Can postpartum constipation cause uterine prolapse?

Written by Du Rui Xia
Obstetrics
Updated on January 29, 2025
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If there is severe constipation after childbirth, and it is not corrected in time, long-term constipation can lead to uterine prolapse in women.

Postpartum constipation increases abdominal pressure, which affects the recovery of pelvic floor muscles, causing the loss of support in the pelvic floor muscles and thus leading to uterine prolapse. However, the main factor contributing to uterine prolapse is not constipation but the damage caused by childbirth, which is the primary cause.

After childbirth, the pelvic floor muscles are weakened. Whether standing, bearing weight, or holding breath for a long period, thereby increasing abdominal pressure, can lead to the inability of the pelvic floor tissues to support and stabilize the internal organs of the pelvis, resulting in a prolapse.

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Written by Shen Li Wen
Obstetrics and Gynecology
1min 29sec home-news-image

The graded treatment for uterine prolapse is what?

According to the severity of female uterine prolapse, it can be categorized into first, second, and third degrees. For first and second degrees, non-surgical treatment methods can be used, such as the commonly practiced anal contraction exercises, which are a type of pelvic floor muscle training. The specific method involves contracting the anus for three seconds, then relaxing, and repeating this action 15 to 30 times per set. Depending on one's physical condition, two to three sets can be done each day. Generally, significant results can be seen after six to eight weeks of consistent practice. Additionally, some women who refuse surgery, such as older women, can also use a uterine pessary. Moreover, for mild or moderate uterine prolapse, treatments such as acupuncture and taking traditional Chinese medicine orally, such as Bu Zhong Yi Qi Tang, can be used. For severe uterine prolapse, surgery is often necessary, but the specific choice depends on various factors such as the woman's age, reproductive needs, and quality of life requirements. For example, older women in their seventies or eighties who might have poor physical condition and possibly no sexual activity might consider undergoing a vaginal closure procedure.

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Written by Wang Jing Hua
Obstetrics and Gynecology
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Can uterine prolapse have a vaginal delivery?

Uterine prolapse does not affect the width of the soft birth canal. It is still possible to have a vaginal delivery with uterine prolapse, as any form of childbirth after a full-term pregnancy can exacerbate uterine prolapse. However, uterine prolapse is not an indication for cesarean delivery; vaginal delivery should still be attempted if possible. Forty-two days after childbirth, a routine pelvic floor examination should be carried out. If there is pelvic floor dysfunction or uterine prolapse, treatment should be administered based on the severity of the condition. Eventually, some individuals may need surgical treatment, not all can be managed conservatively.

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Written by Shen Li Wen
Obstetrics and Gynecology
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What are the clinical manifestations of uterine prolapse?

When women experience uterine prolapse, the clinical symptoms vary depending on the severity of the condition. For instance, mild uterine prolapse often does not cause any discomfort. Severe uterine prolapse, however, may be due to the pulling of the uterus, leading to a reflex tension in the surrounding ligaments and causing congestion in the pelvic area. Women may feel pain in their sacral or lower abdominal area, which intensifies with excessive fatigue or prolonged standing. Some women may also experience stress urinary incontinence or changes in bowel behavior, such as constipation.

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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 Lin
Obstetrics and Gynecology
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Causes of uterine prolapse

The main causes of uterine prolapse include pregnancy, childbirth injury to the pelvic floor muscles, long-term increase in abdominal pressure, such as chronic coughing, habitual constipation, and difficulty defecating. Prolonged heavy lifting. Long periods of squatting or standing, large pelvic tumors causing downward displacement of the uterus, or poor development of pelvic floor tissues and degenerative changes accompanied by prolapse of other organs. In menopausal women, due to the decline in sex hormone levels, the pelvic floor tissues may atrophy and degenerate, which can also lead to uterine prolapse or exacerbate its severity.