BY JENNIFER FINK Originally published Jan 2024
Pelvic organ prolapse—which occurs when the uterus, bowel, bladder or top of the vagina “drops” or bulges into the vagina—affects one in four women in their 40s, one in three women in their 60s and half of all women in their 80s, according to the American College of Obstetricians and Gynecologists.
The condition can cause serious discomfort and affect everything from a woman’s ability to work, exercise, control her bowel and bladder function, and engage in sexual activity. Typically, “the first thing women do when they experience prolapse symptoms is stop or limit activities, often out of fear and in reaction to the discomfort symptoms can cause,” says Sara Wood, MD, MHPE, Washington University urogynecologist and chief of the Division of Urogynecology & Reconstructive Pelvic Surgery. Wood treats patients at Barnes-Jewish Hospital and Missouri Baptist Medical Center.
That change in activity may be helpful in the short term, Wood says, but it often causes women to shrink their lives. Women who would love to jump on the trampoline with their grandchildren instead watch and wave from a lawn chair. They cancel the 5K they’d planned to run with their sister and text her well wishes on the morning of the race instead. They stop traveling, stay close to home and skip sexual intercourse. And those limitations are in opposition to how we enjoy life.
“We know that the No. 1 thing we can do for our long-term health is to be active,” Wood says. Effective medical and surgical treatment can repair pelvic organ prolapse, allowing women to confidently and comfortably participate in activities they enjoy.
Pregnancy and vaginal childbirth increase the risk of pelvic organ prolapse, but women who have never conceived can also experience pelvic organ prolapse, as can women who have had C-sections. Prolapse is even possible after hysterectomy, the surgical removal of the uterus. Other risk factors for pelvic organ prolapse include aging, long-term increased intra-abdominal pressure (which may be caused by chronic constipation, coughing or obesity) and family history.
“There is growing evidence that there may be some genetic risk factors for prolapse,” says Jerry Lowder, MD, MSc, Washington University urogynecologist at Barnes-Jewish Hospital. However, he notes, it’s not yet possible to use testing to determine whether a woman is likely to develop prolapse. Lowder also treats patients at Missouri Baptist Medical Center.