Uterine prolapse occurs when the uterus descends from its normal position into the vaginal canal due to weakened pelvic floor muscles and ligaments. This condition can range from mild to severe and affects women of various ages, especially those who have experienced childbirth or menopause.

Stages of Uterine Prolapse

1. Mild (First Degree)
   The uterus has descended slightly but remains mostly within the vaginal canal. Symptoms may be minimal or absent at this stage.
2. Moderate (Second Degree)
   The uterus descends further into the vaginal canal and may reach closer to the opening. Symptoms such as pressure and discomfort become more noticeable.
3. Severe (Third and Fourth Degree)
   The uterus partially or fully protrudes outside the vaginal opening. This stage is often accompanied by significant symptoms that interfere with daily life.

Common Symptoms of Uterine Prolapse

• Pelvic Pressure and Heaviness: A feeling of weight or pulling in the pelvis is common.
• Bulge in the Vaginal Area: Some women may notice or feel a bulge, especially after prolonged standing or physical activity.
• Lower Back Pain: Discomfort in the lower back often accompanies pelvic pressure.
• Urinary Problems: Symptoms may include frequent urination, difficulty emptying the bladder, or urinary incontinence.
• Sexual Discomfort: Prolapse can cause pain or discomfort during intimacy, impacting relationships and self-confidence.

Understanding these aspects of uterine prolapse is essential for identifying the condition early and exploring effective management options. Whether symptoms are mild or severe, there are remedies and strategies available to improve comfort and quality of life.

Sexual Discomfort: Causes and Risk Factors of Uterine Prolapse

Uterine prolapse can lead to significant discomfort during intimacy, often due to the physical and emotional challenges associated with the condition. To understand why uterine prolapse occurs and how it may lead to these issues, it’s essential to examine the contributing factors.

1. Childbirth and Pregnancy
   One of the most common causes of uterine prolapse is the strain on the pelvic floor during pregnancy and childbirth. Vaginal deliveries, particularly those involving large babies, prolonged labor, or the use of instruments like forceps, can stretch or weaken the muscles and ligaments that support the uterus.
2. Aging and Menopause
   As women age, the natural decline in estrogen levels during menopause can weaken the connective tissues and muscles of the pelvic floor. This hormonal change increases the risk of prolapse, especially when combined with other factors.
3. Obesity
   Excess body weight puts additional pressure on the pelvic floor, making it more difficult for the muscles and ligaments to maintain the uterus in its proper position. Obesity can exacerbate or accelerate the progression of prolapse.
4. Chronic Constipation and Straining
   Repeated straining during bowel movements due to chronic constipation can overwork and weaken the pelvic floor muscles. Over time, this strain contributes to the likelihood of prolapse.
5. Heavy Lifting
   Regularly lifting heavy objects or engaging in physically demanding activities can increase intra-abdominal pressure, placing stress on the pelvic floor and increasing the risk of uterine prolapse.
6. Genetics
   Some women are genetically predisposed to weaker connective tissues, making them more vulnerable to prolapse even without other risk factors.

Understanding these causes and risk factors can help women identify potential vulnerabilities and adopt lifestyle changes or preventative measures to reduce the risk of uterine prolapse. For those already experiencing the condition, addressing these factors can play a key role in managing symptoms and improving quality of life.

Non-Surgical Management of Uterine Prolapse

While surgical intervention can be an effective treatment for more severe cases, many women with uterine prolapse can manage their symptoms and improve their quality of life with non-surgical approaches. These methods focus on strengthening the pelvic floor, supporting the uterus, and reducing the strain that contributes to prolapse progression.

Lifestyle Changes: Weight Loss, Healthy Diet, and Avoiding Heavy Lifting

Lifestyle modifications play a crucial role in managing uterine prolapse. Certain habits and conditions can worsen the symptoms or accelerate the condition’s progression, while others can help reduce the strain on the pelvic floor.

