This is a question I get asked a lot as a pelvic floor physiotherapist!
Prolapse is a common condition that affects many women. It’s characterised by the descent of one or more of the pelvic organs, such as the bladder, uterus, or rectum, into the vaginal canal.
But how do you know if you have prolapse, and what’s considered normal?
Traditionally, prolapse has been defined as a visible or palpable descent of the pelvic organs. However, a recent study by Collins et al 2021 challenges this definition and proposes a new clinical definition based on patient symptoms. According to the new definition, clinical prolapse exists when a patient has descent of at least one of the vaginal walls to or beyond the hymen PLUS either bothersome symptoms such as vaginal bulging, pelvic pressure, or functional or medical compromise such as discomfort during sexual activity, secondary constipation or incontinence.
This new definition is significant because it acknowledges the importance of a patient’s symptoms.
What’s considered normal when it comes to prolapse?
Research has shown that a significant number of women experience stage 1 prolapse, and it may even be considered a variation of normal. According to Harmanli et al 2014 and Buschbaum et al 2006, stage 1 prolapse, as defined by the POP-Q system, is a common finding in young nulliparous women. In fact, 57% of women with an average age of 22 years old were found to have stage 1 prolapse based on the POP-Q. This means that a significant number of women have some degree of wall laxity, even before giving birth.
It’s important to remove fear around prolapse and normalise some degree of tissue laxity especially after a vaginal birth. Just as your breast tissue doesn’t sit in the exact same place after babies neither will your pelvic organs!
I have a lot of postpartum women contact me concerned they might have prolapse.
Let’s change the mentality around prolapse and postpartum recovery. Let’s honour the enormous physiological change that has taken place to grow and birth your baby.
Let’s give your body and pelvic floor time to rest and slowly and gradually rebuild strength, optimise breath control and return to exercise. Let’s focus on improving any symptoms and feeling excited and confident to move your body!
If you want an 8-week App-based Exercise Program designed by a Women’s Health Physiotherapist to help optimise your recovery after birth check out our Restore Your Core Programs! Or schedule a telehealth consultation with me to learn more!