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It happens when the pelvic floor muscles and ligaments become weak and are no longer able to support the uterus. In some cases, the uterus can protrude from the vaginal opening. Complications can include the ulceration of exposed tissue and prolapse of other pelvic organs, such as the bladder or the rectum. This article covers the stages, causes, and treatments for uterine prolapses. Stages of uterine prolapse Share on PinterestCarles Navarro Parcerisas/Getty ImagesMedical professionals categorize uterine prolapses as incomplete or complete: In an incomplete uterine prolapse, the uterus partially displaces the vagina but does not protrude. By contrast, a portion of the uterus protrudes from the vaginal opening in a complete uterine prolapse. This opening is also known as the introitus. Doctors grade the condition by its severity. They determine this by how far the uterus has descended:GradeSeverityFirst gradeThe uterus descends into the upper vagina.Second gradeThe uterus descends into the introitus.Third gradeThe cervix descends outside the introitus.Fourth gradeThe cervix and uterus both descend outside the introitus. Causes of uterine prolapse Pelvic floor muscles can become weak for several reasons:pregnancy and childbirthadvancing age and going through the menopauseoverweight and obesityheavy liftingchronic coughingchronic constipationa history of pelvic surgerygenetic factors leading to weak connective tissue Symptoms of uterine prolapse Symptoms vary depending on how severe the prolapse is. Typical symptoms include:pelvic heaviness or pullingvaginal bleeding or an increase in vaginal dischargedifficulties with sexual intercourseurinary leakagebladder infectionsbowel movement difficulties, such as constipationlower back painuterine protrusion from the vaginal openingsensations of sitting on a ball or that something is falling out of the vaginaweak vaginal tissue In mild cases, there may be no symptoms, or symptoms may change in severity throughout the day. Diagnosing uterine prolapse A healthcare professional will ask about symptoms and perform a physical examination. While examining the pelvis, they will evaluate organ placement and vaginal tone. An ultrasound or MRI may help assess the severity of the prolapse. Uterine prolapse treatment Prolapse up to the third degree may spontaneously resolve. More severe cases may require medical treatment. Options include vaginal pessary and surgery. Vaginal pessary This is a vaginal device that supports the uterus and keeps it in position. It is important to follow the instructions on care, removal, and insertion of the pessary. In cases of severe prolapse, a pessary can cause irritation, ulceration, and sexual problems. Talk with your doctor about if this treatment is right for you. Surgery Surgeons can repair a prolapsed uterus through the vagina or abdomen. It involves skin grafting or using donor tissue or other material to provide uterine suspension. In severe cases, doctors may recommend a hysterectomy. This procedure removes the uterus and, often, other parts of the reproductive system. Preventing uterine prolapse Some strategies can reduce the risk of uterine prolapse developing and stop it from worsening. These include, but are not limited to:performing pelvic floor exercises, such as Kegel exercisespreventing and treating constipationavoiding heavy liftingusing correct body mechanics whenever lifting is necessarymanaging chronic coughingmaintaining a healthy weight through diet and exerciseconsidering estrogen replacement therapy during menopause If the prolapse shows signs of worsening, other types of treatment may be necessary. Uterine prolapse risk factors The most common risk factors for uterine prolapse include:Multiple pregnancies and births: The risk for uterine prolapse increases with each successive pregnancy and birth. Vaginal deliveries may weaken pelvic floor muscles and connective tissues.Overweight: People with a BMI over 25 are at a higher risk than people with a lower BMI. Excess weight can weaken pelvic muscles.Previous hysterectomy: People who have had pelvic surgery, including a hysterectomy, may be more likely to experience prolapse. Age: The structures supporting the uterus and vagina lose their strength as people age. It is diagnosed most often in people ages 60 to 69.Ethnicity: Studies show Hispanic and non-Hispanic white Americans are more likely to develop uterine prolapse than Asian Americans and African Americans.Tissue disorders: Connective tissue disorders may impact the ligaments responsible for holding the uterus and pelvic organs in place. These disorders may include Ehlers-Danlos syndrome and Marfan syndrome.Pelvic floor disorders: Patients with pelvic organ prolapse, which includes uterine prolapse, have a high rate of coexisting pelvic floor disorders. This includes urinary incontinence, overactive bladder, and fecal incontinence.Increased abdominal pressure: People who regularly lift heavy objects may be more likely to experience this condition. People who have constipation or a chronic cough may also. These conditions and situations put increased pressure on the muscles in the abdomen, which can lead to weakening. Summary Although it can be uncomfortable, uterine prolapse is not a life threatening condition. In fact, many patients may not experience symptoms or show signs of the condition until it has advanced to a later stage. People who do have a detectable bulge or pressure in their vagina may be able to treat the prolapse without surgery. Noninvasive treatments, including exercises, may help the prolapse resolve. A vaginal pessary may be necessary to support the organs, too. Surgery is often reserved for the most severe cases. However, it is highly successful. Certain risk factors increase a person’s chances of developing uterine prolapse. These include overweight and having a history of multiple pregnancies and births. These individuals should have regular pelvic exams to check for signs of uterine prolapse. Catching the condition in early stages may allow a person more time to strengthen the pelvic floor muscles and prevent more significant prolapse. Last medically reviewed on May 8, 2022Pregnancy / ObstetricsUrology / NephrologyWomen's Health / Gynecology 5 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Aboseif, C., et al. (2021). Pelvic organ prolapse.https://www.ncbi.nlm.nih.gov/books/NBK563229/Chen, C. J., et al. (2021). Uterine prolapse.https://www.ncbi.nlm.nih.gov/books/NBK564429/Iglesia, C. B., et al. (2017). Pelvic organ prolapse.https://www.aafp.org/afp/2017/0801/p179.htmlMcNeeley, S. G. (2017). Uterine and vaginal prolapse. Merck Manuals: Professional version.http://www.merckmanuals.com/professional/gynecology-and-obstetrics/pelvic-relaxation-syndromes/uterine-and-vaginal-prolapseOverview: pelvic organ prolapse. (2021).https://www.nhs.uk/conditions/pelvic-organ-prolapse/FEEDBACK:Medically reviewed by Valinda Riggins Nwadike, MD, MPH — By Lori Smith, MSN, BSN, WHNP-BC — Updated on May 8, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? 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