abdominal exercise involved and this seems to vary from one style of martial arts to the next. I beleieve that the key is to identify those exercises that might impact detrimentally on your pelvic floor and modifying or performing an alternative exercise. I am mindful of the fact that in the martial arts the whole group does the same exercises and there is little to no modification of exercises, however this comment only applies to group sessions I have watched. It would be worth discussing the issue of modification of exercises with the instructor. If you have questions abour specific exercises then please send them through.
      Michelle

      • Hi Michelle,
        Thank you very much for your reply. Without having to list a lot of individual exercises to determine how safe they are, could you perhaps tell me how to identify which exercises I should avoid so I can then find an alternative? Unfortunately, the first hour of my martial arts class is more boot-camp style and the exercises vary each time but I surmise I will have to stop these types of high intensity workouts. I also like to run, both outside and on the treadmill and understand I will have to find an alternative to that.

        I agree with an earlier post about properly informing women of this issue. I would have taken the advice to do my Kegels more more seriously post-natally if I knew my vagina was going to start falling out! It was pretty scary to discover.

        • Michelle, now that I have had a chance to really peruse your site I think I can answer my own questions; I feel most of us just don’t want to have to give up our favourite forms if exercise but your website is an excellent resource and I see that swimming and cycling are really the best forms of cardio for a person with prolapse. I look forward to exploring your many videos and tips for working out. I would still like to ask however, would a bicycle that leans back (I forget the name for these) not be acceptable since you are pushing away from your body and not resting your pelvis (so to speak)?
          Thank you so much for this site.

  13. Hi Michelle,
    I have a uterine prolapse, and am fitted with a device to keep everything in place.
    I do practise yoga every day. Which exercises should I be avoiding? I want to stay fit, but obviously do not want to exacerbate the condition.
    Many thanks

  14. I am just ending my rehab at home following rectocele with mesh for more internal prolapsing. I had a hysterectomy just one year ago so I can relate to many of the questions here. I too had a large child, natural birth and went through menopause at any early age, all this, I feel, contributed to these recent surgeries, not to mention bladder prolapse 16 yrs. ago. I agree with finding similar exercise options to the ones you currently love to do but try to learn what is meant by straining in exercise and avoid those. I horseback ride (distance) bike, walk, snowshoe, kayak, and lift light weights and work on core stability. I will get back to all of these but full recovery takes awhile and for further quality of life, I will take it slowly, and look at the long term knowing that full recovery is about 1 year. Love yourself, find a good Gyno, ask questions and for me, that meant seeing a woman Gyno. Good luck to all who are dealing with this issue or similar ones. I too wish there had been more information earlier in life that would have helped understand the issues so many women will face.

    • Michelle Kenway says:

      Best of luck Cate
      I believe that straining exercise can differ from one woman to the next as women differ in terms of general strength and pelvic floor strength. Straining exercise is that that makes you strain to do, and places strain on your pelvic floor, this can include high impact exercise such as running.
      Cheers
      Michelle

  15. Very interesting and quite helpfull info. I do kick boxing 3 times a week and it is an extremely important part of my life and the thought that I may have to stop this, is truly depressing. I have been to see a physio and due to see her again next week, so I think I will need to ask which of the boot camp/warm up exercises i will need to avoid or adapt.
    After having my children, I must admit I was advised to do pelvic floor exercises but never realised how vital they are and that they held various organs in place. Having seen the physio, she explained how the pelvic floor muscles hold the female organs from falling through but that the vagina itself is not a muscle and if that drops, then it relies on the pelvic floor holding.
    ps/ never used this type of site/blog before, so not sure how it works.
    Jane

    • Michelle Kenway says:

      Hi Jane
      Thanks for posting your comment – I think you express the sentiments of many women regarding the unrecognised importance of pelvic floor exercises. Interesting how much we take the pelvic floor for granted before childbirth and beyond! Great idea to speak with your physio about your exercises.
      Cheers
      Michelle

  16. Hi every one.

    I was diagnosed with uterus prolapse about 3 years ago, (after the birth of my daughter)

    I must admit that when I was told to do pelvic floor exercises, I didn’t do them.

    Had I known what happens and seen pictures of prolapse, I doubt I’d be posting this today!

