Prolapse and Sex Physiotherapy Guide|Will Sex Worsen Your Prolapse?

Prolapse and sex often causes women to feel unattractive, lacking desire, embarrassed and self conscious during intimacy.

Prolapse and intimacy still remains a socially taboo subject despite so many women world-wide experiencing this physical and emotional challenge.

This health professional information helps you understand and overcome some of the issues associated with prolapse and sex.

Read on now to learn about these common prolapse and sex concerns:

  • Will you or your partner notice your prolapse
  • Practical ways to improve sex and prolapse 
  • Does sex make your prolapse worse
  • Will prolapse diagnosis affect your sex life

Will You or Your Partner Notice Your Prolapse?

a. Women with Pelvic Prolapse

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Women are generally more likely to notice their prolapse during intimacy than their male partner.

Some women don’t really notice their prolapse. They report having satisfying sex and feel quite comfortable with their body and intimacy. This is usually more common in women with mild to moderate pelvic prolapse that doesn’t protrude beyond the vaginal opening.

In contrast other women say they feel deeply burdened by their prolapse. They report feeling self conscious and unattractive because of their condition which they may view as a deformity. Many develop negative emotions such as prolapse anxiety at the prospect of intimacy, especially with a new partner. They are often reluctant to discuss their prolapse with their partner for fear of drawing more attention to it.

Most women don’t experience pain during sex with prolapse. Some do however say they feel physical discomfort, especially when the prolapse is protruding from their vagina or is associated with pelvic floor muscle spasm. This discomfort usually decreases their libido (sex drive) and sexual satisfaction.

b. Partners

Most partners are unlikely to notice a pelvic prolapse unless it is severe and protruding from the vagina during sex.

Gynaecologist examinationIt takes specialized training to be able to diagnose a prolapse with even with careful examination. Your partner will usually not feel or see your prolapse (unless he/she is a gynaecologist), nor does it usually impact your partner’s enjoyment of intimacy with you. It can be more likely that insecurities can impact intimacy if anything does.

Something to think about – if your partner does notice or know about your prolapse, what is the worst case scenario? Perhaps you can let me know in the comments below …

How to Improve Sex With a Prolapse

There are a number of strategies that can improve intimacy with prolapse issues. The following strategies are in no partcular order of importance.

1. Lubrication

Good lubrication can reduce physical discomfort and help promote pleasurable sensations. Prolapse is associated with thinning of the vaginal walls so lubrication can improve comfort as well as arousal. Use the best lubricant ingredients for your vaginal health (oil and petroleum-based lubricants can contribute to vaginal infection).

2. Relaxation and Mindfulness

Choose the right time and situation that helps you and your partner feel relaxed with sex. Consider your own needs and enjoyment, not only those of your partner. Try to stay in the moment by focusing your attention on foreplay, physical sensations and/or closeness rather than negative self talk where possible.

Relaxation and deep breathingSlow deep breathing can help you relax your body including your pelvic floor muscles. If you’re feeling tense you may find that reminding yourself to take a few deep breaths deep into your belly is a good method of calming anxiety and relaxing your body.

3. Positioning for Sex

If your prolapse feels uncomfortable during intercourse you may like to try changing position from the traditional missionary position (lying on your back) to another position.

Instead sidelying with your back to your male partner will help you better control of the depth of penetration. This may help you relax and reduce physical discomfort. Sidelying position can also be useful to improve sensation for you and your partner if you’re vaginal tissues feel lax (loose).

4. Regular Pelvic Floor Exercises

Both women and men can benefit from regular pelvic floor exercises (Kegels) when it comes to improving and maintaining sexual satisfaction.

Regular pelvic floor exercises can help a woman’s sexual arousal and ability to achieve orgasm. Pelvic floor exercises will also help to improve the pelvic floor muscle support for prolapsed tissues and can help to reduce prolapse symptoms and encourage the prolapse to sit higher within the pelvis.

Pelvic floor exercises for men can also improve sex by increasing their ability to maintain an erection by preventing blood escaping from the erect penis. In fact pelvic floor exercises have been shown to be an effective method for treating erectile dysfunction in men (Dorey, 2005).

Does Sex Make Your Prolapse WorseProlapse sex

Vaginal intercourse is very unlikely to worsen vaginal prolapse so the answer is NO.

A pelvic organ prolapse involves the stretched walls of your vagina and/or your cervix moving down within your vagina towards the vaginal opening.

Sexual intercourse doesn’t pull your prolapse down any further, in fact quite the opposite. If you have a uterine prolapse, intercourse actually pushes the cervix to sit higher within the vagina. Many women can happily continue their normal sex life despite having a mild or moderate vaginal prolapse.

Anal intercourse can increase the risk of rectal prolapse in both women and men by stretching the anal sphincter beyond its normal limits. Rectal prolapse involves rectal tissues protruding from the vagina. Rectal prolapse is a different condition to ‘rectocele’ where the rectum bulges into the vagina not out of the anus.

If you have specific safety concerns with prolapse and sex please discuss these with your doctor or gynaecologist.

Will Prolapse Diagnosis Affect Your Sex Life

There is no definitive ‘Yes’ or ‘No’ answer.

Some women are completely unaware of their prolapse and have no problems with intimacy. In contrast, others feel burdened by their emotional concerns and/or physical discomfort. Physical discomfort with intercourse can vary according to the type of prolapse and prolapse severity. It can also be linked to a woman’s attitudes and emotions surrounding intimacy and her prolapse.

Pelvic prolapse doesn’t affect a woman’s pleasure sensitive clitoral nerve endings so in this regard sexual sensation is unchanged. Some women with moderate severity prolapse report decreased libido and reduced sexual satisfaction1. This can also be associated with emotional factors including body image and self esteem in addition to decreased vaginal sensitivity with tissue stretching.

Your prolapse should not affect your partner’s level of physical stimulation. Men and women are aroused by stimuli which may be mental or physical. The actual physical stimulation from touching body parts causes sensitive nerves to release chemicals that are pleasurable. A vaginal prolapse rarely affects the sensation a man receives during intercourse.

For further assistance managing your prolapse and sex, you may consult a pelvic floor physiotherapist, psychologist or sex therapist.

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  1. Roos AM, Thakar R, Sultan AH, Burger CW, Paulus AT. Pelvic floor dysfunction: women’s sexual concerns unraveled. J Sex Med. 2014 Mar;11(3):743-52. doi: 10.1111/jsm.12070. Epub 2013 Jan 24. PMID: 23347592.
  2. Ghetti, C., Skoczylas, L. C., Oliphant, S. S., Nikolajski, C., & Lowder, J. L. (2015). The Emotional Burden of Pelvic Organ Prolapse in Women Seeking Treatment: A Qualitative Study. Female pelvic medicine & reconstructive surgery, 21(6), 332–338.

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