The Symptoms of a Prolapsed Uterus
The symptoms of prolapse vary depending upon how far the uterus has slipped or dropped into the vaginal canal. A woman with a mild prolapse may notice few, if any, symptoms at all, while a woman with a severe prolapse will experience extreme discomfort. If the woman sits or stands for a long period, the pressure can increase and cause some of the symptoms to worsen. Symptoms will also be worse if a woman with prolapse – whether mild, moderate, or severe – tries to lift something that is heavy or strains during constipation. Additionally, symptoms tend to get worse as the day goes on.
Potential symptoms include:
Painful sexual intercourse. This is due to the dropped position of the uterus in the vaginal canal, which will restrict penetration. In a mild case, the woman’s cervix may drop lower in the vagina, which can inhibit the depth of penetration during sexual intercourse, and discomfort or pain may result. In moderate or severe cases, the cervix and/or uterus actually drops out of the vagina, making sexual intercourse impossible.
A sensation of sitting on a small ball. Many women with a dropped uterus report that they feel as though they are sitting on a small ball. This is due to the lower position of the uterus closer to the vagina, so in a sense, the feeling is literal.
Back pain. For some women, the incorrect position of the uterus causes pain and discomfort in the lower back.
Pulling sensation. Some women report a feeling of “pulling” in the pelvic area. This may be due to stretched muscles and ligaments as the uterus is “pulled” down from its normal position in the pelvis.
A feeling that something is coming out of the vagina. Many women experience this sensation before they can actually feel the cervix or uterus at the opening of the vagina. This is one of the symptoms that should be examined right away, as it is a strong indication that uterine prolapse has occurred.
Urinary and bowel problems. It is common for women with uterine prolapse to experience a need to urinate more often, urinary dribbling, or a strong need to urinate even when the bladder is not actually full. Some women also experience difficulty with bowel movements.
Bladder infection. The incorrect position of the uterus sometimes affects the bladder, making the woman more vulnerable to the introduction of bacteria in the bladder, which can cause one infection after another.
Discomfort while walking. This symptom is more likely to be experienced in advanced cases.
Vaginal bleeding. Women with severe cases of uterine prolapse are most likely to experience vaginal bleeding.
Excessive vaginal discharge. For some women, the prolapsed uterus causes an increase in their normal amount of vaginal discharge.
How is Uterine Prolapse Diagnosed?
If the cervix and uterus are protruding from the vagina, the diagnosis is obvious. If the patient is experiencing only mild symptoms, however, a pelvic examination is required to make a definitive diagnosis. The examination, which involves inserting a speculum into the patient’s vagina, may be conducted while the patient is lying down and/or standing. The physician usually asks the woman to bear down as in having a bowel movement, which will help the doctor to see how far the uterus has moved down the vaginal canal. In very severe cases, other organs, such as the bladder and urethra, may have descended farther into the vaginal canal as well.
While imaging tests are not usually utilized in the diagnosis of uterine prolapse, the doctor may recommend an ultrasound or MRI (magnetic resonance imaging) in advanced cases in order to determine the severity of the prolapse.