If you are a woman, and you have had children, know that you are not immune to experiencing in your life what is commonly called “organ descent”. Pelvic organ prolapse is indeed far from rare. Specialists interviewed in the magazine Self evoke a striking reality: approximately 50% of women will develop prolapse at some point in their lives, with the risk increasing markedly with age.
One in 2 women, really?
Does the rate seem exaggerated to you? This is not the case. According to the High Authority of Health, between 30% and 50% of women of all ages, in theory, are affected by this genital pathology.
In practice, these figures are even more straightforward. Dr. Odile Bagot, gynecologist, consulted by True Medical sees them every day in her practice. “Among women over 50, half have at least one stage I cystocele, especially those who gave birth vaginally. she confirms.
This high frequency is explained by the transformations that the pelvic floor undergoes throughout life. Pregnancy, childbirth, hormonal decline linked to menopause or even certain physical constraints gradually weaken the muscles and tissues that support the organs of the pelvis. When these structures lose their tone, the organs can descend slowly: this is called a prolapse, which is not a bad word.
What is pelvic organ prolapse?
The pelvic floor functions like a muscular hammock responsible for holding the bladder, uterus, vagina, rectum and sometimes the small intestine in place. When it becomes loose or damaged, these organs can slide down and put pressure on the vaginal wall.
Depending on the organ concerned, we speak of cystocele when the bladder descends, hysterocele when it is the uterus, or even rectocele when the rectum is involved. In the most advanced forms, a protrusion may appear at the entrance to the vagina.
“However, in the majority of cases, the phenomenon remains moderate and evolves gradually over several years” rassures our expert.
Age is the main risk factor. Decreased estrogen weakens supporting tissues, making prolapses more common during perimenopause and menopause. Pregnancies and vaginal deliveries also increase the risk, as do certain situations that increase abdominal pressure, such as chronic constipation, persistent cough, obesity.
Symptoms that are sometimes discreet… or even non-existent
One of the particularities of prolapse is that it can remain asymptomatic for a long time. Many women live with organ descent without feeling any real discomfort. It is often during a gynecological examination that the diagnosis is made.
When signs do appear, they are usually progressive. Dr. Bagot describes in particular a feeling of intimate embarrassment, “as if a tampon was placed too low“, or the perception of a small ball bulging. Some women also report a feeling of heaviness in the pelvis or the impression of being seated on an object.
“More rarely, urinary problems may occur, with a weaker stream or the need to push to urinate. Difficulty having a bowel movement may also appear if the rectum is involved.” Discomfort during sex or a feeling of pelvic pressure are also possible.
The specialist, however, insists on the slow nature of the evolution: it is generally not necessary to consult urgently.
While waiting for medical advice, it is advisable to avoid anything that increases abdominal pressure, such as carrying heavy loads, poorly performed abdominal exercises or bouts of constipation.
What treatments to relieve or correct a prolapse?
Good news also, there are ways to treat this prolapse, or reduce its effects.
“Treatment depends above all on the intensity of the symptoms and the impact on quality of life. When there is no discomfort, simple medical monitoring may suffice.”
- In beginner forms, hygienic and dietary measures are often recommended, including weight loss and treatment of constipation.
- Perineal rehabilitation also plays an important role. It helps strengthen the pelvic floor muscles and limit the worsening of the prolapse, even if it does not correct the already established descent.
- The vaginal pessary is another option. This silicone device, placed in the vagina, supports sagging organs and can improve everyday comfort.
Dr Bagot emphasizes that this solution is now being offered earlier and earlier, including in relatively young women, even if many patients end up considering surgical intervention.
In more advanced forms or when the discomfort becomes significant, reconstructive surgery makes it possible to put the organs back in place and restore pelvic support. According to recommendations, approximately 10 to 20% of prolapses require an operation.
On the other hand, the installation of Prolift type vaginal prostheses (a synthetic mesh implanted to treat prolapse) is no longer considered. The device is still at the heart of an international health scandal today due to serious complications: chronic pain, infections, organ perforations, sexual disorders, etc.
Break the taboo to take better care of yourself
Despite its frequency, prolapse remains a difficult subject to discuss. Many women feel ashamed or mistakenly believe that this is a rare or abnormal phenomenon.
However, specialists point out that it is a very common disorder, linked to hormonal and obstetric history. Being attentive to unusual sensations, consulting in the event of persistent discomfort and knowing the existing solutions are essential steps to preserve your comfort and quality of life.