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What’s the deal with Prolapse?


Vaginal prolapse is the descent of any of the pelvic organs (bladder, uterus or bowel) into the vaginal canal. Whilst it can sound quite scary, we know around fifty percent of all women will have some degree of prolapse – this means it’s actually quite normal! However, if there are symptoms that are bothering you, or your healthcare professional thinks you might be at risk of this worsening with time, there are lots of things we can do about it.


How do I know if I have a prolapse?


The most common symptoms of prolapse are sensations of heaviness, dragging or pressure in the pelvic floor or vagina. Other signs might be lower back pain or difficulties with emptying the bladder or bowel. Common descriptions are “like I’m sitting on a golf ball” or “like a tampon falling down” – but sometimes it’s really hard to explain the exact feeling.


Some women won’t feel anything at all during day-to-day activities, but might notice an unusual lump or bulge at the vagina when on the toilet or when cleaning the area in the shower. Otherwise, you may have no symptoms at all, and it might be something diagnosed by a health professional such as a GP doing a routine Pap smear, an obstetrician/gynaecologist examination, or a women’s health physiotherapist doing a pelvic floor check.


What causes a prolapse?


Risk factors for prolapse include pregnancy and childbirth, chronic straining through heavy lifting or constipation, inadequate pelvic floor support, and family history. Often we see prolapse repair surgeries fail because some of these underlying risk factors are not adequately addressed, so the prolapse returns.


Is prolapse dangerous?


A mild prolapse will cause minimal problems for most women. However, if your prolapse sits quite low, it is possible for those delicate exposed tissues to get irritated and cause problems. The other risk of bladder prolapse (or a “cystocele”) is incomplete bladder emptying, which can put some women at risk of recurrent urinary tract infections (UTIs).


Some women fear that continuing to have sex with a prolapse might be dangerous or make symptoms worse. We want to reassure you that if sex is not uncomfortable or painful at all, it’s quite safe (and can actually be beneficial as it makes your pelvic floor muscles work!).


You may wish to use a low-irritant moisturiser or lubricant (like our favourite, Olive & Bee cream!) for added daily comfort.

What can I do about my prolapse?


Most women can manage prolapse with non-surgical intervention. This includes:


- Pelvic floor exercises, which are best done under the supervision of your women’s health physiotherapist to ensure correct technique and dosage


- Lifestyle changes, such as optimising general exercise/fitness, constipation management and activity modifications to reduce undue pressure and straining


- Vaginal support pessaries, which can be fitted in-clinic with Mischa (or with a gynaecologist).


Will my prolapse ever get better or go away?


Women who are postpartum will often find early symptoms of prolapse reduce fairly quickly with all-round recovery. Time often improves muscle strength and connective tissue changes caused by pregnancy and hormonal changes. Often a pessary and compression support tights (such as SRC shorts, which you can find at both our Rockhampton and Yeppoon clinics) might be needed short-term to help in the postpartum period, or might be recommended prophylactically if you are deemed at higher risk of prolapse (such as those with connective tissue disorders or a strong family history of prolapse).


Some women will need a pessary or corrective surgery for long-term management. However, many women will find they are no longer aware or bothered by their prolapse with optimisation of their pelvic floor function and other contributing lifestyle factors like chronic heavy lifting or straining. Typically this requires three to six months to achieve, supported by your physio. A graded return to exercise plan with your physio or through a supervised program such as our Postnatal Fitness classes or “Golden Girls” over 60s exercise classes will help you to improve your core strength and general fitness whilst keeping your pelvic floor symptoms in mind.


I have been diagnosed with a prolapse – what should I do next?


If you think you have a prolapse, we recommending coming in for an individualised management plan to optimise your recovery. One size does not fit all when it comes to prolapse management and pelvic floor rehabilitation, so it’s important to have a thorough assessment to make sure we’re doing everything we can to see you symptom-free and getting back to doing what you love doing. Whether that’s getting in the garden, running a half marathon, or jumping on the trampoline with the kids!


We love supporting women to have the freedom to live their best lives, without pelvic floor symptoms holding them back. Book an appointment online with our friendly physios Sophie, Monique or Mischa to get started. We can’t wait to work with you!

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