• Weight Loss: Excess weight, particularly in the abdominal area, can put additional pressure on the pelvic floor muscles and ligaments. For women with uterine prolapse, shedding excess weight through a healthy, balanced diet and regular exercise can significantly reduce the pressure on the pelvic organs, alleviating discomfort and helping to prevent further prolapse.
• Healthy Diet: A nutritious diet rich in fiber is essential for avoiding constipation, which can lead to straining during bowel movements—a significant contributor to pelvic floor weakness. Foods like fruits, vegetables, whole grains, and legumes can promote regular, soft bowel movements and reduce the need to strain. Staying hydrated is equally important to avoid hard stools and maintain bowel health.
• Avoiding Heavy Lifting: Lifting heavy objects, particularly in improper ways, increases intra-abdominal pressure and can exacerbate uterine prolapse. When lifting is necessary, women should use proper lifting techniques (bending at the knees rather than the waist) and, if possible, avoid lifting heavy weights altogether. Engaging in tasks that put less strain on the pelvic floor is advisable to minimize the risk of prolapse worsening.

Pelvic Floor Exercises (Kegels): Detailed Instructions and Tips

One of the most effective non-surgical treatments for uterine prolapse is strengthening the pelvic floor muscles. The pelvic floor muscles support the uterus, bladder, and rectum, and performing pelvic floor exercises—commonly known as Kegels—can help restore muscle tone and improve the position of the uterus.

• How to Perform Kegel Exercises:
  1. Find Your Pelvic Floor Muscles: To identify the correct muscles, try stopping urination mid-stream. The muscles you use to do this are your pelvic floor muscles. However, it’s important not to make a habit of stopping your urine flow during urination, as it can cause urinary issues.
  2. Contract the Muscles: Tighten your pelvic floor muscles, pulling them upward and inward. Hold this contraction for about 5 seconds, then relax for 5 seconds.
  3. Repetition: Perform 10-15 repetitions, three times a day. Gradually increase the duration of each contraction to 10 seconds as you gain strength.
• Tips for Success:
  • Be patient. It may take several weeks of consistent practice to notice significant improvements in muscle strength and symptom relief.
  • Avoid holding your breath while doing Kegels. Breathe freely and focus on isolating the pelvic floor muscles.
  • Ensure that you're not tensing other muscles, such as the buttocks or thighs, while performing the exercises.

Regular Kegel exercises can enhance pelvic floor strength, alleviate pressure on the uterus, and reduce symptoms of prolapse. Additionally, these exercises can improve bladder control, reduce pelvic pain, and enhance sexual function.

Pessaries and Support Devices: Different Options and Their Benefits

For women with uterine prolapse who experience discomfort or functional issues but wish to avoid surgery, pessaries and support devices offer an excellent non-invasive solution. A pessary is a device inserted into the vagina to help support the uterus and other pelvic organs, preventing them from descending further. Pessaries are available in different shapes and sizes, and a healthcare provider will typically recommend the most appropriate option based on the severity of the prolapse.

• Types of Pessaries:
  • Ring Pessary: This is the most common type of pessary and resembles a doughnut-shaped ring. It is placed inside the vagina to support the uterus and prevent further prolapse.
  • Gellhorn Pessary: This type of pessary is used for more severe prolapse cases. It consists of a firm, cup-like structure with a stem that helps keep it in place.
  • Cube Pessary: This is another option for women with moderate to severe prolapse. It is shaped like a small cube and can be more effective for women with larger prolapses or who have trouble keeping other types of pessaries in place.
• Benefits of Pessaries:
  • Non-Surgical Option: Pessaries provide immediate relief for women who are not candidates for surgery or prefer to avoid it. They help prevent the uterus from descending and alleviate symptoms like vaginal bulging, urinary incontinence, and pelvic pressure.
  • Adjustable and Reusable: Pessaries are customizable to fit the needs of each woman and can be adjusted or replaced as needed. They are reusable and can be worn for long periods, although they may need to be cleaned and changed periodically.
  • Improved Quality of Life: Many women report a significant reduction in symptoms of prolapse, including pelvic discomfort and urinary issues, when using a pessary. This improvement in comfort can also enhance sexual function and overall quality of life.
• How to Use a Pessary: A healthcare provider will typically insert the pessary initially and provide instructions on how to remove and clean it. While most women can manage pessary use independently, regular follow-ups with a doctor are important to ensure the device is fitting correctly and that no complications, such as irritation or infection, arise.

Introducing FemiCushion: Innovative Support for Uterine Prolapse

For women dealing with uterine prolapse, finding a non-invasive, comfortable, and effective way to manage symptoms can be a challenge. That's where FemiCushion comes in—a revolutionary support device designed to provide targeted relief and improve quality of life for women experiencing pelvic floor weakness or prolapse. With its unique design and thoughtful features, FemiCushion offers a new level of comfort, support, and discreetness, making it an ideal solution for managing prolapse symptoms.