    Anyway, I have been seeing a gynae for the past 2 yrs, who has tried many different sizes of pessary. But none seem to fit properly, so on Oct 4th 2013 I had surgery.

    It was a traditional repair, no tape or mesh used.

    At first I felt as though it had worked and was overjoyed!!….. I made sure (and still do) I didn’t lift anything heavy, started the pelvic floor exercises, but unfortunately, the prolapse has returned!!

    I’m paying to see a private physio as none was offered on the NHS after surgery.

    I also have a electrical stimulating machine sitting in the cupboard!

    Has anyone tried this type of machine and does it work or help with the prolapse at all?

    Also if I decide to go back to using pessaries, can I still carry on with pelvic floor excersies?…. do they still have any affect on the prolapse if I’m fitted with a pessary?

    I find that the first 5-10 minutes of waking up is great as I FEEL NORMAL!!! And then as soon as I’m making breakfast and getting kids ready for school, I feel the prolapse creeping down again!!

    For some reason it gets worse a few days before my period, with back ache and a horrible dragging feeling.

    I’m already worried for my daughter and she’s only 3!!!

    I will make sure that pelvic floor exercises are part of her daily routine when she’s older!!

    It would be great to hear from anyone who has used an electrical stimulating machine for prolapse!!!

    • Michelle Kenway says:

      Hi Lin
      I preface this reply by inviting other women to comment on your post too as you are asking others, I prefer not to be the only person to comment here. I think it is worth just making a couple of points that may or may not assist you and other ladies.

      The purpose of electrical stimulation is to help activate pelvic floor muscles to ultimately improve the strength and function of the active supports for the pelvic organs. Electrical stimulation is used for women who have little to no pelvic floor activation and once activation is achieved, pelvic floor exercises need to be actively practiced using the e stim which is gradually weaned in favour of unassisted pelvic floor exercises. I can make the analogy of someone bending flexing and extending your elbow for you – unless you actively practice this action yourself the muscles that flex and extend the elbow will never get stronger and the sameis true for the pelvic floor. Perhaps this is the reason why magnetic stimlation does not seem to have a lasting effect on pelvic floor activation as complete relaince is on the machine activation rather than individual muscle activation.

      In relation to worsening prolapse symptoms prior to your period – yes this is a commonly experienced problem caused by the decrease in oestrogen that occurs prior to the period. Some ladies report this during their period as well and things return to ‘normal’ after the period. Anticipate this occuring and be diligent with pelvic floor exercises is the best approach in addition to minimising potential strain on your pelvic floor during this time.

      Finally yes women can definitely do pelvic floor exercises with a pessary in fact as I understand it there is research being undertaken at he moment to investigate whether pessaries actually improve outcomes of pelvic floor exercises (by lifting prolapsed tissues perhaps allowing the pelvic floor muscles to lift and squeeze).

      Hope this helps you out Lin
      Michelle

  17. since my last post, I have seen a physcio again and my gp. Still doing the kegal exercised 3 to 5 times a day. some days there is hardly any prolapse and other days much more and the last couple of days not so good, but I’ve had a cough, which definitely is not good news with a prolapse.
    I have found out that the best cardio exercises to do is cycling and or swimming and with the kickboxing, I just need to avoid tuck jumps and burpees, plus only do crunches as long as I don’t hold my breath and push down to my pelvic. the physio said doing som pilates pelvic floor exercises may help to, so getting that organised.

    Having read Lin’s posting and her comment about making sure her daughter (when she’s older) does her PF exercises, here’s a question for any of you: my daughter (34) is due baby no.3 in April, do I explain how important the PF exercises are and go into detail and do I tell her my problem?

    Jane

    • Michelle Kenway says:

      Hi Jane
      Prolapse problems often run in families owing to the inherited laxity (looseness) of ligaments and tissues. This means that your daughter may be at increased risk of prolapse. All women should do pelvic floor exercises, especially during pregnancy and afterwards for pelvic floor recovery. What you reveal about your own problem is ultimately your decision and how comfortable you feel in discussing this issue however I really think your daughter can only benefit from increased pelvic floor education and awareness.
      Cheers
      Michelle
      PS Best to take care not to push down on the pelvic floor & breath hold during abdo exercises with a prolapse!

