Uterine prolapse is the sinking and falling out of the uterus. It can be mild, when symptoms are generally only felt with exertion or exercise, or severe when the uterus can be seen falling out of the vagina. Prolapse occurs when the muscles, ligaments and other supportive structures in the pelvis weaken and no longer hold up the uterus, which subsequently drops down. The ligaments include the round ligament, uterosacral ligaments, broad ligament and ovarian ligaments.
Causes & Symptoms
Usually affecting post-menopausal women, prolapse can occur at any age. It can be caused by having many vaginal deliveries, gravity, loss of estrogen, or repeated strain such as chronic cough or obesity, and rarely pelvic tumors.
The first symptoms generally include the feeling of sitting on a small ball, a feeling of heaviness or pulling in the pelvis, the uterus or cervix sitting outside the vagina, difficult or painful intercourse, frequent or urgent urination, low back ache, repeated bladder infections, vaginal bleeding, and increased vaginal discharge. These symptoms often become worse when sitting or standing for long periods of time.
Complications of uterine prolapse include recurrent urinary tract infections, ulcers, and the prolapse of other pelvic organs.
Western Medicine Treatment
Unless symptoms are bothersome, treatment generally includes strengthening the pelvic muscles through moderate exercises which include Kegel exercises. A pessary is a removable device that fits into the vagina and holds the uterus in place. Laparoscopy, surgical repair or hysterectomies are sometimes performed, though no longer favored. Topical or oral estrogen therapy may be given. Weight loss as well as avoiding constipation, coughing and heavy lifting are also recommended.
Chinese Medicine Treatment
Prolapse is always due to a deficiency of Qi, more often than not, Spleen and Kidney Qi deficiency occurring due to overwork, chronic illness, childbirth and prolonged coughing. Depending on the degree of prolapse, acupuncture and herbal medicine can greatly improve prolapse.
Caroline Prodoehl, R. TCMP
Maciocia, Giovanni (1998). Gynecology & Obstetrics in Chinese Medicine. Churchill Livingstone. Ny, NY.