What happens if a uterine prolapse is not treated?
If you have a prolapse, you will know that some days feel better than others. A prolapse will change position over time depending on a variety of reasons. On good days you might not be aware of it at all. You may not feel the need to see a doctor, or if you do see one on a good day, they may just reassure you and say no further treatment is needed.
But, do you need to have treatment if you have a uterine prolapse?
What would actually happen if we left a prolapse untreated?
A quick search on the internet gives you a range of answers. One source states that you can expect significant health complications, whereas another says if you only have a mild prolapse it is fine to go untreated.
In this blog we will explore what can actually happen if a prolapse is left untreated, what treatment is and when you should get support.
Firstly, what is a uterine prolapse?
Uterine prolapse occurs when the uterus (also known as the womb) starts to sit lower in the pelvis. When we are young our uterus sits at the top of the vagina (birth canal), within the abdomen (tummy).
In the early stages of uterine prolapse, symptoms might be mild and manageable. They include:
- A sensation of heaviness or pulling in the pelvis.
- Discomfort or pain in the tummy or lower back.
- Bulging or a lump in the vagina.
- A feeling of a blockage with sex or using a tampon.
These symptoms tend to prompt women to seek medical attention. Although some women will avoid seeing the doctor in the hope it improves without the need to be examined. So, what is the right thing to do?
To understand this, it would be useful to understand when a prolapse may happen.
What causes a uterine prolapse?
Numerous factors can contribute to the risk of developing uterine prolapse:
- Age
- Body Mass Index (BMI)
- Menopause
- Number of pregnancies
- Number of vaginal births
- Births that required the use of instruments (ventouse, forceps)
- Episiotomy (the cut the doc gives you to get baby out)
- Perineal laceration (vaginal tear during childbirth)
- Foetal macrosomia (having a baby larger than 9-10 lbs)
- Connective tissue disorders such as Ehlers Danlos syndrome
- Chronic constipation
- Chronic coughing
It is usually a combination of factors that may result in a prolapse. Some women will notice a prolapse starting gradually. Some will find they have a sudden feeling of a prolapse after childbirth, lifting something very heavy, during a bad cough/cold or if they have been very constipated.
Will it get worse?
Not always. Some women will find that their prolapse will start to improve without doing anything. This is particularly the case after childbirth as the body recovers and heals. The uterus isn’t static and it is designed to move. It rises and lowers as part of the hormonal cycle and when we are sexually aroused. So, in some case you may find you can feel the prolapse at certain times of the month.
However, for some women symptoms can worsen over time. Worsening tends to happen with age, menopause or if constipation or chronic coughing persists. If a prolapse continues to progress from mild to moderate or severe without treatment, the uterus sits lower within vagina and may even protrude outside the vagina. This can start to have a huge impact on a quality of life. If uterine prolapse remains untreated at this stage more serious medical complications can arise such as ulceration and infection.
Can a uterine prolapse get better?
It absolutely can, and understanding what to do when is really important. As mentioned, a uterine prolapse can feel different day to day or due to various activities and body positions. There are a few things that everyone with a prolapse should do to help reduce the likelihood of developing a more severe prolapse.
These can include:
- Preventing constipation
- Getting support for any persistent coughs
- Keeping a healthy weight
- Pelvic floor exercises
- Keeping fit and active
- Listening to your body to know what makes your uterine prolapse worse.
Should I get treatment for my prolapse?
If you think you have a prolapse it is important to see a healthcare professional for guidance. The treatment options open to you will vary depending on the severity of a prolapse, your symptoms and what you want to achieve.
These are some of the options:
- An appointment with a pelvic health physiotherapist – to help you optimise your pelvic floor exercises, understand your prolapse, lifestyle changes and modifications you can make to prevent things worsening.
- A pessary – a removable device inserted into the vagina to support the uterus and alleviate symptoms.
- Hormone therapy – Local oestrogen used vaginally can help for postmenopausal and breastfeeding women.
- Surgery -Reserved for more severe cases, surgical options such as hysterectomy or pelvic floor repair may be necessary to correct the prolapse.
A uterine prolapse is a condition that should not be ignored and can get worse if you don’t make any changes. Early intervention and simple lifestyle modifications can prevent complications, improve symptoms prevent a prolapse from worsening.
If you have a prolapse and your symptoms are getting worse, or you are worried about it, please seek further support. Getting the help you need, will enable you to prevent complications and can make a significant difference in maintaining your overall health and well-being.