Tips for a Prolapse of the Uterus, Bowel or Bladder (Uterine Area)

What does a prolapse mean in the uterine area?

A falling or sliding of the uterus/bowel/bladder (pelvic organs), from its normal anatomical position (the pelvic cavity) into the vaginal canal because of a weakening in the surrounding supporting tissues. A bladder or urethra prolapse may cause incontinence (leaking urine), frequent or urgent need to urinate or difficulty urinating. A prolapse of the small or large bowel (rectum) may cause constipation or difficulty defecating. Some women may need to insert a finger in their vagina and push the bowel back into place to empty their bowels. Women with uterine prolapse may feel a dragging or heaviness in their pelvic area, often described as feeling 'like my insides are falling out'.  With severe prolapse, when the uterus is bulging out of the vagina, the skin may become irritated, raw and infected.

Why would this condition occur?

Normally supported by pelvic connective tissue and the pubococcygeus muscle, the uterus is held in position by special ligaments. One way you can help yourself right away to prevent a prolapse from happening in the future is to start exercising your pelvic floor.

What is the pelvic floor?

The foundation of everything is in turn made up of the group of muscles and ligaments called the pelvic floor. These form a hammock-like sling and run from front to back, attached to the tailbone at one end and the pubic bone at the other, and can be activated by simply imagining that you want to stop going to the pee- and clenching but not stressing the muscles that do that for you.

Women do not pay enough attention to this area of the body. While today most yoga and Pilates classes focus on the ‘core.’, women still need an education and awareness on this part of their anatomy. Weak pelvic floor muscles are further weakened by the pressure put on them by the upper body during any form of exercise like running, strength training, functional training, dance classes, aerobics, and all physical activity involving movement. In the long run, signs of a weak bladder involve leaking of urine when coughing, sneezing, or running; and not getting to the bathroom on time), prolapsed uterus, urethrocele (prolapse of the female urethra into the vagina), reduced vaginal sensation, heaviness in the vagina.

Why does a prolapse occur of uterine organs?

1. A weak pelvic floor is usually the main cause of a prolapse
2. A weakening of these tissues allows the uterus to descend into the vaginal canal. Tissue trauma sustained during childbirth, especially with large babies or difficult labour and delivery, is typically the cause of muscle weakness.
3. The loss of muscle tone and the relaxation of muscles, which are both associated with normal ageing and a reduction in the female hormone estrogen, are also thought to play an important role in the development of uterine prolapse.
4. A descent of these organs can also be caused by a pelvic tumour, however, this is fairly rare. Uterine prolapse occurs most commonly in women who have had one or more vaginal births.
5. Other conditions associated with an increased risk of developing problems with the supportive tissues of the uterus include obesity and chronic coughing or straining. Obesity places additional strain on the supportive muscles of the pelvis, as does excessive coughing caused by lung conditions such as chronic bronchitis and asthma. Chronic constipation and the bearing down associated with it causes weakness in these muscles.

How do you help your prolapse or prevent one, by working on your pelvic floor

1. Kegel Exercises: Make sure you get some form of exercise daily especially kegel exercises which involves breathing exercises when you breathe in (balloon belly) – breath out (take navel down to the spine) and engage the muscles that stop you from urinating. Repeat this 10 times daily. This is to strengthen the pelvic floor
2. In foods: Avoid meat, dairy, sugar, white flour, black tea, coffee, alcohol as these promote an acidic blood condition weakening the spleen/pancreas which according to Traditional Chinese Medicine are responsible for holding up the organs in our body. Avoid junk food (too much bread) and hard-baked snacks which will induce constipation causing stress in the pelvic region
3. From the Yoga tradition: You can do Supta baddhakonasana - reclining cobbler pose - benefits: the pelvic floor is stretched and it lifts up prolapsed pelvic organs. Janu sirasana – benefits: improves flexibility of spine and hips, elongates hamstrings and relieves sciatic tension. Massages internal organs and supports good digestion
4. Sometimes physiotherapy and hormone replacement therapy (hrt) may help strengthen the vaginal walls and pelvic floor muscles by increasing the oestrogen and collagen levels in your body, but there is little evidence as to whether it is effective in treating prolapse
5. Avoid standing for long periods, wearing a girdle for support if you have a prolapse could be an option

Here are 2 simple exercises to do every day to work on your pelvic floor and strengthen it

Exercise 1

Pelvic girdle activation

1. Place both hands on your hip bone, put your finger trips on the pubic bone, the bony parts of your pelvis
2. Inhale– balloon belly out – exhale drop navel to the spine (this should be done by stressing that the navel is moving towards the spine) now pull the muscles that stop you from urinating. Release.
3. Repeat this to experience how to engage the pelvic girdle, you will feel the engagement as the muscles under your fingers will be engaged.

Exercise 2

Cushion/Block Squeeze

1. Lie down in a supine rest position
2. Stick a cushion or. Yoga block between the knees
3. Place both palms on your hip bone
4. Inhale and balloon the belly out, now exhale and sink the abdomen (navel) to the spine
5. As you do this squeeze the cushion
6. Repeat this 5 times

Excerpts from the book-'Finding Your Balance: Your 360 Degree Guide to Perimenopause and Beyond' by Dr. Nozer Sheriar and Shonali Sabherwal