What causes uterine prolapse?

Written by Xu Xiao Ming
Obstetrics and Gynecology
Updated on December 15, 2024
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The most common causes of uterine prolapse can be categorized into three types.

The first type is childbirth injury, which is the main cause of uterine prolapse. During childbirth, especially with vaginal surgical assistance or prolonged second stage of labor, uterine prolapse can occur.

The second cause is long-term increased intra-abdominal pressure, such as chronic coughing, habitual constipation, prolonged standing, or weightlifting. These factors can contribute to uterine prolapse.

The third type involves poor development or degenerative changes in the pelvic tissues. This mainly refers to uterine prolapse due to congenital deficiencies in pelvic floor development. Generally, childbirth injuries are the most common cause.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Can you get pregnant with uterine prolapse?

When women experience uterine prolapse, if it is only mild or moderate, it usually does not affect their ability to become pregnant normally. In most cases, when the woman lies down, the protruding part of the uterus might naturally retract, or it can be manually pushed back into the vagina. During intercourse, after ejaculation, the cervix may still be immersed in semen, allowing sperm to pass through the cervix smoothly, and the woman can become pregnant normally. However, in cases of severe uterine prolapse, such as when the entire uterus descends outside the vagina, and cannot be repositioned back into the vagina even when lying down, during intercourse, the ejaculated semen may not sufficiently immerse the cervix, and sperm may not be able to normally enter the cervix and uterine cavity. Additionally, many women with severe uterine prolapse might experience cervix erosion, bleeding, and infection due to friction, which can produce inflammatory cells that hinder the normal passage of sperm, leading to difficulties in conception.

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Written by Li Shun Hua
Obstetrics and Gynecology
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Can an ultrasound detect uterine prolapse?

Uterine prolapse cannot be detected through an ultrasound, because during the ultrasound when it is necessary to hold urine, the uterus is lifted, so the degree and severity of uterine prolapse cannot be determined by this method. Uterine prolapse can be diagnosed by a gynecologist's examination, which can also determine the severity of the prolapse. Treatment methods should be determined based on the severity of the prolapse and the symptoms of the patient. Mild uterine prolapse might recover through treating the underlying disease and exercising. However, uterine prolapse of second degree or higher must be treated surgically to be restored to the normal position.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Natural childbirth uterine prolapse manifestations

After vaginal childbirth, women may experience uterine prolapse due to being over-fatigued or engaging in physical labor too soon. Most women with mild symptoms show no clinical signs. As the symptoms worsen, some women may feel a sense of heaviness in the lower abdomen, and this sensation intensifies when squatting or using the restroom, with a feeling of heaviness in the vulva. Some women may feel something protruding from the vagina, which can be retracted back into the vagina when lying flat; this is uterine prolapse after childbirth. Typically, this condition can be improved by performing anal contraction exercises.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Can you have sexual intercourse with uterine prolapse?

When a woman experiences uterine prolapse, it generally does not affect normal sexual activity, as symptoms might improve in a supine position, regardless of the type of prolapse. For instance, with moderate uterine prolapse, where the cervix protrudes beyond the vaginal opening, it might retract back into place when lying down. However, during sexual activity, cleanliness and hygiene should be considered. When uterine prolapse is severe, part of the uterus may be exposed at or outside the vaginal opening. Prolonged walking or other activities can cause friction, leading to possible cervical erosion and infections. Therefore, during intercourse, actions should not be too rough as it may exacerbate erosions or cause bleeding.

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Written by Shen Li Wen
Obstetrics and Gynecology
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What should not be eaten with uterine prolapse?

When a woman has uterine prolapse, it is best to avoid eating foods that are high in fats, such as fatty lamb chops and greasy pork, as these can lead to obesity in women, increase intra-abdominal pressure, and worsen symptoms of uterine prolapse. Also, avoid eating overly spicy foods, as spicy foods can induce constipation in women. Additionally, for some women who suffer from respiratory diseases, such as chronic pharyngitis, who already experience chronic coughing, eating spicy foods can exacerbate coughing symptoms, increase abdominal pressure, and lead to worsening uterine prolapse.