PELVIC SUPPORT PROBLEMS

Pelvic support problems may begin with childbirth or as a woman ages. Even women who have never had children may develop a pelvic support problem. Any of the pelvic body parts may be affected. These include the small intestine, rectum, urethra and bladder, uterus, and vagina.

When pelvic muscles, ligaments, and tissues are weakened, pelvic support is compromised and may result in a prolapsed (or drooping) pelvic body part. This means that part of an organ drops down from its normal position in the pelvis. It may even drop so far as to be partially exposed outside the body. The rectum turns itself inside out when it prolapses and, as it worsens, may protrude.

The rectum, small intestine, bladder, or uterus, may drop (or prolapse) into the vagina. If the uterus has been surgically removed, the top of the vagina can lose its support and drop. A prolapsed organ cannot repair itself. Women should contact their healthcare provider as soon as symptoms are noticed.

Pelvic support problems are caused by a wide variety of conditions. During childbirth, the muscles and skin of the birth canal (vagina) are stretched and sometimes torn. They repair over time but are never exactly the same. After menopause, changes in the vaginal walls develop from lack of estrogen. Estrogen helps to keep the tissues toned. Low levels of estrogen weaken the vaginal walls and this may result in the bladder shifting from its normal position. Through aging, the loss of muscle tone and the relaxation of muscles may cause the uterus to drop. Over time, certain conditions, like chronic coughing, chronic constipation, straining to pass stool, and obesity, can weaken the pelvic support muscles.

Many women have the feeling of pelvic pressure or trouble holding their urine immediately after childbirth. For some, these feelings go away only to return as they get older.

Symptoms of pelvic support problems depend on the organ involved. Some symptoms are:

leaking urine
difficulty having bowel movements
aching in the lower abdomen, groin, or lower back
bladder infection
feeling of heaviness, pulling, or fullness in the pelvis, or as though something is falling out of the vagina
protrusion from the vaginal opening or
painful sexual intercourse

Treatment varies by the development phase of the problem. Advanced cases of prolapse may require a special plastic device called a pessary that fits into the vagina to support the uterus, vagina, bladder, or rectum. A pessary also helps women who leak urine when coughing, straining, or exercising. Some pelvic support problems may simply be treated with Kegel exercises, changes in diet, medications to soften the stool, weight loss, or avoiding strenuous activities.

For older women, hormones such as estrogen are helpful. In serious cases, surgery may be needed to put the organs back into their proper location. The uterus is often removed with this surgery because of the pressure it puts on the bladder.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIL File WOME3275.RF2 VRS# 7166 Data Version 7.0