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Does Your Uterus Fall Out During Menopause

What Happens At Menopause

What Causes Uterine Prolapse (Prolapsed or âFallenâ? Uterus)?

Women are born with about a million eggs in each ovary. By puberty about 300,000 eggs remain, and by menopause there are no active eggs left.

On average, a woman in Australia will have 400-500 periods in her lifetime. From about 35-40 years of age, the number of eggs left in your ovaries decreases more quickly and you ovulate less regularly until your periods stop. Menopause means the end of ovulation.

Why Does It Happen

FPHL is very common and increases with age and varies across ethnic groups. Although it can happen at any age, the condition occurs most commonly following the menopause. This does not mean that hormones alone are to blame, although oestrogen may have a protective role, helping to keep hair in the growing phase. Age itself is a factor and whilst women can take care of their hair cosmetically, it is one aspect of the ageing process we cannot always control. Genetics are important too and you may notice a family link with both male and female hair loss. Occasionally times of acute stress on the body will influence hair growth, eg illness, emotional stresses and crash dieting. Some medications may have an influence too.

What You Can Do

You might be surprised to learn that if youve given birth vaginally, you may already have some degree of prolapse. You may already be experiencing symptoms that arent giveaways of prolapsea frequent sensation of having to urinate or leaking a drop or two of urine when you run or cough, or even hip or back pain.

Whether or not youre experiencing symptoms, its important to protect your pelvic floor to ensure that mild prolapse doesnt get worse. Heres what you can do:

Eat a high fiber diet. Eating a healthy, whole foods diet with plenty of fiber can help keep you regular and prevent constipation.

Do Kegel exercises. This is one of the most important ways to strengthen your pelvic floor muscles. Heres how to do Kegels:

  • Find the right muscles: Identify your pelvic floor muscles by stopping the flow of urine midstream and squeezing your anal muscles. If youre able to do this successfully, youve identified the right muscles.
  • Get in position. You can do Kegel exercises standing up, sitting, or lying down. Many women find it easiest lying down.
  • Focus. Squeeze, tightening only the pelvic floor muscles and avoiding flexing your abdominal muscles, thighs, or buttocks. Dont hold your breathbreathe naturally.
  • Repeat. Aim for 10 repetitions, three times a day. Try doing your Kegels when you first wake up, while on break or lunch at work, and while lying in bed at night.
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    Feeling Like You’re Sitting On A Ball

    Uterine prolapse doesn’t happen uniformly in all people it can take several forms, from the uterus partially emerging into the vagina, to the uterus fully dropping into the vagina. Sometimes, the uterus is fully expelled out into the world. How do we categorize the severity of a prolapse? Prolapses are measured in degrees, as Gynecologic Specialists explains:

    In a first-degree prolapse, the uterus is only slightly lower than its normal position and most women are totally unaware that something has shifted unless their gynecologist points it out. A further drop creates a second-degree prolapse, which is the point when some women become aware that something is not quite right. Still, many women with a second-degree prolapse have no symptoms. By the time the uterus drops low enough for the vagina to be completely filled and the cervix reaches the opening of the vagina , most women are definitely aware there is a problem. When the uterus has dropped outside the vagina , this usually prompts an emergency visit.

    Second-degree prolapse is the start of the ball-sitting sensation and to be clear, we’re talking a small ball here, not a giant yoga ball. But one can also have second-degree prolapse without any symptoms.

    What Is Pelvic Organ Prolapse Do I Have It

    Uterine Prolapse â Symptoms and Diagnosis

    As women age, the changes that can happen to her body are too vast to count. Just when you think you are past the point of bleeding and pain each month, you realize you arent done with gynecological challenges just yet. Aging brings menopause, increased risks of GYN cancers, and the possibility that your uterus, bladder or rectum will start to sag into your vagina.

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    How Is Uterine Prolapse Treated

    There are surgical and non-surgical options for treating uterine prolapse. Your healthcare provider will pick your treatment path based on the severity of your prolapse, your general health, age and whether or not you want children in the future. Treatment is generally effective for most women. Treatment options can include:

    Non-surgical options

    • Exercise: Special exercises, called Kegel exercises, can help strengthen the pelvic floor muscles. This may be the only treatment needed in mild cases of uterine prolapse. To do Kegel exercises, tighten your pelvic muscles as if you are trying to hold back urine. Hold the muscles tight for a few seconds and then release. Repeat 10 times. You may do these exercises anywhere and at any time .
    • Vaginal pessary: A pessary is a rubber or plastic doughnut-shaped device that fits around or under the lower part of the uterus . This device helps prop up the uterus and hold it in place. A healthcare provider will fit and insert the pessary, which must be cleaned frequently and removed before sex.

    Surgical options

    Degrees Of Uterine Prolapse

    Uterine prolapse is described in stages, indicating how far it has descended. Other pelvic organs may also be prolapsed into the vagina.,. The four categories of uterine prolapse are:

    • Stage I the uterus is in the upper half of the vagina
    • Stage II the uterus has descended nearly to the opening of the vagina
    • Stage III the uterus protrudes out of the vagina
    • Stage IV the uterus is completely out of the vagina.