The Design of FemiCushion: Tailored Support for Prolapse Relief

FemiCushion’s innovative design is specifically engineered to offer optimal support to the pelvic region, ensuring the uterus and surrounding pelvic organs are gently held in place. Unlike traditional support devices, FemiCushion features soft cushion that adapts to the natural anatomy of the vaginal canal, providing more targeted and comfortable support.

• Ergonomic Fit: The device is designed to fit securely and comfortably, featuring a cushion with soft yet durable material that molds to the body’s contours.
• Adjustable Comfort: FemiCushion comes with an adjustable feature that allows the user to customize the fit for maximum comfort. This makes it a versatile option for women at various stages of prolapse severity, ensuring it can be used as a long-term solution.

How FemiCushion Addresses Specific Prolapse Symptoms

Uterine prolapse can cause a variety of distressing symptoms, including pelvic pressure, vaginal bulging, urinary incontinence, and sexual discomfort. FemiCushion is designed to target and alleviate these issues, offering immediate relief and improving overall well-being.

• Pelvic Pressure Relief: FemiCushion’s structure helps lift and support the uterus, reducing the downward pressure on the pelvic floor. This can significantly alleviate the feeling of heaviness or pressure in the pelvic region, which is a common complaint among women with prolapse.
• Vaginal Bulging: By supporting the uterus in its proper position, FemiCushion helps reduce vaginal bulging and the sensation of a "lump" or "ball" in the vaginal canal. This support is crucial for preventing further displacement of the pelvic organs and improving comfort during daily activities.
• Urinary Incontinence Support: Many women with uterine prolapse also experience urinary incontinence due to weakened pelvic muscles. FemiCushion helps to lifts prolapsed organs, reducing the frequency and severity of incontinence episodes by redistributing the pressure on the pelvic floor.

Comfort, Discreetness, and Ease of Use: The Key Benefits of FemiCushion

One of the most significant advantages of FemiCushion is its comfort and discretion. Many women who experience uterine prolapse hesitate to use support devices due to concerns about comfort, visibility, or ease of use. FemiCushion is designed to address all these concerns.

• Discreet and Low-Profile: FemiCushion is discreet and nearly invisible when worn. It can be worn under clothes without detection, allowing women to go about their daily lives with confidence.
• All-Day Comfort: FemiCushion is made from soft, breathable, and hypoallergenic materials that ensures comfort throughout the day. Whether sitting, standing, or moving, it conforms to the body without causing irritation, pressure, or discomfort.
• Easy to Use: FemiCushion is designed for simple wear and removal. No prescription or special skills are required for use. Women can easily put on the device themselves, making it a convenient solution for managing prolapse symptoms at home or on the go.
• Non-Invasive: Unlike surgical options or pessaries that require insertion, FemiCushion provides a non-invasive way to support the pelvic organs without the need for inserting anything into the body.

FemiCushion vs. Other Support Options: What Makes It Unique?

While there are other support devices available for uterine prolapse, FemiCushion stands apart due to its innovative design and superior comfort. Here's how it compares to traditional options:

• Material and Design: Many traditional pessaries are made from rigid or silicone materials that can be uncomfortable over long periods. In contrast, FemiCushion features a cushion which conforms to the shape of the body. It also uses soft, breathable fabrics that ensures it is gentle on sensitive skin and comfortable for extended wear.
• Customization and Adjustability: While many pessaries are designed in one-size-fits-all formats, FemiCushion’s adjustable features allow for a personalized fit, making it a more versatile option for women of different shapes and sizes at different stages of prolapse severity. This adaptability increases its effectiveness and comfort for users.
• User-Friendly: Unlike some other support options that require professional fitting or insertion, FemiCushion can be used independently, providing women with more control and convenience over their treatment. It can be worn during daily activities, including exercise or work, without the fear of it slipping or causing discomfort.

Living with Uterine Prolapse: Tips for Managing Prolapse in Daily Life

While the condition can be distressing, many women with uterine prolapse can effectively manage their symptoms and continue to live an active, fulfilling life. By making some adjustments to daily habits and seeking the right support, you can significantly reduce discomfort and prevent the condition from worsening.

