uterine prolapse stages

Essential facts you need to know about uterine prolapse

The uterus, or womb, is central to the female reproductive system and under normal circumstances is held in place within the pelvis by its attachment to the Fallopian tubes, as well as various ligaments and muscles. Certain events, such as childbirth involving a difficult labour, and vaginal deliveries, can weaken the tissues holding the uterus in place. This, coupled with the natural ageing process and a decrease in the oestrogen hormone levels result in the uterus moving down, and into the vaginal canal. This is the condition known as a prolapsed uterus.

It is possible for the uterus to ‘sag’, and in some cases come out of the body completely. This process occurs in several stages or degrees.4 stages of uterine prolapse

First degree

The cervix begins to descend towards and into the vagina.

Second degree

The cervix moves further down and into the vaginal opening.

Third degree

The cervix moves so that it is outside the vagina.

Fourth degree

The whole of the uterus descends to the point where it is outside of the vagina. This stage of a prolapsed uterus is also known as procidentia, and it’s caused by a weakness in all of the ligaments that should support the uterus and hold it in place within the pelvis.

Further conditions

There are several other conditions that are often associated with a prolapsed uterus. They cause a weakening of the ligaments and muscles that should hold the uterus in place, but instead allow the prolapse to occur. These conditions include Cystocele, which is a herniation, or ‘bulging’ of the uppermost part of the front vaginal wall, caused by a portion of the bladder encroaching into the vagina. It can cause several bladder problems, including urine retention, or an urgent or frequent need to urinate.

Another common condition associated with a prolapsed uterus is Enterocele, which is the herniation of the vagina along its upper most side, due to a portion of the small intestines protruding into the vagina. This results in a pulling sensation when standing, as well as backache, which is relieved upon lying down.

Finally, the protrusion of the back virginal wall, sometimes caused by the rectum bulging forwards, can cause a prolapsed uterus. Known as Rectocele, this condition can result in difficult bowel movements.

For more information about uterus prolapse, or Mr Jonathan Broome’s sacrohysteropexy procedure, contact The Pelvic Clinic today.


exercise for prolapse

Create a pelvic-healthy January exercise regime

If one of your New Year’s resolutions is to do more exercise, you may have already thrown yourself into a new sport or activity; the question is, do you know if your new exercise regime is good for your pelvic floor? No matter if you’re awaiting prolapse surgery or have undergone prolapse repair, it’s incredibly important that you choose the right types of exercise and physical activity to prevent worsening your prolapse problem. Here are our tips to help you set off on your January exercise regime in the healthiest way possible.

Consult your doctor before doing high impact exercise

Jogging, aerobics, Zumba and other similar high impact exercise can put a great deal of pressure on your pelvic floor and prolapse, so consult with your doctor to check that it will be safe for you. Your doctor may recommend that you limit weekly exercise sessions, or make you aware of activities that could be particularly harmful or beneficial for your unique circumstances.

Try yoga or Pilates

Yoga and Pilates are both gentle exercises that help you to strengthen your core, which is very important for pelvic floor strength. Plus, they help you to focus on slow, steady breathing as you move from pose to pose which is really important, since holding your breath during exertion can put extra pressure on the pelvic muscles.

Work with a personal trainer

A personal trainer will create a bespoke exercise regime that works for your body; if you make them aware of your prolapse problems or surgeries they will be able to guide you through specific routines that will strengthen your muscles without causing undue pressure or damage. They will also prevent you from overexerting yourself in particularly risky positions such as squats or lunges, something that can occur all too easily when following along in a group exercise class.

Alternate high and low impact exercise

Even if your doctor has given the go-ahead for you to do high impact exercise, you should make an effort to intersperse it with gentler activities that will give your core and pelvic muscles chance to rest and recuperate. Walking, gentle swimming and slow cycling are all great ways to get your body moving without too much overexertion, so be sure to do these activities in between high impact sessions.

If you need any advice or help regarding your own situation, please do not hesitate to contact us.


Understanding the menopause and how it can weaken your pelvic floor

Most people know that the menopause is the time in a woman’s life when her menstrual cycle ceases, and she becomes infertile. The average age for this to happen is between 45 and 55, and it is often confirmed medically when no menstrual bleeding has occurred for at least one year.

Symptoms of menopause

The menopause rarely happens suddenly; for the vast majority of women it can be felt to be on its way for months or even years before menstruation stops altogether. Periods become more irregular, they may be lighter or heavier, longer or shorter in duration, and the time between them can alter as well. Another very common symptom is experiencing hot flushes, when sweating and reddening of the skin can occur out of the blue, along with shivering and even light-headed spells. These hot flushes can last from just a few seconds up to a few minutes, and usually stop after one or two years. Other symptoms associated with the menopause are sleeping issues, vaginal dryness and itchiness, and mood disturbances. Other health problems that may arise are osteoporosis, where the bones can become softer and more brittle, and changes in blood lipids, or fats, that may require medication.


These symptoms are caused by alterations in the female sex hormones – hormones that can have very profound effects on the body and mind. These hormones are responsible for the workings and maintenance of the female reproductive organs and their associated tissues. When hormone levels drop, these tissues are affected and become weaker. The weakening of the tissues and muscles around the uterus and pelvis can leave you at an elevated risk of vaginal prolapse. If you have any discomfort in the area, or are experiencing any of the other symptoms detailed on the Pelvic Clinic website, you should arrange an assessment.

Maintaining a healthy pelvic floor

The best way to maintain a healthy pelvic floor post-menopause is to get regular moderate exercise, such as walking. Exercises can also be performed to more directly target the muscles in question. These include Kegel exercises and the plank. Performing these exercises regularly, whether you have symptoms of prolapse or not, can help you maintain good health and prevent any problems occurring in the future. If you have any concerns, you can always seek the opinion of a specialist such as Mr Broome who will be able to advise you.

Why you should talk about uterus problems

Whilst we’re quick to tell people if we suffer from a cold, sprained ankle and many other medical conditions, when it comes to problems related to our intimate health we tend to clam up and keep quiet. This is understandable as it can be embarrassing to discuss issues such as uterus problems, pelvic pain, urine leaks and prolapse. However, we could be doing more harm than good by failing to talk about these crucial issues.

You’re not alone

Whilst you may not wish to tell the world and his dog about your prolapse, confiding in trusted friends can help you to get the worry off your chest and help them to understand when you don’t seem like yourself. You may also find that they themselves are suffering from similar symptoms or have had the same problem in the past. It can be useful to know you’re not alone and to share advice on getting better. Furthermore, your experience may motivate others to get medical help for uterus problems which they have previously been avoiding.

Opening up is the first step to treatment

If you suffer from any symptoms of prolapse it is essential that you see a doctor as soon as possible in order to get the medical treatment or prolapse repair surgery you need to continue with a pain-free life. It can be daunting telling your GP about intimate issues, but the sooner you do, the sooner it can be fixed.

Confide in your partner

Uterus pain and prolapse can make intimacy and sex painful for you, and this may come between you and your partner. Chatting to your partner about how you’re feeling and about your medical condition will help them to understand the reasons why you may have been avoiding intimacy and ensure that you remain emotionally close during the times where you need to stay strong, during your prolapse repair surgery and recovery.

Although intimate health, incontinence and prolapse are somewhat ‘taboo’ issues, they shouldn’t be since they are so crucial to our health. The more we talk about them, the easier it is for women everywhere to have the confidence to get help.