If you have a prolapsed uterus, it means your uterus has slipped out of place and is pushing into your vagina. This happens when pelvic muscles and connective tissue become too weak to support your pelvic organs.
You may not have any symptoms with a mild prolapse. But as the uterus slips, it can push into the vagina. In severe cases, the uterus can bulge out of the vaginal opening.
A prolapsed uterus can cause a variety of symptoms affecting the vagina, lower abdomen, and lower back, such as:
- pain, pressure, feeling of heaviness in the vagina
- frequent urination, trouble urinating
- pain during sex
- problems moving your bowels
- vaginal discharge or bleeding
Pelvic floor exercises can ease symptoms and sometimes reverse a mild case, but severe cases may call for additional treatment.
Discover the right way to do pelvic exercises for a prolapsed uterus and which exercises to avoid.
What to know before doing Kegels
It’s harder to find your pelvic floor muscles than, say, your biceps, because they don’t show.
- The pelvic floor muscles wrap around and support the uterus, bladder, and bowel.
- To find them, pretend you need to stop peeing in midstream and avoid passing gas at the same time. That’s your pelvic muscles in action.
- When performing Kegels, it’s important not to hold your breath or squeeze your stomach, thighs, or buttocks.
- You’ll feel more comfortable, and avoid dripping urine, if you empty your bladder first.
- Once you get the hang of it, Kegels are simple to do, and they can easily become a habit.
How to do Kegels
Start by choosing your position:
- Sit upright with your feet touching the floor and legs slightly apart.
- Lie down with your knees bent and feet on the bed or floor.
- Continue to breathe normally.
- Pull up and tighten the muscles around your vagina and anus, so the muscles are squeezed up and in.
- Hold for 3 seconds.
- Relax for 3 seconds.
- Repeat up to 10 times.
Do your pelvic floor exercises 3 times a day. Increase your hold time by 1 second a day until you reach 10 seconds.
As your comfort level grows, you’ll find that Kegels can become second nature and you can do them when standing or walking. This exercise will help with muscle strength and endurance.
Quick version for reaction time
You can also do a quick version to improve pelvic muscle reaction time, which will help if you have pain or leakage when you sneeze, cough, or laugh:
- Just do the same exercise but hold and relax for only 1 second. Repeat this 10 times.
- Practice your Kegels 3 times a day for 6 months or until your doctor advises otherwise.
- Realize that excessive Kegels won’t help and may even cause more problems, so don’t overdo.
- After 6 months, once a day may be enough to keep your muscles in good shape.
If you have trouble remembering to do Kegels, there are Kegel trainers and apps that can send you reminders and keep you motivated.
Heavy exertion can aggravate uterine prolapse. Your doctor can recommend exercises based on the severity of your prolapse. Discuss your overall exercise routine before doing activities that involve:
- lifting weights
Because you have a prolapsed uterus, your doctor may refer you to a physical therapist. Pelvic floor therapy can be tailored to your needs and the therapist can monitor your progress.
Biofeedback can be incorporated into your routine to make sure the correct muscles are contracting as you exercise. This will help you get the most out of your efforts.
There are a few self-care measures that may improve symptoms or prevent them from getting worse. These include:
- Avoid straining when you move your bowels. Using a footstool to elevate your legs or leaning your body forward can be helpful.
- Eat a high-fiber diet and drink plenty of fluids to avoid constipation.
- Get treatment for chronic cough.
- Don’t lift heavy objects.
- Lose weight if you’re overweight.
Uterine prolapse doesn’t always require medical intervention. But if it does, the treatment you choose depends on factors such as:
- severity of symptoms
- whether you want to keep your uterus
- other health concerns
A vaginal pessary is a rubber or silicone ring-shaped device used to support pelvic organs. They come in many shapes and sizes, so your doctor can help you find a good fit.
You’ll also learn how to insert it and remove it safely, as well as how to keep it clean. These devices can be used as short- or long-term treatment.
Surgical options include:
- Native tissue repair: A procedure in which the prolapsed part is stitched to a ligament or muscle in the pelvis.
- Surgical mesh repair: When your own tissues aren’t strong enough, mesh is used to help hold the uterus in place.
- Obliterative surgery: This procedure narrows or closes the vagina to support prolapsed organs. However, sexual intercourse is no longer possible after this surgery.
- Hysterectomy: The uterus can be surgically removed.
The uterus can slip when pelvic muscles and connective tissue weaken and can no longer provide adequate support. There are several reasons this might happen, including:
- vaginal delivery or assisted delivery
- constipation or frequent straining to move your bowels
- chronic cough
- overweight and obesity
- lack of estrogen due to menopause
- frequent lifting of heavy objects
- high-impact exercise
Over time, the severity of the prolapse can get worse.
You can’t control everything that can contribute to a prolapsed uterus. But
Other ways to help lower the chances of pelvic organ prolapse are:
- manage weight
- treat chronic cough or constipation
- try not to strain when you go to the bathroom
- use good technique when lifting heavy objects
If you have a mild prolapse, you might not have any symptoms. But see your healthcare professional if you have:
- a feeling of heaviness or pressure in your vagina
- pain during sex
- urine leakage
- trouble urinating or moving your bowels
- unusual discharge or bleeding
- frequent urinary tract or vaginal infections
It’s important to get a diagnosis because uterine prolapse symptoms are similar to those of bladder, rectum, and vaginal vault prolapse. It could also be that several organs are slipping out of place.
Your doctor will likely begin with pelvic and rectal exams. Imaging tests may be needed to help make the diagnosis, which will guide the next steps.
A prolapsed uterus has moved out of place and is pushing into the vagina. This can cause symptoms such as painful sex, general discomfort, and a feeling of heaviness in the vagina.
In some cases, it’s possible to ease symptoms or reverse a mild uterine prolapse by doing pelvic muscle exercises, along with other self-care measures. Prolapsed uterus doesn’t always require other treatment. But in severe cases, use of a vaginal pessary can provide the necessary support. There are a few surgical options as well.
Pelvic muscle exercises may also help prevent organ prolapse, so consider making Kegels part of your daily routine. If you have symptoms of uterine prolapse, see a healthcare professional to find out for sure.