Menopause vaginal prolapse
Vaginal prolapse is one of the less talked about menopause symptoms but it can have quite an impact on your life. While it might be something you feel uncomfortable talking about, understanding the condition and how to manage it can help you have a better quality of life.
VAGINAL PROLAPSE DEFINITION
Vaginal prolapse happens when the muscles that support the organs in a woman’s pelvis weaken. This weakening means the uterus, urethra, bladder, or rectum become more likely to droop down into the vagina. If the pelvic floor muscles weaken enough, these organs can even protrude out of the vagina.
It is possible to have more than one of these prolapse types at the same time.
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FOUR TYPES OF VAGINAL PROLAPSE
- Anterior prolapse – The bladder bulges into the front wall of the vagina
- Uterine prolapse – The womb bulges or hangs down into the vagina
- Vaginal prolapse – The top of the vagina sags down, which happens to some women after they have had surgery to remove their womb
- Posterior wall prolapse – The bowel bulges forward into the back wall of the vagina (posterior wall prolapse)
HOW LIKELY IS MENOPAUSE PROLAPSE?
- While vaginal prolapse can happen at any time during a woman’s life, it is most common during the latter stages of postmenopause
- Women are more at risk to have some form of prolapse during menopause and postmenopause if they’ve had more than one vaginal birth compared to women who have not given birth
- This likelihood increases for women who have had particularly difficult vaginal deliveries. There is also some evidence to indicate that women who have had C-sections may also develop vaginal wall weaknesses during menopause
Read more about the stages of menopause.
DO YOU HAVE PELVIC ORGAN PROLAPSE?
Pain, a feeling of heaviness or pressure in your pelvis or vagina
A dragging discomfort inside your vagina
Sensation or sight of tissue protruding from your vagina
Problems peeing (feeling like your bladder is not emptying fully, needing to go to the loo more often, or leaking a small amount of pee when you cough, sneeze or exercise)
Lower back pain or pain, discomfort or numbness during sex
Sometimes, menopause prolapse has no symptoms and is found during an internal examination carried out for another reason, such as cervical screening. You may have other symptoms, such as vaginal discomfort, urinary incontinence or urinary tract infections (UTIs).
VAGINAL PROLAPSE TREATMENT
The first thing to do is talk to your doctor about your symptoms. They may recommend:
Pelvic floor exercises
You can do them anywhere and they are effective in strengthening your pelvic floor. It’s never too early to start doing them! The most important thing is accuracy – learning how to do the exercises properly – and consistency, remembering to do them every day. Download Stella for a personalised pelvic floor strengthening plan.
If your prolapse is mild it may be recommended that you take oestrogen in the form of a cream, tablet you insert into your vagina or a vaginal ring. A ring pessary supports your vaginal walls and pelvic organs. It is fitted by a specialist nurse or gynaecologist.
For severe cases, your doctor may talk to you about:
- Surgical repair to lift and support your pelvic organs
- Hysterectomy if you have a prolapsed womb and are postmenopausal
- Closing your vagina for cases of advanced prolapse when other treatments haven’t worked and a sex life is no longer wanted
As we age, our muscles and tissues weaken and this is worsened by the effect of decreasing oestrogen during the menopause transition.
Also women commonly do not do pelvic floor exercises to maintain strength.
Pelvic organ prolapse is not life-threatening but can cause pain and discomfort.
Although it’s not life-threatening, prolapse can affect your quality of life if you haven’t found treatment or support that works for you.
You might also increase your risk of subsequent UTIs.
You should see a doctor when your symptoms are uncomfortable and affect your daily life.
You should also see your doctor if you notice a lump in or around your vagina.
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- Tinelli A, Malvasi A, Rahimi S, et al. Age-related pelvic floor modifications and prolapse risk factors in postmenopausal women. Menopause. 2010;17(1):204-212. doi:10.1097/gme.0b013e3181b0c2ae
- Versi, E., Harvey, MA., Cardozo, L. et al. Urogenital Prolapse and Atrophy at Menopause: A Prevalence Study. Int Urogynecol J 12, 107–110 (2001). https://doi.org/10.1007/s001920170074