What Can I Do For My Prolapse?

Prolapse can sound scary and the pictures and stories you may find on the internet can be scary.

First of all, know it is common and there are many things you can do to help without needing surgery.

I always suggest pelvic floor therapy as a starting point. A pelvic floor therapist can assess which organ is prolapsed (bladder, uterus, or rectum) and can assess whether you need to do kegels to give your prolapse more support from the bottom. Note, this is not the case for everyone. Kegels are not the only answer, nor are they the only answer.

Pelvic floor therapy can also give other exercises that may be specific to helping your body support your prolapse. Everyone is different so there are no cookie cutter exercises. These can include breathing, stretching, hip strengthening, core strengthening, etc.

For many of my women they may have vaginal atrophy from lack of estrogen which causes a thinning of the vaginal tissues. When this happens the prolapse can feel like it is more prominent. These hormonal changes are common in pregnancy, postpartum, when breastfeeding and in menopause. For many women applying an estrogen cream to the vaginal tissues can reverse the vaginal atrophy, because there are estrogen receptors in the vaginal cells, and give their prolapse a more supportive feeling. A medical doctor would need to prescribe this.

A pessary is another option for supporting a prolapse. This is a device that is inserted into the vagina to support the organs. This can be a short or long term aid. It doesn't have to be forever, but can give you relief while you simultaneously build pelvic floor strength and support. A urogynecologist is typically the doctor who fits this in the United States. Some gynecologists can fit them as well, but may not be as experienced. Check with your provider.

Time is the other factor that may be on your side. Fixing these things earlier rather than later is helpful. If you are a new mom with a prolapse, remember your body will be continuing to change until you stop breastfeeding.

I recommend my clients try all these things before pursuing surgery. Sometimes surgery is necessary and gives a lot of relief, but surgery shouldn't be the first or only option.

Also, really try, like put in the work of going to physical therapy and doing the prescribed exercises and give it time. I see too often clients saying physical therapy didn't work or the pessary didn't work, but often they need to be done together.

People who have surgery also have better outcomes if they do pelvic floor therapy before or after surgery. Surgery is fixing the anatomy, but if you still have weak muscles that aren't able to support the surgery or you are constipated and constantly pushing down on the organs, then more likely the surgery will fail over time. Do the work. All of it. Then it should work.