Prolapse is common after pregnancy and later in life. Here’s what to look out for

Pelvic organ prolapse is a common condition that affects many women, particularly those who have given birth or are going through menopause. It occurs when the muscles and tissues that support the pelvic organs weaken, causing one or more organs to drop from their normal position. This can result in a variety of symptoms, including pressure, heaviness, a bulge at the vaginal opening, and difficulties with bladder and bowel control.

Although the risk of prolapse increases with childbirth, vaginal birth of a large baby, forceps-assisted delivery, and prolonged labor, it can also occur due to factors like obesity, age, certain medical conditions, and activities that place excessive pressure on the pelvic floor. Even women who have never been pregnant or have given birth may experience prolapse.

Symptoms vary in severity and can include a persistent sensation of pressure or heaviness in the pelvis, a bulge at the vaginal opening, and difficulty with urination or bowel movements. Some women may not experience any symptoms at all, while others may feel anxious, depressed, or have concerns about their body image due to the condition.

Treatment options for prolapse include conservative measures such as pelvic floor muscle exercises (Kegel exercises) to strengthen the muscles and improve symptoms, as well as the use of a vaginal pessary, a silicone device fitted in an outpatient clinic to provide support. In more severe cases, surgical procedures may be recommended to repair the vaginal walls and strengthen the support around the bladder and rectum. These surgeries are typically performed vaginally and aim to reduce the bulge and improve symptoms.

However, it's important to note that surgery may not be suitable for all women, especially those who have completed their childbearing years and are concerned about preserving sexual function. Older or frail women may opt for a procedure that partially or completely closes the vagina.

Despite the potential physical, emotional, and social impacts, many women hesitate to seek treatment due to embarrassment, lack of awareness, cultural beliefs, and cost. Health-care providers can help by routinely screening for prolapse symptoms during prenatal, postnatal, and menopause-related visits, as well as providing education in a culturally sensitive and non-judgmental manner. If you suspect you have a prolapse, it's essential to consult your GP or visit a Women's Health Centre for appropriate care and support.