(Pelvic Floor Relaxation)
Vaginal prolapse is the inward and downward bulging of the vaginal walls. The severity of vaginal prolapse may be defined as:
- First degree—collapse into the upper part of the vagina
- Second degree—collapse further into the vaginal canal, down to the level of the vaginal opening
- Third degree—collapse that extends beyond the opening
Vaginal prolapse is caused by weakened support structures in the pelvic region. The lack of support causes the walls of the vagina to weaken, sag, and collapse.
Pelvic Floor Muscles and Organs
Your risk of vaginal prolapse increases with age. Other factors include:
Symptoms may include:
- Pelvic pressure
- A feeling of vaginal fullness or heaviness
- A feeling of pulling in the pelvis
- Vaginal discomfort
- Urinary urgency and frequency
- Urination when laughing, sneezing, coughing, or exercising
- Difficult or painful intercourse
- Low backache that is relieved with lying down
You will be asked about your symptoms and medical history. A physical exam will be done. Vaginal prolapse that has no symptoms may be diagnosed during routine examinations. You may be referred to a gynecologist, who will do a pelvic exam.
Talk with your doctor about the best treatment plan for you. First- or second-degree prolapse without symptoms may not require treatment. Treatment options include:
Kegel exercises involve tensing the muscles around the vagina and anus, holding for several seconds, then releasing. The repetition of this exercise will help to tone pelvic muscles.
Estrogen therapy may be advised. This may help prevent further weakness of the pelvic floor.
A pessary may be inserted into the upper portion of the vagina. A pessary is a rubbery, doughnut-shaped device. It helps to prop up the uterus and bladder. Pessary placement is more often used in older women.
To help reduce your chance of vaginal prolapse:
- Do Kegel exercises.
- Maintain a healthy weight.
- To avoid constipation, eat plenty of fruits, vegetables, and whole grains. Drink plenty of fluids throughout the day.
- If you smoke, talk to your doctor about ways to quit. Smoking may cause chronic coughing and weakening of connective tissues.
- Limit heavy lifting.
American Congress of Obstetricians and Gynecologists
Office on Women's Health
Canadian Women's Health Network
Society of Obstetricians and Gynaecologists of Canada
Pelvic organ prolapse. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114467/Pelvic-organ-prolapse. Updated March 23, 2015. Accessed September 27, 2016.
Pelvic organ prolapse. International Urogynecological Association website. Available at: http://c.ymcdn.com/sites/www.iuga.org/resource/resmgr/Brochures/eng_pop.pdf. Published 2011. Accessed March 8, 2016.
Uterine and vaginal prolapse. The Merck Manual Professional Edition. Available at: http://www.merckmanuals.com/professional/gynecology_and_obstetrics/pelvic_relaxation_syndromes/uterine_and_vaginal_prolapse.html. Updated December 2013. Accessed March 8, 2016.
Vaginal pessary. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/drugs-procedures-devices/procedures-devices/vaginal-pessary.html. Updated May 2014. Accessed March 8, 2016.
5/11/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T114467/Pelvic-organ-prolapse: Fritel X, Varnoux N, Zins M, Breart G, Ringa V. Symptomatic pelvic organ prolapse at midlife, quality of life, and risk factors. Obstet Gynecol. 2009;113:609-616.
Last reviewed March 2016 by Andrea Chisholm, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.