Uterine prolapse is a condition in which the uterus descends into the vagina and may even protrude outside the vaginal opening. This condition, along with the prolapse of other organs like the bladder, urethra, small intestine, and rectum, is often collectively referred to as "pelvic organ prolapse."

As uterine prolapse progresses, it can lead to difficulties with urination and defecation, as well as sexual dysfunction. Pain and bleeding may make walking difficult, significantly impacting one’s quality of life (QOL). Furthermore, embarrassment may prevent women from seeking medical help or confiding in family and friends, leading to silent suffering. Many women wonder if there are ways to treat this condition at home without visiting a hospital.

Causes of Uterine Prolapse

Uterine prolapse occurs when the pelvic floor muscles, which support the pelvic organs, weaken or are damaged. The main causes include:

• Pregnancy and Childbirth: During pregnancy, the uterus enlarges, and the vagina and pelvic floor muscles stretch. These muscles can be damaged during childbirth. Women who have given birth vaginally, especially those who have had three or more children or large babies, are at higher risk. It is said that 95% of women with pelvic organ prolapse have experienced childbirth.

• Aging: Pelvic floor muscles weaken with age, increasing the risk of uterine prolapse. The decline in estrogen after menopause also contributes.

• Heavy Labor: Regular heavy lifting and other strenuous activities that increase abdominal pressure can contribute to uterine prolapse.

• Excessive Obesity: Obesity increases abdominal pressure and strains the pelvic floor, raising the risk of prolapse.

• Chronic Coughing, Sneezing, and Constipation: These actions increase abdominal pressure, which can contribute to uterine prolapse.

Risks of Self-Treatment Without Professional Oversight

While some conservative methods can help manage uterine prolapse, attempting to treat it without consulting a doctor carries risks. Self-treatment may delay proper diagnosis and management of the condition, potentially leading to worsening symptoms. For example:

• Infections: Using unsanitary materials, such as rolled-up tissue paper, to prevent organ descent can introduce bacteria, increasing the risk of infections.

• Progression of Prolapse: Improper handling of the prolapse or reliance on ineffective methods may allow the condition to worsen.

• Missed Diagnosis: Self-treatment may mask symptoms of more serious conditions, such as infections or even cancer.

It is crucial to seek professional help if symptoms persist, worsen, or significantly affect daily activities. A healthcare provider can offer tailored guidance and appropriate treatment options.

When to Seek Professional Help

Seek medical advice promptly if:

• The prolapse becomes more pronounced or persistent.

• You experience significant pain, bleeding, or signs of infection (e.g., foul-smelling discharge).

• Conservative treatments, such as Kegel exercises, fail to provide relief.

• You are considering a medical device, like a ring pessary, but are unsure how to use it safely.

Treatment for Uterine Prolapse

Treatment options range from conservative management to surgical interventions, depending on the severity of the prolapse and individual circumstances.

Conservative Treatment (Self-Care and Non-Surgical Methods)

Conservative treatment aims to alleviate symptoms without surgery. Common methods include:

• Pelvic Floor Muscle Training (Kegel Exercises):

  • Strengthens the muscles supporting the uterus, bladder, and rectum.

  • Simple exercises include contracting the pelvic floor muscles (as if trying to stop urination), holding for 5 seconds, and releasing. Repeat 10 times, several times a day.

• Lifestyle Changes:

  • Lose weight if overweight.

  • Improve bowel habits to prevent straining.

  • Avoid heavy lifting to reduce abdominal pressure.

• Medical Devices (e.g., Ring Pessaries):

  • Inserted into the vagina to support the prolapsed uterus. Regular hospital visits are required for cleaning and replacement.

• Specialized Support Wear (e.g., FemiCushion):

  • Supports the prolapsed organs externally, minimizing strain on the vaginal walls. FemiCushion is washable, reusable, and can be worn as needed.

Surgical Treatment

Surgery is the only way to completely cure uterine prolapse, but it carries risks and may not be suitable for everyone. Procedures include:

• Transvaginal Mesh Surgery (TVM): This procedure has been discontinued in some regions due to risks such as mesh erosion and infection.

• Other Surgical Methods: A doctor will recommend the most appropriate procedure based on individual circumstances.

Managing a Prolapsed Uterus at Home

If your uterus is consistently prolapsed, repositioning it gently can help alleviate discomfort. Follow these steps:

1. Wash your hands thoroughly.

2. Gently grasp the uterus with two fingertips and push it upward toward the vagina.

3. Consider wearing a support device, like FemiCushion, to prevent further descent.

Important Notes

• Always consult a healthcare provider before starting any treatment.

• Self-treatment should only be a temporary measure while awaiting professional advice.

• Regular follow-ups with a gynecologist or urogynecologist are essential to monitor progress and adjust treatment.

Uterine prolapse is a manageable condition with various treatment options, from lifestyle changes to specialized medical devices and surgery. However, professional oversight is crucial to ensure effective and safe management. Seeking timely medical advice can prevent complications, improve quality of life, and provide access to the most suitable treatment options.

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.