What a women's health expert wants you to know about vaginal prolapse

Vaginal prolapse, or pelvic organ prolapse, takes place when one or more of the organs in the pelvis slip down and move away from their normal position, creating a bulge in the vaginal walls.

Despite being a common condition, it's one many people feel uncomfortable talking about, but it is important to normalise vaginal prolapse by emphasising that it is a common issue affecting many women and assigned female at birth (AFAB) individuals.

In addition, vaginal prolapse is treatable and easy to diagnose, so there is no reason to keep silent about the condition or feel embarrassed.

Many gynaecological health conditions are associated with unnecessary stigma and shame, which is largely due to the overwhelming lack of information and education on women's health.

The most important thing we can do to normalise conditions such as vaginal prolapse is to talk about them candidly and openly, and to create an environment where patients feel comfortable sharing their experiences.

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What causes vaginal prolapse?

Vaginal prolapse happens when the group of muscles and tissues that normally support the pelvic organs, known as the pelvic floor, becomes weakened and cannot hold the organs in place firmly.

Vaginal childbirth, old age, obesity, lack of strength training, chronic constipation, hormonal changes and having a hysterectomy all leave you more prone to pelvic prolapse.

Other factors that can increase your risk of the condition include any activity that puts pressure on the pelvic muscles, such as being overweight or obese from a very young age or having a job that requires lifting heavy loads without proper training.

The four main types of prolapse are the bladder bulging into the front wall of the vagina (anterior prolapse), the womb bulging or hanging down into the vagina (uterine prolapse), the top of the vagina sagging down, and the bowel bulging forward into the back wall of the vagina (posterior wall prolapse).

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Need to know

Vaginal prolapse is common

Almost 50 per cent of all women and AFAB folks between ages 50 and 79 have some degree of uterine or vaginal vault or some other form of pelvic organ prolapse. You are not alone!

Vaginal prolapse can occur at any time, not just after menopause or childbirth – case in point, six per cent of women and AFAB individuals under 30 are affected, while 30 per cent of women aged 51-59 years have the condition and 50 per cent of women over 80 experience prolapse.

Signs of prolapse

Some of the common symptoms of prolapse include incontinence, a sense of fullness or heavy weight in the pelvis, a bulging sensation in your vagina, lower-back pain and constipation.

Symptoms can also include a feeling of bulging or something coming down the vagina, difficulty with bladder or bowel movements, or pain during sex and urination

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Can you prevent vaginal prolapse?

You may be able to prevent this condition with weight loss, a high-fibre diet to minimise the risk of constipation, drinking plenty of water to keep your bowel movements easy and smooth, not smoking, and doing Kegel exercises, as well as strength and Pilates training, both of which help you maintain strength in your pelvic floor.

How to treat vaginal prolapse

Treatment for vaginal prolapse includes lifestyle changes, a pessary, or surgery to remove the uterus. In some cases, the vagina may need to be stapled back in place with a surgical stapler.

That said, surgical intervention is not always needed for vaginal prolapse. The recommended treatment will depend on the type and severity of the prolapse, your symptoms and your overall health.

You may be assigned a pelvic floor physiotherapist who will support your healing and recovery. Non-surgical options include lifestyle changes, pelvic floor exercises, hormone treatment and vaginal pessaries.

A vaginal pessary is a device, usually round in shape, that is placed in the vagina and supports the pelvic organs. It can be used as a short or long-term treatment option for prolapse.

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When to seek help

Seek help regarding vaginal prolapse if you experience symptoms that affect your daily life or cause discomfort.

Like many other health conditions, vaginal prolapse is best treated when detected early. It's best to see a doctor as soon as possible if you suspect vaginal prolapse.

In addition, beyond treatment, we should also emphasise the importance of early prevention and pelvic floor health. We go to great lengths to maintain our overall health and should extend our pelvic floor the same courtesy.

Valentina Milanova, women's health expert and founder of Daye, a gynaecological health company that offers products and services for period pain, at-home STI testing and the treatment of vaginal infections.