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    Bleeding In Between Periods

    Some women experience unexpected bleeding which occurs in between their normal menstrual periods. If this is heavy, prolonged or persistent it must be reported to a doctor as it may require urgent investigation. It is also important to report any bleeeding which occurs during or immediately after sexual intercourse . This may be caused by an infection or abnormality of the cervix.

    The most serious cause is cervical cancer athough this is unlikely if you have always had regular smears. Minor bleeding or spotting in between periods is unlikely to have a serious cause. Some women have slight bleeding in the middle of their cycle or in the lead up to each period. If this bleeding is light and regular it is most likely to be due to hormone changes but if in doubt always consult your doctor. Irregular bleeding or spotting may be a side effect of some hormonal treatments such as contraceptives or hormone replacement therapy.

    This is known as break through bleeding. Usually women are warned to expect this in the first few months of any treatment but if bleeding is heavy or fails to settle a pelvic examination and possibly other investigations, described in the next chapter, will be required.

    Persistent bleeding in between periods may be caused by hormonal changes or by a polyp or fibroid attached to the uterine lining. These abnormalities can be detected by ultrasound or hysteroscopy and can usually be removed by minor surgery.

    Is Mesh Safe To Use During Surgery To Repair Pelvic Organ Prolapse

    Menstrual Back Pain

    Mesh used to repair pelvic organ prolapse through the abdomen is safe. But, because of safety issues, mesh is no longer used to repair prolapse through the vagina.8

    If you had surgery with mesh to repair pelvic organ prolapse through the vagina, you may not need to do anything if you do not have any symptoms or problems. Talk to your doctor or nurse if you notice any symptoms or problems, such as vaginal bleeding or discharge, pelvic pain, or pain during sex.

    Learn more about what to do if you had this type of surgery from the Food and Drug Administration.

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    What Is The Uterus

    The uterus, referred to since Biblical times as the womb, is a very remarkable organ, capable of expanding to contain a full-grown baby and of shedding its lining up to 500 times during your life at the time of your monthly period.

    The resultant stresses and strains on its supporting structures during pregnancies and the repeated shedding and re-growth of its lining may lead to problems such as prolapse or heavy menstrual bleeding. This chapter describes what the normal uterus and its related structures look like and how they work, and summarises what may go wrong.

    When youre not pregnant, your uterus is approximately pear-sized. It has a thick muscular wall and a central cavity with a lining that is richly supplied with blood vessels. This lining is known as the endometrium and it provides nourishment for the embryo during the very early days of life. Otherwise, the lining of the uterus is shed each month, resulting in a flow of blood lasting for several days. This is known as the menstrual flow, menstruation or the monthly period.

    Perimenopause: Rocky Road To Menopause

    What are the signs of perimenopause? You’re in your 40s, you wake up in a sweat at night, and your periods are erratic and often accompanied by heavy bleeding: Chances are, you’re going through perimenopause. Many women experience an array of symptoms as their hormones shift during the months or years leading up to menopause that is, the natural end of menstruation. Menopause is a point in time, but perimenopause is an extended transitional state. It’s also sometimes referred to as the menopausal transition, although technically, the transition ends 12 months earlier than perimenopause .

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    The Fallopian Tubes And Ovaries

    The ovaries are situated on either side of the pelvis and are white, slightly knobbly and grape-sized. They are extremely important because they are the source of eggs and also of the hormones, oestrogen and progesterone , which control the menstrual cycle.

    Each month an egg is released from one of the two ovaries in turn by a process called ovulation. This occurs at around day 14 of the menstrual cycle. The egg then enters the adjoining fallopian tube, one of two long, delicate structures attached to the uterus. This is where the egg may meet up with sperm if you have had sexual intercourse, so beginning a pregnancy.

    A woman is born with a full supply of immature eggs and, from puberty onwards, these eggs gradually mature so that one is released each month until the egg supply finally runs out at the time of the menopause .

    What Is A Prolapsed Cervix

    The #1 Guide to Pelvic Uterine Prolapse: What is a ...

    A prolapsed cervix is a health condition in which the lower part of a womans uterus extends further into the vagina than it should. In severe cases, the cervix may extend so far that it actually comes out of the vaginal opening. The condition is sometimes also referred to as a uterine prolapse. It can affect any woman, but some are generally considered to be at higher risk. Depending on the severity, treatment may range from watchful waiting to lifestyle changes to surgery.

    The cervix is the bottom opening of the uterus. In most women, the cervix and uterus are normally held in place at the top of the vaginal canal by the pelvic muscles. When these muscles are injured or become weak, a prolapsed cervix can result.

    Some women may have no symptoms of a prolapsed cervix, especially if it is minor. If symptoms do occur, they may include a feeling of pressure in the vagina, pain during sex, problems urinating or backache. Women with severe cases may also feel or see the uterine tissue coming out of the vaginal opening.

