A rectocele is a common pelvic floor condition where the rectum bulges into the vagina due to weakening of supportive tissues. Many women experience a rectocele, which can lead to various uncomfortable symptoms. This article explores the nature of a rectocele and how estrogen cream may be a treatment option.
Understanding Rectocele
A rectocele forms when the tissue wall separating the rectum from the vagina becomes thin and weak, allowing the front wall of the rectum to sag and create a bulge into the back wall of the vagina. This condition is a type of pelvic organ prolapse. Common causes include vaginal childbirth, chronic straining from constipation, and the natural aging process.
Symptoms vary, with small rectoceles often having no noticeable signs. When present, they may include a feeling of pelvic pressure or fullness, or a sensation that something is “falling out” of the vagina. Many individuals experience difficulty with bowel movements, such as incomplete emptying or the need to press on the vaginal bulge to pass stool. Painful intercourse can also occur.
How Estrogen Cream Works
Estrogen cream is a local treatment applied directly to the vaginal tissues, delivering estrogen primarily to the targeted area with minimal bloodstream absorption. The female genital tract is highly responsive to estrogen, and a decrease in this hormone, particularly after menopause, can lead to thinning and weakening of vaginal and pelvic tissues.
Applying estrogen cream helps restore the health and integrity of these tissues. It improves the elasticity and strength of the vaginal walls and supporting pelvic floor structures. This provides better support for pelvic organs, including the rectum. Enhanced blood flow also contributes to tissue revitalization and resilience.
When Estrogen Cream is Used and What to Expect
Estrogen cream is often considered for postmenopausal women whose rectocele symptoms are mild to moderate and linked to estrogen deficiency. This treatment is not a standalone cure for severe prolapse but aims to improve the quality of vaginal and pelvic floor tissues, reducing associated symptoms like dryness, discomfort, and mild bulging. The cream helps strengthen the vaginal lining and make it less dry or painful.
Improvements may include reduced vaginal dryness and pain during intercourse, and potentially less sensation of a bulge or pressure. It primarily enhances tissue health rather than physically reducing the size of the prolapse. The cream is applied vaginally, with frequency varying from daily initial use to a few times a week.
Discuss candidacy and expectations with a healthcare provider. Possible side effects are usually localized, such as vaginal irritation, but serious systemic side effects are less common due to low absorption. Contraindications include a history of certain hormone-dependent cancers, undiagnosed vaginal bleeding, or active blood clots. Estrogen cream is frequently part of a broader treatment plan, complementing other management strategies.
Other Approaches to Management
Beyond estrogen cream, several other strategies manage a rectocele, ranging from conservative measures to surgical interventions. Lifestyle adjustments are often the first step, focusing on preventing constipation and straining during bowel movements. This includes a high-fiber diet, adequate hydration, and sometimes stool softeners.
Pelvic floor physical therapy is a common non-surgical approach that can significantly help. A specialized physical therapist guides patients through exercises, such as Kegels, to strengthen pelvic floor muscles and improve bowel movement coordination. Biofeedback is sometimes used to help individuals learn to properly contract and relax these muscles.
Another non-surgical option is a vaginal pessary, a removable device inserted into the vagina to support prolapsed organs. Pessaries come in various shapes and sizes and alleviate symptoms by physically supporting the vaginal walls. If conservative treatments do not sufficiently relieve symptoms, surgical repair may be considered to correct the bulge and reinforce weakened tissue.