Proper Body Mechanics: Protecting Your Pelvic Floor

Maintaining good posture and using proper body mechanics can help reduce the strain on your pelvic floor, which is crucial for managing uterine prolapse. When you lift or move, always keep these tips in mind:

• Lift with your legs, not your back: When lifting objects, especially heavy ones, bend at the knees and use the strength of your legs rather than your back or waist. This reduces the intra-abdominal pressure that can exacerbate prolapse.
• Avoid straining: Whether lifting, exercising, or performing daily activities, avoid activities that put undue pressure on the pelvic floor. This includes straining during bowel movements, which can weaken the pelvic muscles over time.
• Strengthen your core and pelvic floor: Regularly performing pelvic floor exercises (such as Kegels) can help strengthen the muscles that support the uterus. In addition, core exercises like abdominal breathing, gentle pilates, and yoga can improve overall muscle tone and posture, providing better support for your pelvic organs. 

Bladder and Bowel Health: Preventing Strain and Discomfort

Bladder and bowel health are key areas to focus on when managing uterine prolapse. Certain habits can contribute to pelvic floor dysfunction, but with a few simple adjustments, you can protect your pelvic organs and reduce prolapse symptoms:

• Stay hydrated and eat a fiber-rich diet: To prevent constipation, which can lead to straining, ensure you drink plenty of water and consume a diet rich in fiber. Foods such as fruits, vegetables, whole grains, and legumes will help keep your bowel movements regular and soft.
• Avoid constipation: Chronic constipation can significantly strain the pelvic floor muscles. If you do experience constipation, consider gentle laxatives or stool softeners under the guidance of a healthcare provider.
• Bladder health: Empty your bladder fully and avoid holding urine for prolonged periods. It’s also essential to maintain healthy bladder habits by going to the bathroom regularly—especially if you experience urinary incontinence or urgency as a result of prolapse.
• Pelvic floor relaxation: If you're experiencing pelvic floor tightness or discomfort, learning techniques to relax the pelvic muscles can be beneficial. Gentle stretching, pelvic floor relaxation exercises, and breathing techniques can help release tension in the pelvic region.

Sexual Health and Intimacy: Navigating Physical and Emotional Changes

Many women with uterine prolapse experience changes in their sexual health, including discomfort during intercourse. While this can be a difficult aspect of living with prolapse, there are ways to manage the condition to preserve intimacy:

• Communicate with your partner: Open communication is essential. Let your partner know how you’re feeling physically and emotionally. Understanding and mutual support are key to navigating sexual intimacy while managing prolapse.
• Use lubricants: Vaginal dryness, which can occur due to prolapse or other hormonal changes, can make intercourse uncomfortable. Using water-based lubricants can reduce friction and increase comfort.
• Explore comfortable positions: Certain sexual positions might be more comfortable than others. For example, positions where the woman is on top allow for more control over depth and pressure, which can help reduce discomfort.

Finding Support: Resources and Networks for Women with Prolapse

Living with uterine prolapse can be isolating, but you’re not alone. Connecting with others who understand your experience can provide emotional support, helpful advice, and valuable resources.

• Support groups: Many women find it beneficial to join online or in-person support groups dedicated to pelvic health. These communities provide a space to share experiences, ask questions, and learn from others who have faced similar challenges.
• Healthcare professionals: If you're managing uterine prolapse, a pelvic health specialist, physical therapist, or gynecologist can offer guidance on managing symptoms and creating a treatment plan tailored to your needs.
• FemiCushion Support: For those looking for non-surgical options, FemiCushion is a great resource for managing prolapse symptoms. This innovative support device provides pelvic support and relief, making daily activities and intimacy more comfortable.

Supervising Doctor of This Article

Koichi Nagao, MD PhD

Professor, Department of Urology, Toho University Faculty of Medicine
Director of Urinary tract reconstruction center, Toho University Omori Medical Center
Director of Reproduction Center, Toho University Omori Medical Center

Professor Nagao specializes in plastic surgery in the field of reproductive medicine. He completed eight years of plastic surgery training at Showa University before majoring in urology at Toho University. With his meticulous surgical techniques and careful examinations that combines urology and plastic surgery, Professor Nagao became a Board Certified Specialist with multiple associations including the Japanese Urological Association, the Japan Society for Reproductive Medicine, and the Japanese Society for Sexual Medicine.