Is Uterine Prolapse Painful?
Uterine prolapse occurs when the uterus descends lower into the pelvic cavity and can cause symptoms such as pelvic pressure, heaviness, a vaginal bulge, urinary symptoms, and pain. This article explains what uterine prolapse can feel like, why symptoms may fluctuate, and when to seek an evaluation.
Pelvic floor physical therapy can help manage prolapse symptoms by addressing pelvic floor muscle tone, endurance, coordination, bowel health, and overall strength. Pessary support may also be helpful for some patients.
What Uterine Prolapse Feels Like
Have you ever had the sensation of heaviness, pressure, a bulge or the sensation of something coming out in your pelvis? Pelvic prolapse can be very distressing. Although it is a common injury, it can cause a lot of emotional stress since it involves our pelvic organs. Pelvic organ prolapse is the descent of one of the organs (bladder, uterus or rectum) lower down in the pelvic bowl. It is caused by an increased laxity of the ligaments in the pelvis caused by pregnancy, childbirth, constipation, trauma, coughing or decreased pelvic floor strength.
Uterine prolapse can feel like a fullness in the pelvis or a feeling of dragging at the end of the day. Patients also often describe uterine prolapse as “something there,” a tampon was “hanging out,” or as if something was going to fall out from between your legs. Uterine prolapse also causes feelings of pelvic pressure, heaviness or a bulge.
When Uterine Prolapse Causes Pain
Uterine prolapse can put pressure on other structures in the pelvis and as a result can cause pain. There is a high correlation between uterine prolapse and low back pain since the spine and lower back is located very close to the pelvis and pelvic floor muscles. Given that these areas share attachments, the pressure from a prolapse can cause pain in the lower back area.
Pelvic floor muscle tension can also cause pelvic pain. When the muscles of the pelvic floor are very tight or hypertonic, they can cause pain, burning and discomfort in the pelvis. This pain can also radiate to the low back, hips, lower abdomen and inner thighs. Pelvic floor muscle tension can also cause other symptoms such as pain with intercourse, urinary frequency, urgency and leaking and difficulties with bowel movements.
Uterine prolapse can also cause discomfort during intercourse. If the uterus has descended lower in the bowl of pelvis, there can be increased pressure and friction on it during intercourse leading to pain and discomfort. This can be influenced by the severity of the prolapse and by the positioning during intercourse.
Other Symptoms of Uterine Prolapse
- Feeling of heaviness or pressure in the vagina.
- Difficulty emptying the bladder completely.
- Urine leakage (stress incontinence)
- Visible or palpable bulge in the vaginal area.
- Discomfort when standing for long periods or during bowel movements.
- Symptoms may worsen late in pregnancy or after exertion.
- Symptoms usually improve with rest and laying down
Why Prolapse Symptoms Vary
Prolapse symptoms can be very confusing to patients as they can come and go. For example, often prolapse symptoms will be worse at the end of the day or worse after a period of prolonged standing or walking. This may be due to increased pressure because of being upright for longer as well as a result of decreased endurance at the end of the day.
Prolapse symptoms are also directly influenced by the pressure in our abdomen. For example, increased coughing, straining or lifting can make symptoms worse. If you are constipated, the pressure of increased stool in the bowel or rectum can also increase symptoms. Many women feel more symptomatic during their menstrual periods. Anything that can cause increased pressure is a factor.
It is important to understand that increased symptoms do not necessarily mean that the prolapse is getting worse. Many patients can have a flare or increase in symptoms after a bad respiratory infection, a period of increased constipation or after lifting something they wouldn’t usually handle. While this can cause an increase in symptoms, most patients are able to return back to their baseline after the flare.
When to Seek Evaluation
If you have been struggling with heaviness, pressure, pelvic pain, urinary symptoms, low back or tailbone pain, reach out to a pelvic floor therapist or urogynecologist. Pelvic floor therapists are specifically trained to help you understand your prolapse, the contributing factors and appropriate treatment.
How Pelvic Floor Physical Therapy Can Help
Pelvic floor physical therapy and pessary support can be very helpful for prolapse management. A pelvic floor therapist will take on a holistic approach that extends beyond strengthening and Kegels. A pelvic floor specialist will first assess your pelvic floor muscle tone, endurance and coordination. For example, many patients have increased pelvic floor muscle tone that will need to be addressed first. The therapist can also discuss your bowel health and make sure to address any constipation or straining. Addressing bowel health can help reduce the additional pressure that may be making your prolapse worse.
Patients with prolapse symptoms also greatly benefit from targeted strengthening to the hip and core muscles. A physical therapist can specifically assess which hip muscles need to be targeted and focused on. Exercise programs should progress to include resistance training that challenges the trunk and that includes overhead, single leg and dynamic movements. While many patients see improvement in weeks, therapy needs to be consistent long-term for goals to be met.
Physical therapy also focuses on lifestyle and stress factors that may be affecting prolapse symptoms. This can include exercise, stress management, sleep and more.
What is A Pessary? How Can It Help Uterine Prolapse?
Alongside therapy, many patients may benefit from the use of a pessary. A pessary is a removable device made of silicone that can act as a support for the pelvic organs. A urogynecologist can help fit a pessary. Sometimes, you need some time and trial and error to find the right fit for comfort. A pessary can help decrease the symptoms of heaviness and pressure associated with a uterine prolapse. Some patients use a pessary only for high impact activities, whereas others will wear their pessary all the time.
While some patients may associate a pessary with the elderly population, it is important to note that pessaries can be incredibly beneficial tools for women with prolapse of all ages. For example, there is now some research showing that the use of a pessary in the early postpartum period can help improve pelvic organ prolapse long-term.
Where To Find Uterine Prolapse Treatment and Pelvic Floor Physical Therapy in Queens, NYC
If you are experiencing uterine prolapse symptoms, help is available! Pelvic floor physical therapy is the gold standard treatment for this condition. If you are in the Forest Hills, Queens, NYC area and you are looking for help today, reach out to us! Give us a call or fill out our contact form today!
Next On Your Reading List:
