Pelvic organ prolapse is a very common problem for women.
In fact it’s estimated that up to 1 in 2 women who’ve had a vaginal delivery will experience some degree of pelvic organ prolapse in their lifetime.
Knowing your prolapse risks may help you reduce your risk or prolapse worsening or repeat prolapse after surgery.
Read on now to learn:
- 7 major risks for pelvic organ prolapse
- How you can manage your risks
7 Major Risks For Pelvic Organ Prolapse
The pelvic organs include the bladder, uterus, vagina and rectum.
Pelvic organ prolapse is a condition where one or more of the pelvic organs move out of position and descend, protruding into the vaginal walls and sometimes out of the vaginal entrance.
1. Pregnancy & Childbirth
Pregnancy and childbirth can damage the muscles and tissues supporting the pelvic organs contributing to the development of pelvic organ prolapse.
The risk of prolapse increases with:
- Vaginal delivery
- Number of deliveries
- Large birthweight babies
- Instrumental delivery
- Damage to pelvic floor supports (muscles and connective tissues)
- Damage to nerves supplying pelvic floor muscles
Pelvic floor exercises after childbirth are very important for rehabilitating pelvic floor tissues after pregnancy and childbirth.
If you’ve suffered pelvic floor damage during childbirth you may benefit from Pelvic Floor Physiotherapy to help restore your pelvic floor supports and reduce your future risk of prolapse.
2. Hormonal Changes
The risk of pelvic organ prolapse increases with the hormonal changes of menopause.
The pelvic floor muscles and some supporting tissues have receptors (sensors) that detect oestrogen.
When oestrogen declines these muscles and strong supports weaken, becoming more susceptible to strain and overload.
Menopause and ageing are associated with decreased collagen. Collagen promotes flexibility and stretch in the pelvic floor tissues. When your tissues lose the ability to stretch they become more prone to injury.
Fortunately muscles can strengthen with exercise at any age. Regular pelvic floor exercises during and after menopause can help you maintain your pelvic floor strength and support long-term.
Some women say that hormone replacement therapy or vaginal oestrogen helps with pelvic floor strengthening however this remains to be supported by research.
3. Straining With Constipation
Straining with constipation stretches and weakens the pelvic floor. This can set up a cycle where stretched tissues make emptying the bowels even more difficult.
The more you strain to empty your bowels, the greater your risk of pelvic organ prolapse.
Managing your bowels to avoid constipation and straining involves:
- Keeping the right stool consistency for bowel emptying
- Using the correct bowel emptying position and technique
- Doing regular pelvic floor exercises.
4. Inappropriate General Exercise
General exercise is great for your health and wellbeing however the wrong kind of exercise for your body can increase your risk of injury.
If your pelvic floor is weak or not working well, your risk of pelvic organ prolapse with some types of exercise is increased too.
Exercises that increase the risk of pelvic organ prolapse include:
- Heavy lifting e.g heavy weight training
- High impact exercises e.g. jumping, running
- Intense core abdominal exercises e.g. some intense Pilates abdominal exercises
Pelvic floor safe exercises can help you maintain your fitness and strength while minimising the load on your pelvic floor. Many women with mild-moderate prolapse continue to exercise without prolapse symptoms or prolapse worsening.
Obesity is another risk factor for pelvic organ prolapse, especially with excess abdominal fat.
Abdominal (visceral) fat is stored in the abdomen and sits around the abdominal organs such as the intestines. When you’re upright your abdominal fat rests above your organs. Abdominal fat loads the pelvic floor during upright daily activities.
Long-term body weight management and losing unnecessary abdominal fat is an important aspect of holistic prolapse management. Along with appropriate diet for weight loss, appropriate general exercise can help you target and lose abdominal fat.
6. Pelvic Surgery
Pelvic surgery increases the risk of pelvic organ prolapse.
Prolapse surgery may increase the risk of repeat prolapse. The first prolapse surgery is usually the most successful. This is one reason why some gynaecologists delay prolapse surgery in young women.
Other forms of pelvic surgery may also increase the risk of prolapse. Some types of bladder surgery along with hysterectomy may cause defects in the pelvic floor supports.
Managing your particular prolapse risks, using strategies to avoid prolapse worsening and doing regular pelvic floor exercises are important after prolapse surgery.
7. Chronic Coughing
Coughing forces the pelvic floor downwards, thereby stretching and weakening the pelvic floor supports (including the pelvic floor muscles and ligaments).
Chronic coughing is associated with a range of conditions including:
- Chronic bronchitis
Prolapse prevention and management involves good chest management along with pelvic floor rehabilitation.
Chest management for prolapse may include:
- Chest physiotherapy to learn effective chest clearance techniques for chronic conditions
- Management of acute chest infections and acute cough with appropriate medication
- Pre-bracing the pelvic floor muscles for coughing
- Not smoking
Key Points For Risks For Pelvic Organ Prolapse
Some of the main risks for pelvic organ prolapse include:
1. Pregnancy and childbirth
2, Hormonal changes
3. Straining with constipation
4. Inappropriate general exercise
6. Pelvic surgery
7. Chronic coughing
If you’re at increased risk of pelvic organ prolapse, you may be able to modify your risks through appropriate management including lifestyle changes, weight management and regular pelvic floor exercises.
with Pelvic Floor Physiotherapist Michelle Kenway
Learn how to exercise safely, strengthen your prolapse and reduce your risk of repeat prolapse.
Prolapse Exercises is a complete exercise guide for women after prolapse surgery seeking to exercise safely and protect their pelvic floor.