What Is Vaginal Prolapse?

Vaginal prolapse, also known as vaginal hernia, is when the vagina slips out of place in the body. Sometimes the vagina moves only slightly or it can shift significantly. In the most severe cases, it can protrude from the body. Vaginal prolapse can cause discomfort but can be treated with vaginal physical therapy, medication, or surgery, if necessary.

This article discusses the signs, causes, and treatment of vaginal prolapse.

Signs and Symptoms of Vaginal Prolapse

Many women do not have any symptoms of vaginal prolapse. Healthcare providers may discover it during a gynecological exam. Women who experience signs and symptoms may have:

• A feeling of fullness or bulging (may be more noticeable after coughing, lifting something, or toward the end of the day)
• Lower back pain
• Leaking urine
• Bladder infection
• Difficult bowel movements
• Discomfort during sex
• Difficulties when inserting a tampon

In severe cases, an organ may protrude through the vaginal opening.

Types of Vaginal Prolapse

There are two types of vaginal prolapse, categorized by how much the vagina has moved.

When the prolapse is small and the vagina has dropped only partway into the vaginal canal, it is called an incomplete prolapse. Larger prolapses are called complete prolapses, in which some vaginal tissue can protrude from the body.

Prolapses are also categorized by the affected organs:

• Cystocele: Bladder falls due to prolapse of front vaginal wall (if urethra also falls, it's called a cystourethrocele)
• Rectocele: Rectum falls due to prolapse of the back wall of the vagina
• Enterocele: Hernia of the small bowel due to weakened vaginal support, sometimes due to a hysterectomy
• Prolapsed uterus: Due to weak ligaments at the top of the vagina
  

Causes of Vaginal Prolapse

As many as a third of all women will have some sort of vaginal prolapse at some point in their lives. The most common causes are:

• Vaginal childbirth, especially multiple deliveries
• Menopause
• After hysterectomy
• Obesity
• Straining from lifting heavy objects or bowel movements

There are some other rare medical conditions, such as a tumor or a congenital bladder condition, that can cause prolapse.

How Is Vaginal Prolapse Diagnosed?

Healthcare providers diagnose a vaginal prolapse from a physical examination. They may ask you to move muscles like you are having a bowel movement or as if you are stopping urination.

They will also ask about any symptoms, such as incontinence, that you may be experiencing.

If a complete prolapse is suspected, they may order an imaging test such as an ultrasound to see how the prolapse may be affecting or affected by other organs.

Treatment and Prevention of Vaginal Prolapse

If the prolapse is minor and you are not having symptoms, you may not need treatment. If it is causing discomfort, treatment includes:

• Vaginal physical therapy for mild vaginal prolapse or general pelvic floor prolapse. This therapy can include Kegel exercises.
• Being fitted for a pessary, a small device inserted in the vagina that provides support.
• Surgery, usually minimally invasive, to repair weakened structures and increase support. Surgeons can also stitch the vagina shut, which stops symptoms, but you can no longer have full penetration during sex.

You can help prevent prolapse by:

• Doing Kegels
• Staying at a healthy weight
• Not smoking
• Using your leg muscles to help you lift and put down heavy objects

Summary

Vaginal prolapse is a condition in which the vagina slips down in the body. It's more common in women who have delivered several children vaginally, and in older, post-menopausal women. Vaginal prolapse may not cause any symptoms, but if it does, physical therapy and possibly surgery (if the prolapse is severe) can strengthen the pelvic muscles and help support the vagina.

A Word From Verywell

Vaginal prolapse can cause discomfort. If you notice a feeling of heaviness or like you are sitting on something that bulges, you may have a prolapse. Contact your healthcare provider or gynecologist if you experience symptoms so you can get treated.