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In Pursuit of Pelvic Prolapse Prevention

Pelvic floor muscle, along with other tissue and ligaments, keep your uterus where it’s supposed to be. If those muscles become weak, the uterus may begin to sag internally or come entirely out of a woman’s body. That means it can range from a little internal protrusion to an external one you may not want to imagine. The proper terms for this condition are “prolapsed uterus” or “pelvic organ prolapse.”

The weakening of pelvic floor muscle is also one cause of urinary incontinence (loss of bladder control).

Common causes for a prolapsed uterus are vaginal deliveries when having children, as that can cause the pelvic floor muscle to weaken. Other factors are things that put additional stress on the pelvic floor muscle like being overweight, frequent coughing (ex — people with asthma or smokers), constipation, getting older/menopause, or even your genes – you may have inherited naturally weaker pelvic muscles than other people.

If you haven’t experienced a prolapsed uterus, you’re probably wondering whether or not you can prevent it. You probably also want to know if there are early signs that would alert you, so you and your medical provider could stop its progression.

Let’s answer the second question first; how would you know if you had this condition? A mild case of uterine prolapse probably won’t produce any symptoms, but there are several attributed to moderate or severe prolapse according to Mayo Clinic like a sensation of heaviness or pulling on your pelvis, protruding tissue, urinary problems, trouble having a bowel movement, and several others. If you are experiencing any of those symptoms, especially if they get worse as the day goes on, you should schedule an appointment with your medical provider and explain your symptoms precisely even if they’re a little difficult to describe.

There are a few ways to treat uterine prolapse. The treatments include taking hormones, doing Kegel exercises that tighten the muscles in the area, placement of a device called a “pessary” that provides support and helps push organs back into place, and there are surgical options your provider may discuss with you.

Now, the big question for many of you. Can it be prevented?

As mentioned above there are certain risk factors that make prolapse more likely. Some can’t be prevented, for example, giving birth once you’re pregnant, aging/menopause, and genetics. But some things are within your control. You can perform Kegel exercises regularly whether or not you’ve ever had a baby (but especially if you have). Do what you can to prevent constipation and don’t let it go on longer than necessary if it happens. Lift heavy object correctly, control coughing by seeing your medical provider to treat a cough if you’re ill or quitting smoking if that’s the issue, and keep your weight within a healthy range.

You’ve undoubtedly noticed the frequency with which this blog post mentions Kegel exercises also known as pelvic muscle or “pelvic floor” exercises. Exercising these muscles can prevent you from leaking urine, gas, or bowel movements, as well as “pelvic organ prolapse.”

Working with your medical provider (doctor, nurse,  physical therapist, etc.) to help you get started and ensure you’re correctly executing the exercises can be especially helpful because learning which muscles to tighten is sometimes hard to figure out at first.

We strongly encourage you to speak to your provider openly and honestly about any symptoms you may be experiencing and to learn what options he or she recommends. There are treatment options that can help and improve your quality of life.


The information presented here was reviewed by Terrence E. Babb, MD, FACOG, FACS (April 2019)

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