Pelvic Organ Prolapse: A Quick And Helpful Q And A For Women During And After Menopause

Menopause can be a difficult time, with many changes happening to your mind and body. Although the last thing you need at this time is another failing or falling part, a pelvic organ prolapse can strike, meaning your uterus, bladder or other organ is out of place and headed downward. While a prolapse can affect anyone at any age, it's more common for someone going through menopause or one that's (finally) put it behind them. 

How Do You Know It's Happening?

The idea of organs shifting or falling out of place, especially if they're coming out of your body, is enough to cause panic in anyone, but it's important to stay calm and clearly identify the symptoms you may be having:

  • The sensation of pressure in your pelvic area
  • Feeling as if something is pushing through your vagina
  • Actually being able to feel something emerging from the area
  • Slight bleeding or other (unexpected) discharge
  • Urinary incontinence or not being able to urinate
  • Worsening symptoms upon standing, coughing or straining

A prolapse can seem to happen suddenly or your symptoms may be prolonged, getting progressively more pronounced. 

Why Does It Happen?

Aging may be a factor in pelvic organ prolapse; however, vaginal childbirth, particularly multiple births, tends to over-tax the muscles supporting the organs of the lower abdomen and is considered a leading risk factor in prolapse. The slack muscles can no longer sustain the internal organs, causing them to gradually drop and eventually, unfortunately, drop down until they begin to emerge from the vaginal opening.

Is Pelvic Organ Prolapse A Medical Emergency?

Yes! If you experience any symptoms, it's crucial that you immediately seek medical attention. Even if your symptoms don't exactly match any list, when you feel strange things happening to your body, especially when basic functions are compromised, call for help. Prolapses aren't necessarily life-threatening, but they're not something to take a "wait and see" approach with either.

What Are The Treatments?

Depending on the severity of your prolapse, you may require treatment right away. A full pelvic examination will be needed, to determine which of your organs are most affected and to what extent they've been displaced. Once that conclusion is ascertained, a recommendation for treatment will follow:

  • Physical therapy for mild-to-moderate prolapse, to strengthen inner-core muscles
  • Hormonal therapy (estrogen), which can help rejuvenate and maintain those muscles
  • A medical device, called a pessary, used to support the vaginal walls and, thus, the associated organs
  • Surgical intervention to tighten, reconstruct or lift the uterus to its normal position

Patients most typically begin with the most conservative treatments available to them, only reverting to surgery if it's absolutely necessary, particularly in light of insurance requirements. A mild prolapse may not mandate any intervention, but more extreme cases usually cause discomfort, at the very least, leading both patients and doctors to want to take action.

The worst aspect of a prolapse may be the actual idea that your organs feel like they've come undone and are now trying to exit your vagina, just in time to coincide with everything else you have going on during or after menopause. You and your doctor can create a plan, though, to either stay one step ahead of this condition or to nip it in the bud before it gets any more noticeable or threatening.