Cervical prolapse is a common condition where the cervix, and sometimes the uterus, shifts from its normal position. This occurs when the pelvic floor’s supportive structures weaken. It is a form of pelvic organ prolapse that can affect people with a vagina, often becoming more noticeable with age.
Understanding Cervical Prolapse
Cervical prolapse is a specific type of pelvic organ prolapse (POP) involving the cervix and potentially the uterus. The pelvic floor muscles and ligaments typically form a supportive “hammock” that holds pelvic organs, including the uterus, bladder, and rectum, in their correct anatomical positions. When these muscles and connective tissues lose their strength or elasticity, they can no longer adequately support these organs. This weakening allows the cervix and uterus to sag or drop downward into the vaginal canal. The mechanism of descent involves the overstretching or damage to the ligaments and fascia that suspend the uterus within the pelvis.
Visual Characteristics and Stages
The visual appearance of cervical prolapse varies depending on its severity, which is often categorized into stages.
Stage 1
The cervix begins to descend but remains entirely within the vaginal canal and is not visible externally. It is often asymptomatic and discovered during an internal examination.
Stage 2
The cervix descends further, reaching the vaginal opening. A slight bulge or mass may appear at the entrance of the vagina, particularly when standing or straining.
Stage 3
The cervix starts to protrude beyond the vaginal opening. A portion of the cervix, or a fleshy mass, becomes visible outside the body.
Stage 4
This involves the complete descent of the cervix and often the entire uterus outside the vagina. A noticeable fleshy protrusion will be consistently visible outside the vaginal opening. These stages describe the increasing extent of the visual presentation as the prolapse worsens.
Accompanying Sensations and Symptoms
Cervical prolapse often presents with a range of physical sensations and symptoms. A common sensation is pressure or heaviness in the pelvis or lower abdomen, which can worsen throughout the day or after physical activity. Some individuals describe a feeling that something is “falling out” of their vagina or a sensation of sitting on a small ball. Discomfort or pain during sexual intercourse is another symptom. The prolapse can also interfere with bladder function, leading to issues such as urinary incontinence, difficulty fully emptying the bladder, or needing to urinate more frequently. Bowel problems, including constipation or difficulty with bowel movements, may also occur.
Factors Contributing to Prolapse
Several factors can contribute to the weakening of pelvic floor muscles and ligaments, leading to cervical prolapse. Childbirth is a significant cause, particularly vaginal deliveries. The physical strain of pregnancy and delivery can stretch and damage supportive tissues. Chronic straining, such as from ongoing constipation or a persistent cough, also puts continuous pressure on the pelvic floor, weakening it over time. Aging plays a role, as muscles naturally lose strength and elasticity. Menopause, with its decline in estrogen levels, can affect connective tissues supporting pelvic organs. Other factors include obesity, which adds excess pressure on the pelvic floor, and a family history of weak connective tissues.
Importance of Medical Consultation
If a person suspects cervical prolapse or experiences related symptoms, seeking professional medical advice is important. Self-diagnosis based solely on visual inspection or symptoms can be inaccurate, as various conditions present similarly. A healthcare provider can perform a thorough examination, including a pelvic exam, to accurately diagnose the condition and rule out other potential issues. A medical evaluation allows for an accurate assessment of the prolapse type and stage. Treatment options exist and vary depending on severity and individual circumstances, and consulting a healthcare provider ensures the most appropriate course of action, which can significantly improve comfort and quality of life.