Lots of women have pelvic organ prolapse (POP). And lots of women with the condition also want to get pregnant, leading to the next logical question: can you get pregnant with pelvic organ prolapse?
Good news! You can still get pregnant if you have POP. That said, if POP makes sex painful for you, you may find it more challenging to conceive naturally. And POP presents extra challenges during pregnancy and delivery—which is why women with POP who want to have children should speak to their doctors.
Here’s what you need to know.
Pelvic Organ Prolapse
As you probably know if you’re worried about POP and fertility, prolapse is a condition where one of the pelvic organs (primarily the uterus, bladder, or rectum) drops into or out of the vagina (or sometimes the anus). While not life threatening, POP can be uncomfortable, make penetration painful or difficult, and/or affect the quality of your life.
POP happens when the pelvic floor muscles, which are supposed to hold up your pelvic organs, become too weak to do so. Perhaps ironically for any woman who would like to have more than one child, pregnancy is one of the biggest culprits of the condition.
- Pelvic Floor Exercises (Kegel Exercises): Regularly performing pelvic floor exercises, often referred to as Kegel exercises, can help strengthen the pelvic floor muscles, which may provide support to the prolapsed organs. Consult a healthcare provider or physical therapist for guidance on how to perform Kegel exercises correctly.
- Maintain a Healthy Weight: Excess body weight can place additional strain on the pelvic floor muscles and exacerbate POP symptoms. Maintaining a healthy weight through a balanced diet and regular exercise can be beneficial.
- Fiber-Rich Diet: Constipation can worsen POP symptoms, so including high-fiber foods in your diet can help prevent constipation and reduce straining during bowel movements.
- Avoid Heavy Lifting: Limit heavy lifting, as it can put extra pressure on the pelvic area. When lifting, use proper body mechanics and engage your core muscles.
- Pelvic Floor Support Devices (Vaginal Pessaries): In consultation with a healthcare provider, women with POP may use a pessary, a device inserted into the vagina to provide support to the prolapsed organs. These devices should be fitted and managed by a healthcare professional.
- Good Bowel Habits: Ensure regular and soft bowel movements to prevent straining. Drinking plenty of water and incorporating fiber-rich foods can aid in bowel regularity.
- Bladder Management: Maintain healthy bladder habits, such as emptying the bladder regularly and avoiding excessive fluid intake close to bedtime to reduce the risk of urinary symptoms.
- Posture and Body Mechanics: Pay attention to your posture and body mechanics during daily activities. Avoid prolonged periods of sitting or standing, and use proper techniques when lifting or carrying objects.
- Pelvic Floor Physical Therapy: Consider consulting a pelvic floor physical therapist who can provide personalized exercises and techniques to address POP symptoms.
- Stress Management: Stress can exacerbate POP symptoms. Practicing relaxation techniques such as deep breathing, meditation, or yoga may help manage stress and improve overall well-being.
- Supportive Undergarments: Wearing supportive undergarments like a well-fitted, supportive bra or a supportive panty may offer some relief from the sensation of pelvic pressure.
That said, POP is certainly not a life sentence, nor will it prevent you from becoming pregnant. It’s also not a given. Doing things like Kegels and maintaining a healthy weight can help prevent or treat POP. And there are many other surgical and non-surgical treatments available—learn more about treatment options for POP here.
All of which is to say that if you suspect you have this condition, and especially if you would like to have more children, then you should speak to your doctor. There’s simply no reason to suffer in silence!
It’s also important to note that surgical options are typically only available to women who are positive they don’t have to have more children. This isn’t because the surgery will make you infertile, but because future pregnancies may lead to more POP.
“With very few exceptions, we don’t repair prolapse until women are 100% done having children,” says Dr. Levin of Penn Medicine. “If we repair your prolapse and then you carry another pregnancy, we may be right back where we started.”
How to Know if You Have a Prolapsed Uterus:
- Feeling of Pressure or Discomfort: One of the most common signs is a sensation of pressure or heaviness in the pelvic area. It might feel like something is falling or bulging into the vaginal canal.
