Prolapse at a Young Age
What Can Cause a Prolapse at a Young Age?
The cause of a prolapse, whatever pelvic organ it affects and whatever age you are, is a weakened pelvic floor. When the pelvic floor becomes loose, or is weakened, a pelvic organ prolapse occurs. Any one of the organs, or multiple organs, can prolapse downwards and press against the vagina.
Pregnancy and Childbirth
Pregnancy and childbirth are the main causes of a weakened pelvic floor, and therefore a common cause of prolapse in younger women. This is because:
- carrying a baby, especially a heavy one, can cause the pelvic floor muscles to stretch and loosen beyond their rebound limits
- pregnancy hormones cause the pelvic floor muscles to relax to accommodate the baby and prepare for childbirth
- a vaginal delivery, especially a traumatic one with lots of pushing and some tearing can do the same
- giving birth vaginally can cause scar tissue and nerve damage to the pelvic floor muscles, even more so if forceps are used
- more than one baby or more than one pregnancy can make matters worse
Other Causes of Pelvic Organ Prolapses
Younger women who haven’t had children can also suffer a pelvic organ prolapse due to other factors which result in a weakened pelvic floor:
- chronic lung disease such as bronchitis or asthma, or smoking, all of which can cause a persistent and heavy cough which puts pressure on the pelvic floor muscles
- connective tissue or collagen disorders such as lupus or rheumatoid arthritis could possibly be a risk factor
- having had previous surgery for abdominal hernias
- being overweight or obese from a very young age
- having persistent and regular constipation, meaning that you have always had to strain to pass a bowel movement
- having a job that requires lifting heavy loads, such as working in the building trade, or in nursing where you have to lift patients
- having a hysterectomy (a complete removal of the womb) means that the top support for the vagina is no longer present and can cause the vagina to collapse in on itself (a vaginal vault prolapse)
What Are the Symptoms of a Prolapse at a Younger Age?
If you know which pelvic organ prolapse you are suffering from, visit the Types of Prolapse page for more specific information. The symptoms of a pelvic organ prolapse do not differ depending on age. However, depending on your overall health and the stage of your prolapse, you may experience some or all of the following symptoms:
- difficulty or pain when having sex
- loss of sensation or ‘tightness’ when having sex
- difficulty urinating
- a frequent urge to urinate
- an urgent urge to urinate
- frequent bladder infections such as cystitis
- feeling unsatisfied that you’ve emptied your bladder after going to the toilet
- urinary incontinence – the inability to hold in urine
- urinary stress incontinence – the inability to hold in urine when you cough, laugh or run etc.
- pain in the lower back or pelvic area
- unusual bleeding not associated with your period
- a feeling of pressure inside the vagina
- a feeling that there is something inside the vagina
- a dragging feeling inside the vagina
- tissue protruding to the outside of the vagina
What Can Be Done to Prevent Prolapse in Younger People?
As with any medical complaint, prevention is better than cure. There are many lifestyle habits you can take to help prevent a weakening of the pelvic floor muscles and subsequent prolapse, regardless of whether you’ve had children or not:
- maintain a healthy weight of less than 30 BMI -as recommended by the National Institute for Heath and Care Excellence (NICE)
- eat a healthy diet full of fibre to avoid constipation
- stay well hydrated to avoid constipation
- use a toilet stool to go to the toilet in a more natural ‘squat’ position and avoid straining
- seek medical help or take steps to avoid a chronic cough (such as quitting or not taking up smoking)
- learning to lift properly or avoiding lifting altogether, the National Health Service (NHS) suggest holding the load close to your waist and avoid bending your back
- reduce high impact exercise such as running and choose pelvic floor friendly lower impact exercise
- do Kegel / or pelvic floor exercises daily!
- make your pelvic floor exercises more beneficial by doing them with a Kegel8 Ultra 20 Electronic Pelvic Toner
These preventative steps, due to their strengthening of the pelvic floor, will reduce your risk of suffering from a severe prolapse in the future.
What Treatment is Available for Prolapses at a Young Age?
If you have a pelvic organ prolapse, and you’re a younger woman, your doctor will usually avoid surgery and only perform it if it is absolutely necessary. This is because falling pregnant after a vaginal prolapse repair will likely mean that the operation will be undone and will need to be carried out again. Instead, your doctor will usually ask you to make the preventative lifestyle changes mentioned above. These are often enough to treat mild and moderate prolapses.
They may suggest fitting a vaginal pessary to support your prolapse. It’s a small device, usually made from silicone, that is placed inside the vagina to help support the vaginal wall and prevent other pelvic organs collapsing further into it. Different shapes and sizes of vaginal pessaries suit different shapes and sizes of women. Your doctor can help you find the right one and help you change the pessary every four to six months. This is commonly the favoured treatment for those unable to undergo surgery due to other medical conditions or those wishing to have children in the future. Some vaginal pessary's prevent sexual activity, however there are some available that can be used if you wish to remain sexually active,
To read more about other treatment options, visit the prolapse treatment page. If you know which pelvic organ prolapse you are suffering from, visit the types of prolapse page for more detailed treatment explanations.
Mørkved, S. Salvesen, K. Å. Salvesen, Ø. Volløyhaug, I. (2015). Ultrasound in Obstetrics & Gynecology. Forceps delivery is associated with increased risk of pelvic organ prolapse and muscle trauma: a cross-sectional study 16-24 years after first delivery. [online] 46(4), p 487-495. [viewed 22/03/2018] Available from: https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1002/uog.14891
NHS. (2016) Safe lifting tips [online] National Health Service, 2016 [viewed 20/03/2018]. Available from: https://www.nhs.uk/livewell/workplacehealth/pages/safe-lifting-tips.aspxNHS. (2018) Pelvic organ prolapse [online] National Health Service, 2018 [viewed 14/03/2018]. Available from: https://www.nhs.uk/conditions/pelvic-organ-prolapse/
NICE. (2015). Urinary incontinence in women: management, 1 Recommendations [online] National Institute for Health and Care Excellence, 2015 [viewed 14/03/2018]. Available from: https://www.nice.org.uk/guidance/cg171/chapter/1-Recommendations#physical-therapies
Women's Health Concern. (2015). Prolapse: Uterine and vaginal [online] Women's Health Concern, 2015 [viewed 14/03/2018]. Available from: https://www.womens-health-concern.org/help-and-advice/factsheets/prolapse-uterine-vaginal/