Pelvic Organ Prolapse (POP) is a common condition that affects many women nowadays, and it can feel quite alarming or even frightening to experience. Concerns regarding the performance of day-to-day activities, such as lifting heavy objects, and their potential impact on long-term health issues or future pregnancies often arise. And then, of course, there are the concerns that many women silently carry. One such personal concern many women have but may feel too embarrassed to ask is about sex. “Is it possible to have sex with pelvic organ prolapse?” is a common question that most women have after being diagnosed.
In this article, we shall take a closer look at pelvic organ prolapse and the effect of pelvic prolapse diagnosis on sex life.
The pelvic floor muscles refer to the muscles and tissue that hold and protect the organs in the pelvic cavity. The pelvic floor muscles ensure that internal reproductive organs, such as the uterus and ovaries, urinary system organs, including the bladder, and organs of the lower gastrointestinal tract, like the rectum, remain in their proper position. They enable important functions such as bladder and bowel control, thereby allowing waste to be removed from the body. Any change in position can lead to health issues, such as faecal or urinary incontinence, along with a condition known as pelvic organ prolapse.
Pelvic organ prolapse refers to a condition in which the pelvic floor muscles become too weak to support and protect the pelvic organs. The organs drop downwards from their regular positions and start pressing against the vagina. In severe cases, the pelvic organs may even protrude from the vaginal opening, thus creating an extremely uncomfortable experience that many describe as being a feeling of something “falling or bulging out.”
The severity of the prolapse can be measured on a scale of one to four. While stage one refers to mild cases, stage four indicates a complete prolapse, whereby the pelvic organs bulge entirely outside the vagina. Most cases of pelvic prolapse are treatable, either surgically or non-surgically, and the treatment mode depends on the severity and type of the prolapse.
Pelvic prolapse is a condition that can be caused by the following:
● Weakened pelvic floor muscles due to the ageing process. During menopause, lower estrogen levels can weaken the connective tissues that support the pelvic floor.
● Long-term pressure in the abdominal area, usually due to conditions like chronic constipation or even due to frequent lifting of heavy objects, could lead to pelvic prolapse.
● Giving birth multiple times vaginally, delivering twins or triplets, having a large baby, or needing assistance during delivery with tools like forceps or a vacuum can all raise the likelihood of pelvic floor muscle weakening.
● Excessive body weight, or obesity, can lead to increased strain and pressure on the pelvic floor muscles, causing them to stretch and weaken.
● Sometimes, this condition could be genetic and passed on from earlier generations of the family.
No, sexual intercourse does not cause pelvic prolapse. The pelvic muscles are naturally flexible and built to adapt to different sexual positions. This is an important point to remember when thinking about intimacy and pelvic organ prolapse.
Once the prolapse has been confirmed through diagnosis, numerous questions arise. One of the most common concerns most people have is about the ability to continue healthy sexual relations. Questions like these often come up:
“Can you have sex with prolapse?”
“Will sex be painful or uncomfortable?”
“Will the pelvic prolapse worsen with sex?”
“Will my partner notice a difference or be affected by it?”
Sexual intimacy is possible even after being diagnosed with pelvic organ prolapse, and the experience differs from person to person. While the condition usually does not worsen during vaginal intercourse, there is an increased chance of rectal prolapse in cases of anal intercourse.
The treatment path recommended for resolving the prolapse can also have an impact on sexual intercourse. Surgeries, known as obliterative procedures, work by closing or narrowing the vaginal opening to prevent the organs from protruding. While effective in relieving symptoms, these procedures typically eliminate the ability to have penetrative sex.
Pelvic organ prolapse affects individuals in different ways, and the experience during intimacy can vary for each person.
Some women with mild to moderate prolapse continue to enjoy comfortable and satisfying sex without any significant issues. However, others may struggle emotionally, feeling self-conscious or unattractive due to their condition, especially if the prolapse has bulged out from the vaginal opening. This can affect their confidence levels and can lead to feelings of anxiety around intimacy. Concerns about being judged or feeling uncomfortable often make it difficult to discuss the condition, which can create distance in the relationship.
As for partners, most are unlikely to notice a prolapse unless it is visibly severe or protruding. In many cases, it does not interfere with their physical experience of intimacy.
As regards pelvic prolapse and painful intercourse, it should be noted that in most cases, there isn’t much pain during sexual intercourse. Women may feel discomfort, especially if the prolapse is severe, and there could be a decrease in libido or sex drive because of this.
Here are some tips on how to improve intimacy for people suffering from pelvic organ prolapse:
● Adopt a healthier lifestyle by adopting a fitness regimen that includes regular exercise to strengthen the pelvic floor muscles.
● Use a good lubrication product that will minimise any physical discomfort.
● Practice relaxation and mindfulness techniques that will help overcome anxiety and stress.
● Find appropriate sex positions that will minimise any discomfort during sexual intercourse. Most experts recommend sex positions that minimise gravitational pull. Using pillows for support or trying side-lying positions can also help increase comfort and reduce pressure on the pelvic area.
Being diagnosed with a condition like pelvic prolapse can be an overwhelming experience, as it opens the door for a plethora of concerns regarding one’s health. It is natural to feel anxious or uncertain, especially when it comes to intimate relationships. It is vital to seek support as early as possible and to have open communication with sexual partners to minimise the physical and emotional toll that comes with the prolapse.
