A prolapsed uterus is a common occurrence among women, mostly of the older age group. That is not to say younger women do not experience it at all; it is rare, especially among those who have not been through a pregnancy. How common the condition is better explained with some statistics. In a study conducted on 27342 women in the United States, 14 percent of the participants were found to have some degree of uterine prolapse. In another study on 1,49,554 women, it was found that there is an 11 percent lifetime risk of surgery for prolapse or incontinence among the participants.1
What Is Prolapsed Uterus?
The uterus, like the bladder, is held in its position (which is just above the inside of the vagina) by a hammock-like structure made of supportive muscles and ligaments. Any wear and tear to these supportive structures can result in the bottom of the uterus to sag through these layers of muscles and ligaments. In mild cases, this can create a bulge in the vagina but in severe cases, the uterus can sag its way down far enough for it to appear at the mouth of the vagina. When this happens, you call it uterine prolapse.2
How Do You Know If You Have Uterine Prolapse?
You know you have uterine prolapse when you feel certain discomfort at the mouth of the uterus. It could feel like a bulge at the vagina or that something is coming out of it. Sex will feel different but not in a good way. Frequent urination is another sign. You don’t feel like you have emptied the bladder fully prompting you to visit the loo often.3 Strangely you could have uterine prolapse and won’t realize it at all until a routine cervical screening throws a surprise!
If you want to avoid such unpleasant surprises, you need to take enough precautions to avoid it. For that, knowing the risk factors will certainly help.
What Are The Risk Factors Of Uterine Prolapse?
There are various reasons why your uterus makes that downward journey but certain factors put you more at risk for the condition.
Age, Race, And Genes
Race: Women of certain races and ethnicities are more prone to uterine prolapse than others. If you are a woman of color, you have a reduced chance of uterine prolapse. It is more prevalent among Hispanic women.4
Genetics: Has your mom or grandmom been through it? The chances are you too could experience it at least once in your lifetime. A study done on 108 women showed that women with a mom or sister who had or has uterine prolapse showed more chances of developing uterine prolapse.5
Age: Studies have shown age is a risk factor; the chances of uterine prolapse is more in older women than younger ones. While age is a factor, menopause, as against popular belief, is not. This means that uterine prolapse in older women is due to other factors like reduction in protein content and estrogen in uterosacral ligaments, pelvic trauma, the number of childbirth, reduction in collagen, etc.6 and not always menopause. Yes, you could argue that menopause results in the reduction of estrogen in the body which could, in turn, lead to prolapse, but a study on 270 menopausal women in the UK proved otherwise.7
Repeated vaginal childbirths, lack of enough estrogen in the body, intraabdominal pressure, smoking, etc are also found to be risk factors.8
Repeated Pregnancy And Vaginal Birth
It’s anybody’s guess that pelvic muscle strength plays an important role in keeping the uterus in place. For this reason, the weaker the pelvic muscles, the more the chances of uterine prolapse.9
Pregnancies and vaginal births are associated with a decrease in the strength of the perineal muscles. Vaginal birth also increases a woman’s chance for various injuries as well as wear and tear of these muscles, all of which can contribute to increasing the chances of uterine prolapse soon after pregnancy or in the future.10 Studies done in various developing countries have shown excessive physical labour during pregnancy contributing to weak perineal muscles and uterine prolapse.11
Is Obesity A Cause For Uterine Prolapse?
Apparently yes. Obesity can lead to uterine prolapse, studies have revealed. This is due to the damage to the pelvic floor from increased weight. But what is more worrying is that pelvic damage from obesity could be irreversible.12 However studies have also revealed that weight loss, in case of obese patients with uterine prolapse, lead to a considerable improvement in the quality of life.13 So, always keep your weight in check but not always for cosmetic reasons.
Various Pelvic Stresses And Injuries
While childbirth puts considerable pressure on the pelvic muscles, these muscles could get affected by other stresses like constipation. Straining to pass stool can weaken the pelvic muscles leading to uterine prolapse. Another stressor is a chronic cough.14 Repeatedly coughing, possibly from smoking or other reasons, can put a strain on the pelvic muscles, weakening them in the process.
Another possible cause for uterine prolapse is the injuries to the pelvic muscles. The pelvic organs are suspended by the pelvic ligaments and supported by muscles called levator ani muscles. Any break in the connective tissue or damages, neural or muscular, to the pelvic floor muscles can put the uterus at risk for prolapse.15
These are some of the common causes of uterine prolapse. Working on strengthening the pelvic muscles can keep the uterus firm in its position.
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