Many women’s pelvic organs change as they age. They may have a feeling of pelvic pressure or heaviness. It may feel like “something is falling out of the vagina” , these symptoms may be caused by pelvic support problems. These problems may begin with childbirth. Women may notice them even more as they age.
The Pelvic Organs
The parts of the body affected by pelvic support problems include the urethra, the bladder, the small intestine, the rectum, the uterus and the vagina.
The pelvic organs are held in place by 3 types of support:
- Layers of connecting tissue called endopelvic fascia.
- Thickened parts of the fascia called ligaments.
- A paired group of muscles that lies on either side and around the openings of the urethra, vagina and rectum.
The main causes of pelvic support problems are childbirth and aging. Occasionally pelvic support problems do affect women who have never gone through childbirth.
The symptoms of pelvic support problems depend on the organs involved. Symptoms may include:
- A Feeling of pelvic heaviness or fullness
- A feeling that something is “falling out of the vagina”
- A pulling or aching feeling in the lower abdomen, groin or lower back
- Leakage of urine or problems having a bowel movement
- Cystocele (SIS-tow-seel)- bladder
- Enterocele (en-TARE-oh-seel)- small intestines
- Rectocele (REK-tow-seel)- rectum
- Uterine Prolapse- Uterus
- Vaginal Prolapse- Vagina
Types of Pelvic Support Problems:
Cystocele is something that occurs when the bladder drops from its normal place into the vagina. Some cystoceles cause urine to leak when you cough, sneeze lift objects or walk.
Enterocele is something that forms when the intestine bulges into the upper vagina.
Rectocele is something that happens when the rectum bulges into or out of the vagina.
Uterine Prolapse this happens when the uterus drops down into the vagina.
Vaginal Prolapse sometimes after a hysterectomy (the removal of the uterus), the top of the vagina loses its support and drops.
Proper diagnosis is key to treating pelvic support problems. Diagnosis is not always simple though. The symptoms of pelvic support problems often mimic those other conditions. In most cases, a woman with these symptoms will know that she has a problem, but the cause may be unclear.
Treatment of pelvic support problems may involve special exercises or insertion of a special device called a pessary. These treatments may improve support. Your Physician may suggest a high-fiber diet or medications to soften the stool and make bowel movements easier. Keeping your weight under control, eating right, not smoking and not doing activities that stress the pelvic support muscles may help.
No form of treatment, even surgery, is certain to solve the problem.
Exercises called Kegel exercises, or pelvic muscle exercises, are used to strengthen the muscles that surround the openings of the urethra, vagina and rectum.
The Physician may suggest that you drink cranberry juice to help reduce the risk of infection.
Sometimes a medication that softens stools is prescribed along with a special diet to help control intestinal symptoms.
Pelvic support problems may be corrected by surgery. The type of support problem you have will decide whether surgery is done through the vagina or abdomen.
Sometimes surgery is too risky because of a woman’s general health. In such cases, a pessary may be inserted into the vagina to support the pelvic organs. When a pessary is used, it must be removed, cleaned and reinserted on a regular basis.
Finally…many women suffer from pelvic support problems. If you have any symptoms, talk to your healthcare provider about them.