Women who have a prolapsed uterus face stress and uncertainty about their condition.
Those women who want to start or extend their family face added stress, wondering: Can you get pregnant with a prolapsed uterus?
Let’s explore this difficult question and get some answers.
What is a Prolapse?
The pelvic floor is a key part of our anatomy that we often don’t understand until something goes wrong. It’s a hammock-like structure of muscles, ligaments and tissues that support your uterus, rectum, vagina, bladder and other pelvic organs.1
When these muscles age, are damaged, or are weakened, they can lose strength to the point that they can’t support your pelvic organs. Those organs then drop from their original position, sometimes into or out of your vagina. This is called a prolapse.1
What is a Prolapsed Uterus?
A prolapse can affect different organs in your pelvis, including your bladder, vagina, bowel, rectum and uterus.
When it impacts your uterus, this is called uterine prolapse, which most often affects women after menopause who have had one or more vaginal deliveries. The uterus slips down into the vagina, or protrudes out of the vagina. It doesn’t usually require treatment, but uterine prolapse can cause discomfort, or disrupt daily life, and then treatment might be worth it.2
Sometimes it’s hard to know if you have uterine prolapse, as there aren’t always symptoms present. Signs include bulging in the vagina, feeling pressure in the pelvis or vagina, and lower back pain accompanied by bulging in the vagina.3
Can You Get Pregnant With A Prolapsed Uterus?
Uterine prolapse is common after menopause. In fact, it’s believed that nearly one-half of all women between the ages of 50 and 79 have some degree of uterine or vaginal vault prolapse, or some other form of pelvic organ prolapse. Factors that increase your risk of uterine prolapse include childbirth, age, obesity, chronic constipation and having a hysterectomy.3
But women of child-bearing age can also have a prolapse, which raises the question about becoming pregnant with uterine prolapse. The short answer is yes, pregnancy during uterine prolapse is possible. It might require careful assessment, and monitoring to prevent complications during delivery, but pregnancy during uterine prolapse is possible.4
However, it’s also true that a prolapse can impact fertility. For instance, because a prolapsed uterus is near, at or beyond the opening of the vagina, it may not be a conducive environment for sperm, which thrives in a moist warm place like the deeper parts of the vagina. A uterus that’s prolapsed out of the vagina might result in sperm being pushed outside of the vagina.5
Another exception to getting pregnant may occur if you have had some kind of medical intervention due to prolapse. Obviously, having a hysterectomy to remove your uterus is one such exception. But other treatments such as using mesh to support vaginal tissues could impact pregnancy.6
That’s why doctors typically don’t take steps to repair prolapse until women are “100% done having children,” according to Dr. Pamela Levin, a urogynecologist and Assistant Professor of Obstetrics and Gynecology with Penn Medicine. “If we repair your prolapse and then you carry another pregnancy, we may be right back where we started.”7
If you do become pregnant with uterine prolapse, your doctor may suggest a Cesarean Section rather than a vaginal birth.
See a Doctor
The first step is to seek diagnosis from a women’s health care specialist, who can also answer questions about prolapse, pregnancy and birth. Difficulty getting pregnant may not be due to prolapse. Use our Physician Finder to find a doctor near you with expertise in women’s health to help with your concerns about prolapse, pregnancy and birth.
1 https://my.clevelandclinic.org/health/diseases/16030-uterine-prolapse
2 https://www.mayoclinic.org/diseases-conditions/uterine-prolapse/symptoms-causes/syc-20353458
5 https://www.miklosandmoore.com/prolapse-and-infertility/
6 https://www.augs.org/assets/1/6/Pregnancy_in_Women_With_Prior_Treatments_for.4.pdf