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    Causes Of Pelvic Organ Prolapse

    Pelvic organ prolapse happens when the group of muscles and tissues that normally support the pelvic organs, called the pelvic floor, becomes weakened and cannot hold the organs in place firmly.

    A number of things can weaken your pelvic floor and increase your chance of developing pelvic organ prolapse.

    These include:

    • pregnancy and childbirth especially if you had a long, difficult birth, or if you gave birth to a large baby or multiple babies
    • getting older and going through the menopause
    • being overweight

    The 4 main types of prolapse are:

    • the bladder bulging into the front wall of the vagina
    • the womb bulging or hanging down into the vagina
    • the top of the vagina sagging down this happens to some women after they have had surgery to remove their womb
    • the bowel bulging forward into the back wall of the vagina

    It’s possible to have more than 1 of these at the same time.

    Pelvic organ prolapse will usually be classified on a scale of 1 to 4 to show how severe it is, with 4 being a severe prolapse.

    Page last reviewed: 24 March 2021 Next review due: 24 March 2024

    What Is The Pelvic Floor

    The pelvic floor is a hammock-like system of muscles that keeps your pelvic organsuterus, vagina, bladder, urethra, and bowelfirmly in place.

    The pelvic floor muscles are part of your core they help your body maintain intra-abdominal pressure when you sneeze, cough, laugh, or otherwise physically exert yourself. If youve given birth and you notice that you lose a drop or two of urine when you laugh, cough, sneeze, or exercise, youre not alone. A quarter to a third of women in the U.S. will experience it at some point.1,2 Its called stress urinary incontinence, and it happens when the pelvic floor muscles become weakened.

    Since the pelvic floor muscles are also involved in orgasm, weak muscles can lead to diminished sexual satisfaction during vaginal intercourse.

    When the pelvic floor muscles become weakened from pregnancy, childbirth, or changes that occur during menopause, an organ can slip from its normal position in the pelvis and begin pressing against the vaginal wall. In the case of a prolapsed uterus, the organ can begin to slide down into the vagina.

    Any of the pelvic organs can be affected by prolapse in fact, the bladder is the most commonly affected organ, with the uterus not far behind.

    The following conditions can cause uterine prolapse:

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    Are There Risk Factors

    The risk of having a prolapsed uterus increases as a woman ages and her estrogen levels decrease. Estrogen is the hormone that helps keep the pelvic muscles strong. Damage to pelvic muscles and tissues during pregnancy and childbirth may also lead to prolapse. Women whove had more than one vaginal birth or are postmenopausal are at the highest risk.

    Any activity that puts pressure on the pelvic muscles can increase your risk of a uterine prolapse. Other factors that can increase your risk for the condition include:

    Treat Promptly And Work Toward Prevention

    And then my uterus fell out! Review

    There are several measures that you can take to tackle as well as lower your risk of getting a prolapsed uterus:

    Treatment: Your doctor may advise exercises that strengthen your pelvic floor muscles or estrogen treatment if you have a prolapsed uterus. You may also be given a pessary, which is a disc inserted into your vagina that acts as a support. Some women may also be advised surgery to either repair weak tissues or remove the uterus.

    Prevention: Incorporate regular physical activity into your life and make sure you do exercises that strengthen your pelvic floor. Also, avoid lifting heavy things and keep constipation at bay by having high fiber foods and drinking lots of fluids.8

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    How To Treat Vaginal Prolapse

    Most vaginal prolapses will gradually worsen over time and can only be fully corrected with surgery. However, the type of treatment that is appropriate to treat a vaginal prolapse depends on factors such as the cause and severity of the prolapse, whether the woman is sexually active, her age and overall medical status, her desire for future childbearing, and her personal preference.

    • Nonsurgical options may be most appropriate for women who are not sexually active, cannot undergo surgery because of medical reasons, or experience few or no symptoms associated with the condition.
    • Surgical repair is the treatment option that most sexually active women who develop a vaginal prolapse choose because the procedure is usually effective and durable.

    What Are Proper Lifting Techniques

    There are several tips for lifting heavy objects that can help you avoid injury. These techniques for lifting include:

    • Do not try to lift objects that are oddly shaped or too heavy for you to lift alone. Also, avoid lifting heavy objects above waist level.
    • Before you lift an object, make sure you have firm footing.
    • To pick up an object that is lower than the level of your waist, keep your back straight, and bend at your knees and hips. Do not bend forward at the waist with your knees straight.
    • Stand with a wide stance close to the object you are trying to pick up, and keep your feet firm on the ground. Tighten your stomach muscles and lift the object using your leg muscles. Straighten your knees in a steady motion. Do not jerk the object up to your body.
    • Stand completely upright without twisting. Always move your feet forward when lifting an object.
    • If you are lifting an object from a table, slide it to the edge to the table so that you can hold it close to your body. Bend your knees so that you are close to the object. Use your legs to lift the object and come to a standing position.
    • Hold packages close to your body with your arms bent. Keep your stomach muscles tight. Take small steps and go slowly.
    • To lower the object, place your feet as you did to lift, tighten stomach muscles and bend your hips and knees.

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