Older Women May Face "Sagging" of Pelvic Organs

Patient Expert

After going through menopause, some women start complaining about their sagging body parts. Often it's the area under their upper arm or it's the neck and chin that we worry about. However, we often don't realize that "shifts" can take place internally, leading to pelvic organ prolapse. In fact, about 10 percent of women will need surgery for prolapse by the time they reach 80 years of age.

Pelvic organ prolapse is a term that covers several difference conditions.   According to the Harvard Medical School's Family Health Guide, these include:

  • Cystocele and urethrocele. Cystocele happens when the bladder pushes into the front wall of the vagina. Urethrocele happens when the urethra pushes into the front wall of the vagina.
  • Rectocele. This condition involves the rectum pushing into the back wall of the vagina. This condition can make it difficult for a woman to have a bowel movement.
  • Uterine prolapse. This condition involves the uterus dropping into the vagina. A similar condition called vaginal vault prolapse may be seen in women who have had a hysterectomy; in this situation, the top of the vagina pushes into the lower vagina.

While researchers haven't solved why some women experience pelvic organ prolapse while others do not, they have identified factors that increase the risk of this condition. These factors include menopause, aging, giving birth vaginally, being overweight, chronic coughing or straining to have a bowel movement.

So what are the symptoms? In fact, the Mayo Clinic's Health Letter reports that symptoms aren't always evidence. "It may simply feel like something has fallen out of place," the newsletter states. However, the condition can cause a variety of problems, such as:

  • A tissue bulge at the vaginal opening.
  • Pressure or pulling in the pelvic area that worsens when a woman is standing, lifting, coughing or straining.
  • Experiencing incontinence in either the urine or bowel movement when the woman is coughing or sneezing.
  • Experiencing difficulty emptying the bladder or bowels.
  • Suffering sexual discomfort or embarrassment.

Harvard Medical School's Family Health Guide also pointed to the following symptoms:

  • A feeling of pelvic pressure, leg fatigue and lower back pain.
  • Bowel symptoms, including stool becoming trapped, causing pain, pressure and constipation.

If you think you may be experiencing one of the pelvic prolapse conditions, you should see your primary care provider or gynecologist to see if he or she can make a diagnosis. If you do end up with a diagnosis, here are both non-surgical and surgical options to help you.

Non-surgical options include the following:

  • Physical therapy to learn how to properly do Kegel exercises, which strengthen the pelvic floor muscles. After learning to do these exercises, women would develop a daily routine of exercising the muscles that are used to stop urine flow.
  • Taking steps to reduce pressure on the pelvic floor. These steps can include losing weight, avoiding lifting anything heavy, correcting constipation issues, and clearing up a chronic cough.

While these steps will not cause a prolapsed organ to return to its previous place, women who take these steps can improve symptoms as well as help them from getting worse.   Furthermore, a doctor can prescribe a removable intravaginal device alled a pessary that can be fitted to your body to hold the pelvic organs in place.

There also is a surgical option. In this situation, a doctor will move shifted organs back into place, often removing the uterus to make this happen. The Mayo Clinic Health Letter reports that the clinic's surgeons often encourage postmenopausal women to use a low-dose estrogen replacement cream on the vagina, which helps these tissues to become thicker and healthier, thus making surgery more effective and facilitating better healing.

The type of surgery depends on what type of prolapse a woman is experiencing. Some are done through the abdomen while others are through the vagina. Talk to your doctor about which is right for you, since each type of surgical procedure has pros and cons. The Harvard Medical School Family Health Guide points out that there are potential complications from this type of surgery, including urinary tract infection, temporary or permanent incontinence, infection, bleeding, chronic irrigation, pain during intercourse, and (rarely) damage to the urinary tract that requires additional surgery.

So if you are experiencing problems with this type of internal sagging, be sure to talk to your physician. Help can easily be yours_Primary Sources for This Sharepost:_

Harvard Medical School Family Health Guide. (2005). What to do about pelvic organ prolapse.

Mayo Clinic Health Letter. (2013). Pelvic organ prolapse: Deciding on surgery.