If you’ve landed on this page, then chances are you probably know what prolapse means. Or maybe you’ve heard of it but aren’t quite sure if it’s what you’re dealing with or not. In this post we’ll go over what prolapse is, its symptoms and what puts you at risk for developing prolapse. Additionally, we’ll go over how to fix a prolapse without surgery.
How to Fix a Prolapse without Surgery: What is Prolapse?
First things first, what is prolapse? Prolapse occurs when organs that are normally supported by your pelvic floor muscles drop down or “prolapse.” Prolapse occurs when one or more of the pelvic organs (bladder, uterus, and/or bowel) move downward into the walls of the vagina. This happens when there is weakness or a lack of support by the pelvic floor muscles. Pregnancy and labor and delivery put a lot of pressure on the pelvic floor muscles. This can make them weak. As the pelvic floor recovers after childbirth, symptoms of prolapse can improve. However, any prolapse could indicate future potential future problems. There are different types of prolapse as well:
- Uterine Prolapse– this is the prolapse of the cervix and uterus into the vagina
- Bladder Prolapse (Cystocele)- this is the bladder prolapsing into the front wall of the vagina
- Bowel Prolapse (Rectocele)- this is the rectum prolapsing into the back wall of the vagina
These can occur individually or separate from each other.
What Causes Prolapse
There can be a variety of causes of prolapse, and typically the cause is multifactorial. Under normal conditions, the pelvic floor muscles sit like a sling at the base of the pelvis. Those muscles help support the organs above. If those muscles are too weak, prolapse can occur due to lack of support. Increased pressure from things like pregnancy or constipation (constant straining) can put more pressure than the pelvic floor can handle on that area. This could lead to prolapse over time. If there is not enough support from ligaments internally, this can cause organs to descend. This can happen with surgeries like a hysterectomy.
Symptoms of Prolapse
Symptoms of prolapse can vary from person to person. The symptoms can also vary depending on the time of day. Typically, symptoms of prolapse are worse in the evening or at the end of a work day. This is due to the effects of gravity on the pelvic floor. Symptoms of prolapse can include:
- Heaviness in the vaginal area
- Pressure or dragging feeling in the vaginal area
- Feeling of a bulge in the vagina
Risk Factors for Prolapse
Risk factors for prolapse are also multi-factorial. Essentially, anything that can cause there to be excess pressure on the pelvic floor could lead to prolapse. Most often, these risk factors can lead to prolapse over time and not in one instant.
- Traumatic delivery/ instrument- assisted delivery (forceps/ vacuum)
- Large birth weight baby
- Chronic constipation and straining
- Multiparity (having more than one baby)
- Being obese or overweight
- pelvic floor weakness
- Chronic Coughing
- Having to splint with bowel movements
How to Fix a Prolapse without Surgery
There are two main non-surgical treatments when it comes to how to fix a prolapse without surgery. However, I’ve divided it into three categories to make posture and alignment their own sections.
Posture and alignment are paramount when it comes to fixing a prolapse without surgery. You can do all the pelvic floor exercises in the world, but if you continue to move through your day with poor posture, it’s unlikely the problem will be solved.
Keep these things in mind when it comes to posture:
- Sit or stand with your ears in line with your shoulders
- Have your shoulders stacked over top of your hips
- Avoid jutting your rib cage out
- Relax your shoulders and jaw
- Imagine a string drawing your head toward the ceiling
When it comes to moving throughout your day, consider these tips for good body mechanics:
- Bend with your knees when you’re lifting something
- Exhale on the effortful part of the movement
- Keep heavy items close to your body when you lift them
Pelvic floor exercise- Kegels are often prescribed to manage prolapse. If you’re not sure where to get started, check with a pelvic floor therapist about whether your muscles are too tight or weak so that you can start in the right place with exercise. It’s likely that the muscles are not strong enough to provide support, however, it’s possible that there is tension in the muscles as well. The following are exercises that I would recommend to start with when you’re getting started:
- Breathing Exercises– Breathing exercises are key for healing a prolapse. They help to get the diaphragm (our main breathing muscles) and our pelvic floor working together. Start with 360 breathing when you’re working on breathing exercises.
- Pelvic Floor Contract and Relax– Laying down, sitting, supported lying are all great positions to start to bring awareness to the pelvic floor. Before strengthening the muscles, it’s important to learn more about how to use them.
- Pelvic Brace– Part of pelvic floor strength also comes from the core. The pelvic brace is a great exercise to bring the core and pelvic floor together.
- Kegel + Inner Thigh Squeeze– If you’re having trouble activating or finding your pelvic floor, adding an inner thigh squeeze can be very helpful.
- Kegel + Hips Elevated– One exercise that can be really beneficial with prolapse symptoms is doing a kegel with hips elevated. Because gravity is not friendly to a prolapse, elevating the hips can make gravity work in your favor.
- Bent Leg Fall Out– This exercise is done with a pelvic brace and adds an extra challenge.
In addition to these exercises, following a guided program after a c-section or vaginal delivery for return to exercise is also very effective and helpful. Expecting and Empowered has a 12 week program following either a vaginal or cesarean delivery with exercises to help manage or fix a prolapse. (Use code SIMPLI for $20 off!)
Pessaries are the most common support aide for prolapse and have been found to be very effective in managing symptoms. Pessaries along with pelvic floor exercise have shown a reduction in symptoms.
In addition to pessaries, there are products that you can wear over underwear to help support a prolapse as you do exercise to help improve symptoms. For example, SRC health creates compression shorts that provide support in the right places to help limit symptoms throughout the day.
How to Fix a Prolapse without Surgery: Tips
Taking care of your pelvic floor after childbirth is important regardless of symptoms. Check-out this post to find things to avoid in order to prevent prolapse. Outside of basic hygiene and care after childbirth, the following are some additional things to consider if you’re managing prolapse.
- Rest- avoid prolonged standing or lifting in the early days after a vaginal delivery
- Ice- ice or padsicles can help decrease swelling that can help promote healing after vaginal delivery.
- Elevation- laying on your back with a pillow under the hips allows gravity to assist prolapsed organs back into place.
- Manage constipation- Constipation and straining put excess pressure on the pelvic floor and can actually worsen prolapse. Take care to eat fiber and drink water as well as elevate the feet. This will allow you to have bowel movements without straining.
- Breath- Don’t hold your breath with exercise, pooping, or lifting.
There are a lot of options when it comes to fixing a prolapse without surgery. It’s always important to discuss any issues with your healthcare provider. However, often conservative management is a successful treatment for many with prolapse!