  18. Marnie Danielle says:

    I am waiting to see my gynecologist on doing a surgery on my prolapse (rectocle).
    I am not sure if i can continue downhill skiing and do not want to risk making my prolapse worse. Any thoughts on how suitable this activity would be?

    Thank you!
    Marnie

    • Michelle Kenway says:

      Hi Marnie
      Great question – I think proficient skiers have little to be concerned about with downhill skiing (obviously avoiding jumps). I suspect that planting the stocks and pulling hard on them to move the body uphill on the skis may have potential to impact the pelvic floor but not the smooth downhill action of skiing in a reasonably proficient skier.

      Hope this helps
      Michelle

  19. Is hula hooping a safe exercise for prolapse? Trying to slim my waist.

    • Michelle Kenway says:

      Hi Laura
      Hoola hooping shouldn’t be an issue for most women with mild-moderate prolapse – enaure the action comes from the pelvis and avoid drawing the abdomen too forcefully throughout.
      Cheers
      Michelle

  20. Hi Michelle

    I wondered if you knew anything about the connection between progesterone and pelvic floors?

    I am on HRT and have been on long-cycle HRT until recently- which means a period ( induced by progesterone) once every 3 months. However, due to period pain and heavy bleeding my gynae has suggested I have a monthly regime. This will involve taking more progesterone during every month.

    I read on the web that some women are saying that progesterone loosens the ligaments and makes the PH worse.

    I had a repair- uterine and bladder- 25 years back. It’s been great but I do notice a slight descent now of I try to use tampons, so I am worried about the loosening effect ( if any) of progesterone taken for maybe 2 weeks out of 4.

    Obviously the oestrogen I take is taken daily, 365 days, so maybe this will offset the progesterone.

    Is this something you know anything about please?

    • Michelle Kenway says:

      Hi Sarah
      Thanks for your interesting question.

      I have done a little research into this following your question. An interesting study was performed looking at the effect of oestrogen and progesterone on collagen in the pelvic floor (of rats). It is generally thought that when collagen breaks down this contributes to the development of pelvic organ prolapse. The researchers actually found that oestrogen and progesterone had a protective effect against degradation of the vaginal tissues in other words less collagen breakdown in the presence of both these hormones.

      This research suggests that in rats at least progesterone has a protective effect on the supportive pelvic floor tissues rather than the opposite effect.

      I hope this helps you out Sarah

      Regards
      Michelle

      PS the study reference for information Journal of Biology of Reproduction (2009) Wenjun Zong, Leslie A. Meyn and Pamela A. Moalli “The Amount and Activity of Active Matrix Metalloproteinase 13 Is Suppressed by Estradiol and Progesterone in Human Pelvic Floor Fibroblasts” (p367-374)

  21. Hi – I’m 37 with a 4yr old (4kg baby, 30 hour labour ending in forceps) and a 1 year old, 4kg again but only 10 hour labour.
    No issues post my first, but within days of my 2nd i knew I had incontinence issues. at the 3 month mark i started seeing a physio as I couldn’t feel myself squeezing when doing pelvic floors – turns out I couldn’t do any! After a month of twice weekly appts I could finally do 3 squeezes for 10 seconds each before muscles were fatigued and I could do no more. Months later after electrostimulation I felt things were improving immensly – I could finally bend and wipe down the shower screen without pee’ing myself! I was so happy and back on my ‘pre-baby body mission’ with exercised planned for the coming months. I was very achey even post any lowimpact exercise, but i put it down to weak pelvic floors and loose ligaments from bfeeding etc
    I then got my period at 11months when i finished breastfeeding.
    Little did i know when i finally got my period that my insides would literally fall out! I can’t wear a tampon! If i manage to get one in it falls out by the time i’ve walked down the hall ;o(
    I went to the GP for a smear and to get a mirena inserted to fix my stupidly heavy periods only to be told that she couldn’t find my cervix to do a smear as my uterus was coming out and in the way!
    I’m mortified – I feel about 80! I was so diligent with my pelvic floors during and after pregnancy too.
    I’m seeing a urogynocologist in a few weeks and wondering what will be done from there. I’d like to avoid surgery if I can but I also want some sort of lifestyle back too.
    For those that have had surgery – has it improved things? Are you happy?

    Sorry for the long post, I find it hard to find info or to find anyone who has gone through this too. thanks

  22. I’m happy I had the surgery it sounds like you would be too

  23. Im 64 teach zumba gold and just discovered I have prolapse going to Gn tomorrow to find out the verdict so to speak ~ If you have a pessary inserted how long do you have to wait before you can exercise? I can seem to find this info anyway? Is this a minor operation? Thank you for listening!

    • Michelle Kenway says:

      Hi Jo-Anne
      Once you know the pessary fits correctly there should be no need to wait to exercise. Fitting a pessary is a minor procedure – it simply requires getting your size and then fitting the correct pessary for you. You will be asked to move around and empty your bladder to make sure that the fit is correct and then you are off and away. Sometimes the pessary becomes uncomfortable after fitting in which case you know that it is not the correct size and return to the clinic for refitting.

      All the best
      Michelle

  24. Dear Michelle,

    I am at my wit’s end. Have had prolapse slowly increasing 4-5 years. Tried physical therapy, exercise, etc. and taking care with lifting, coughing, bowel management, etc. But also with much work, stress, and family needs I could not commit 100 percent to daily exercise. Now prolapse is extreme and I guess I am facing surgery, though I had hoped to maintain it by natural means. Certainly I had hoped to be in best possible condition if I did end up with surgery.

    My questions: even with advanced prolapse, if I work hard enough with pelvic floor strengthening can I see at least a little improvement and stability? I do not expect full cure: just less discomfort and prolapse. I was hoping to try pessary but at this point may be too advanced. It is uncomfortable to walk long distances so it is very disruptive to any truly active recreation. I am well past menopause, average weight. But not in top fitness because I have had to curtail so much activity — walking, yoga, gym.

    I would so much like to achieve just some relief and improvement with pelvic floor exercise, and just would love reassurance that it can be worth working harder!

    I have not seen a specialist yet. I hear so much about failed surgery,and about having to be so cautious with movement, lifting, exercise, even after surgery. Is it worth it? Does surgery usually work? Can one return to a “normal” lifestyle….walking, yoga, lifting grandchildren and pets??? How long is an average recovery, before one can resume usual daily routine?

    Also I live in the USA. Do not know what you are referring to by support garments?

    Would love any guidance you can give.

    Thank you for providing wonderful resources!

    Pat

    • Michelle Kenway says:

      Hi Pat

      Yes you must be absolutely at your wits end from what you describe here.

      I will answer your questions here however think the first thing that will help you is to see a gynaecologist or urogynaecologist to have the severity of your prolapse professionally assessed – this will give you a good basis from which to make an informed decision about your management. While this may seem confronting, you will then know exactly what you are dealing with and you don’t have to do anything you don’t want to – it’s entirely up to you whether you have surgery or get fitted with a support pessary at least just find out your options for starters.

      • Unfortunately with severe prolapse, pelvic floor exercises are unlikely to reduce prolapse symptoms. This doesn’t mean they are a waste of time – they will still benefit your pelvic floor health regardless (bladder, bowel and support especially if you do have surgery in the future).
      • There are in fact support pessaries for women with severe prolapse – this is worth speaking to a specialist about
      • Unfortunately much more publicity is given to failed prolapse surgery than successful prolapse surgery – there are an enormous number of women who have successful prolapse surgery and go on and lead active lives walking, and making simple modifications to avoid heavy lifting and intense inappropriate exercises
      • Support briefs (the large brief firm support type) do assist some women but very unlikely in the case of severe prolapse.

      Let me know how you go Pat, things can definitely be a lot better than what they currently are for you however you will need to take some appropriate action.

      I hope this helps you get started on your recovery journey
      All the best
      Michelle

  25. Hi Michelle,
    I’d like to ask first if I’m doing the levels right. I try to lift up my vagina and while I do this my lower stomach muscles seem to go tight too, after that I squeeze my urethra and anus. Also about support briefs. If the elastic is tight on the stomach will it push the uterus down? What about tummy control jeans that come up to the waist?
    Thanks for the valuable advice you continue to give.
    Pauline

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