- Visible or Sensible Bulge: In more advanced cases, you might notice a bulge or something protruding from the vaginal opening. This can be the uterus itself or other pelvic organs like the bladder or rectum.
- Backache or Pelvic Pain: Some women with uterine prolapse experience lower back pain or pelvic discomfort, especially during activities like lifting heavy objects or standing for long periods.
- Urinary Symptoms: You may have difficulty controlling your urine flow, leading to urinary incontinence or frequent urination. This is because the prolapsed uterus can put pressure on the bladder.
- Difficulty with Bowel Movements: In severe cases, a prolapsed uterus can affect bowel movements, causing constipation or difficulty passing stools.
Degrees of Uterine Prolapse:
The severity of uterine prolapse is typically categorized into four degrees:
- Grade 1 (Mild): The uterus has dropped slightly and is close to its normal position. Symptoms are often minimal, and some women may not even notice it.
- Grade 2 (Moderate): The uterus has descended further into the vaginal canal but hasn’t protruded out of the vaginal opening. Symptoms like pressure and discomfort become more noticeable.
- Grade 3 (Severe): The uterus protrudes out of the vaginal opening, either partially or completely. This is often visible or palpable as a bulge.
- Grade 4 (Complete): The uterus is entirely outside the vagina, which is a severe and uncommon form of prolapse. This is considered a severe prolapse and you should consult your doctor before getting pregnant.
The Difference Between POP and a Uterine Prolapse
A prolapsed uterus and a prolapsed bladder are two distinct medical conditions, but they can sometimes have similar symptoms. A prolapsed bladder, also known as a cystocele, happens when the wall between the bladder and the vaginal wall weakens or stretches, allowing the bladder to drop into the vaginal canal. This condition is specifically related to the bladder and its support structures.
Symptoms of Prolapsed Bladder (Cystocele):
- Feeling of pressure or fullness in the vaginal area.
- Urinary symptoms, such as frequent urination, difficulty emptying the bladder completely, or urinary incontinence.
- Pain or discomfort during sexual intercourse.
- A bulge or something protruding into the vaginal canal, especially when straining or bearing down.
How to Know if You Have a Prolapsed Bladder: If you experience symptoms like pressure in the vaginal area, urinary problems, or notice a bulge in the vaginal canal, it’s essential to consult a healthcare provider, often a urogynecologist or a urologist. They can perform a physical examination, sometimes involving bladder testing, to diagnose a prolapsed bladder (cystocele) and recommend appropriate treatment, which may include pelvic floor exercises, a pessary, or surgery.
POP & Fertility
POP alone won’t make you infertile. But like we’ve covered, it can make penetrative sex painful or uncomfortable. If this is the case for you, you may want to speak to your doctor about IVF or other fertility treatments.
The following resources might also help:
- Causes and Treatment of Pelvic Pain During Sex
- Pelvic Floor Physical Therapy For Painful Sex
- Sex Positions To Reduce Pelvic Pain
POP & Pregnancy
Finally, given the realities of POP, you may be wondering if you even want to get pregnant if you have the condition.
Again, it’s always important to talk to your doctor about your condition and your concerns. That said, you can have a healthy baby if you have POP, although your pregnancy will have to be closely monitored.
According to the Journal of Medical Case Reports, “pregnancy during uterine prolapse is possible and that careful assessment is required to prevent complications during delivery. According to our experience, an elective caesarean section near term could be the safest mode of delivery.” 1
POP & Vaginal Birth
A pelvic organ prolapse can potentially affect vaginal delivery during pregnancy. The impact of the prolapse on childbirth can vary depending on several factors, including the type and severity of the prolapse, the individual’s overall health, and their pregnancy history.
The severity of the prolapse plays a crucial role. A mild to moderate prolapse may not necessarily pose significant obstacles to vaginal delivery, although it can increase the risk of certain complications during labor and delivery.
Our advice? Speak with a pelvic floor specialist if you think you have POP or are at risk for developing it, whether or not you plan to get pregnant. You can use our Physician Finder to find one in your area.