The uterus is a muscular structure that’s held in place by pelvic muscles and ligaments. If these muscles or ligaments stretch or become weak, they are no longer able to support the uterus, causing prolapse.
Uterine prolapse occurs when the uterus sags or slips from it’s normal position and into the vagina.
Uterine prolapse can be categorized as incomplete or complete-
• Incomplete uterine prolapse –
The uterus is partially displaced into the vagina but does not protrude.
• Complete uterine prolapse-
A portion of the uterus protrudes from the vaginal opening.
The condition is graded by its severity, determined by how far the uterus has descended –
• 1st grade – descended to the upper vagina.
• 2nd grade – descended to the introitus.
• 3rd grade – cervix has descended outside the introitus.
• 4th grade – cervix and uterus have both descended outside the introitus.
More severe cases may need surgery, but in the early stages, exercises may help.
Women who have a minor uterine prolapse may not have any symptoms. Moderate to severe prolapse may cause symptoms, such as –
• the feeling that you are sitting on a ball
• increased discharge
• vaginal bleeding
• a pulling or heavy feeling in the pelvis
• the uterus or cervix protruding out of the vagina
• problems with sexual intercourse
• constipation or difficulty passing stool
• recurring bladder infections or difficulty emptying your bladder
Uterine prolapse happens when vaginal childbirth or other conditions weaken the muscles and tissues of the pelvic floor so they can no longer support the weight of the uterus. It can happen as a result of –
• Pregnancy/childbirths with normal or complicated delivery through the vagina.
• Weakness in the pelvic muscles with advancing age
• Weakening and loss of tissue tone after menopause and loss of natural estrogen.
• Being overweight or obese with its additional strain on pelvic muscles.
• Major surgery in the pelvic area leading to loss of external support.
• Conditions leading to increased pressure in the abdomen such as chronic cough, straining (with constipation), pelvic tumors, or an accumulation of fluid in the abdomen.
Uterine prolapse is often associated with prolapse of other pelvic organs. Patient might experience –
• Anterior prolapse (Cystocele)-
Weakness of connective tissue separating the bladder and vagina may cause the bladder tobulge into the vagina.Anterior prolapse is also called prolapsed bladder.
• Posterior vaginal prolapse(rectocele) –
Weakness of connective tissue separating the rectum and vagina may cause the rectum to bulge into the vagina. Patient might have difficulty having bowel movements.
Your doctor can diagnose uterine prolapse by evaluating your symptoms and performing a pelvic exam. During this exam, your doctor will insert a device called a speculum that allows them to see inside of the vagina and examine the vaginal canal and uterus.
Your doctor may ask you to bear down as if you are having a bowel movement to determine the degree of prolapse.
Treatment is not always necessary for this condition.
Nonsurgical treatments include –
• losing weight to take stress off pelvic structures
• avoiding heavy lifting
• doing kegel exercises, which are pelvic floor exercises that help strengthen the vaginal muscles
• wearing a pessary, which is a device inserted into the vagina that fits under the cervix and help push up and Stabilize the uterus and cervix.
The use of vaginal estrogen in effective in vaginal tissue regeneration and strength.
Surgical treatments include uterine suspension or hysterectomy.
• In uterine suspension. the uterus is placed back into its original position by reattaching pelvic ligaments or using surgical materials.
•In hysterectomy, the uterus is removed from the body through the abdomen or the vagina.
Surgery is often effective, but it is not recommended for women who plan on having children. Pregnancy and childbirth can put an immense strain on pelvic muscles, which can undo surgical repair of the uterus.
Ayurvedic Perspective –
According to Ayurvedic perspective uterus prolapse is the problem of Vata aggravation, with air being locked in the tissues.The Ayurvedic prolapse treatment therefore focuses on lowering Vata, taking care to avoid foods which aggravate Vata.
Some yogic practices can help greatly, though some should be avoided like kapaal bhati. The most useful practices include –
• Ashwani Mudra –
• Kumbhak Pranayam –
• Kandharasan –
• Marjarasan –
Effective Herbs –
• Bala –
• Ashwagandha –
• Ashoka –
• Majuphal –
• lajjalu –
• Lajjalu Kashayam
• Lajjalu Paste for external application
• Phal Ghrit
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