Menopause vaginal prolapse
Vaginal prolapse is one of the less talked about diagnoses associated with menopause but it can have a huge 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 live a better quality of life.
VAGINAL PROLAPSE DEFINITION
Vaginal prolapse happens when the muscles and connective tissue that support the organs in your pelvis weaken.
This weakening means your uterus, urethra, bladder, or rectum become more likely to drop down into your vagina. If your pelvic floor muscles weaken enough, one or more of these organs can even bulge out of your vagina.
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FOUR TYPES OF VAGINAL PROLAPSE
- Anterior prolapse – Your bladder bulges into the front wall of your vagina
- Uterine prolapse – Your uterus bulges into your vagina
- Vaginal vault prolapse – The top of your vagina sags down after your uterus has been removed
- Posterior wall prolapse – Your rectum bulges into the back wall of your vagina
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HOW LIKELY IS MENOPAUSE PROLAPSE?
- While vaginal prolapse can happen at any time during your life, it is most commonly diagnosed during the later stages of postmenopause
- You are more at risk to have some form of prolapse during menopause and postmenopause if you had a full-term pregnancy. You also have more risk if you have had one or more vaginal deliveries compared to only C-sections
- This likelihood increases for those who have had more extensive tears during delivery and required forceps or vacuum delivery
Read more about the stages of menopause.
SIGNS OF PELVIC ORGAN PROLAPSE
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Pain, a feeling of heaviness or pressure in your pelvis or vagina
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A dragging feeling or sensation or sight of tissue bulging from your vagina
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Problems peeing and difficulty completing bowel movements
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Pain, discomfort, spotting, 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 healthcare provider about your symptoms as a pelvic examination is usually required to properly diagnose prolapse. 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.
Estrogen
If your prolapse is mild it may be recommended that you take estrogen in the form of a cream, or tablet you insert into your vagina or a vaginal ring. A pessary is a silicone ring that comes in several shapes and sizes and supports your vaginal walls and pelvic organs. It is fitted by a specialist nurse or gynecologist.
Surgery
If the symptoms from your prolapse continue to be bothersome even after initial treatments, your healthcare provider may refer you to a urogynecologist – a healthcare provider who specializes in problems like prolapse, incontinence, and bladder pain. They may talk to you about:
- Surgical repair to lift and support your pelvic organs
- Hysterectomy if you have a prolapsed uterus and you do not want any more kids
Vaginal prolapse and menopause FAQs
As you age, your muscles and tissues weaken and this is worsened by the effect of decreasing estrogen during the menopause journey.
Pelvic organ prolapse is not life-threatening but can cause pain, disrupt bowel and bladder function, and make sex uncomfortable.
Although it’s not life-threatening, prolapse can affect your quality of life. It can be uncomfortable and a bit embarrassing and may lead you to avoid social events – especially if you haven’t found a treatment that works for you.
- You should see a healthcare provider when your symptoms are uncomfortable and affect your daily life
- You should also see your healthcare provider if you notice a lump or bulge at the entrance to your vagina
I need to know if sex is part of my future
- Healthline, Vaginal prolapse
- Cleveland Clinic, Pelvic organ prolapse
- 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
- Women’s Health Concern, Vaginal prolapse