Because vaginal and uterine prolapse have several different causes, there is no single way to prevent these problems. Currently, a woman cannot change her genetic risk profile which influences the strength of her connective tissue. Women can make lifestyle choices that can influence risk factors that are modifiable.In general, avoiding increased pressure inside the abdomen will diminish pressure placed upon the pelvic floor is wise.
This can be done by:
- Maintaining a normal weight or losing weight if overweight. Overweight women are at a significantly increased risk of developing prolapse.
- Avoiding constipation and chronic straining during bowel movement, which increase a woman’s chance of developing prolapse, especially a rectocele. A diet with plenty of fiber and fluids, as well as regular exercise is important for maintaining regular bowel function. If constipation persists despite these measures, further evaluation and treatment is recommended.
- Seeking medical attention to evaluate and treat a chronic cough which increases abdominal and pelvic pressure.
- Avoiding heavy lifting and learn how to lift safely by using leg and arm muscles as much as possible.
- Not smoking or kicking the habit!
- Avoiding repetitive strenuous activities.
- Learning and performing pelvic floor muscle exercises (Kegels) regularly to improve the strength of the pelvic floor and limit the likelihood of developing prolapse. Once prolapse has developed, pelvic floor exercises will not correct the prolapse, but they may limit the development of worsening prolapse and may diminish some of the symptoms.
There has been considerable discussion about whether a cesarean delivery (C-section) might reduce the chance of developing prolapse later in the life. Operative vaginal deliveries (forceps or vacuum deliveries) may increase the risk of pelvic floor injury and increase woman’s risk of developing prolapse. Route of delivery is very important and a complicated topic, which one should address with their obstetrical provider. It is clear that being pregnant alone, regardless of the type of delivery, contributes to the development of pelvic floor disorders. However, it is important to remember that there are women who have never been pregnant who leak urine and stool or have prolapse - and women who have delivered many times who do not. There is no clear answer to this question at this time.
When considering your treatment options it is best to work with your urogynecologist to make a plan that works best for you. A lot depends on your individual problems, and more depends on your preferences. A woman should seek treatment whenever her symptoms have a negative impact on her life – you don’t have to wait until your symptoms are 'really bad'. Prolapse can worsen one’s quality of life and vaginal and uterine prolapse, while common, is not a normal result of childbirth and aging. You do not have to 'learn to live with it'. Seeking medical help does not mean that you have to have surgery right away. Some women start with more conservative treatment like physical therapy, and go on to surgery only if their symptoms from prolapse are not under control.
Original publication date: May 2008; Content Update: July 2013