Jacqui Lambie has spoken out about vaginal prolapse. What is it – and how common is it?

What is prolapse and who does it affect?

Vaginal prolapse is a form of pelvic organ prolapse, when the bladder, uterus or bowel protrudes into the vagina.

Anything that puts pressure on the pelvic floor muscles can cause a prolapse, but pregnancy and birth are the most common causes. The weight and hormonal changes of pregnancy and the physical strain of giving birth both weaken and stretch the muscles, ligaments and tissues of the pelvic floor, which can cause the pelvic organs to move.

Vaginal prolapse can also occur for other reasons, including regular heavy lifting or weight bearing, heavy coughing, or straining from other conditions such as constipation. Perimenopause, menopause, hysterectomy, hypermobility and connective tissue conditions like Ehlers Danlos syndrome are also risk factors for prolapse.

Its prevalence is difficult to establish. Some studies that rely on women self-reporting symptoms have estimated it affects about 3% to 8% of women. Others, which rely on internal examinations to diagnose the condition, have found it affects up to 50% of women.

Almost 50% of women who have been pregnant will experience a form of prolapse.

What are the symptoms?

Amy Steventon, a pelvic floor physiotherapist at Jean Hailes, said common symptoms include a sensation of “vaginal dragging or bulging, or feeling like a tampon’s dropped down”.

“Or they might be able to feel something coming outside their vagina, like a little bulge,” Steventon said.

Other symptoms include difficulty or straining when going to the toilet, persistent or recurring urinary tract infections, or discomfort, pain or lack of sensation during sex.

Many women with prolapse do not notice the condition when it first occurs, or do not experience symptoms until it progresses or the organs move further.

Vaginal prolapse is measured in four stages of progression, from one, where the uterine wall or organ drops partly into the vagina, to four, where the uterine wall or organ slips completely outside the vagina.

How is it treated and who can help?

Mild to moderate prolapse can be effectively treated with physiotherapy and lifestyle changes, including reducing heavy lifting and straining. Some women will need a specially fitted device called a pessary that sits inside the vagina and supports the organs and vaginal walls. More severe cases are treated with surgery.

In the early 2000s, some women used transvaginal mesh implants to attempt to treat the condition, however its efficacy was limited, and investigations would later find harmful side-effects and complications.

In 2017, an Australian Senate inquiry into pelvic implants, prompted after receiving complaints from hundreds of women, warned the devices should only be used as a last resort. A class action was launched in Australia to compensate women for the immeasurable pain they endured as a result of the medical scandal. Similar actions have occurred in the US and the UK.

Women can be afraid or embarrassed to seek help for prolapse because of the intimate nature of the condition, persistent stigma, and the circumstances in which it often occurs.

“Prolapses are so emotive. It can be so scary,” Steventon said.

“It can also [occur] at a really vulnerable time where women are post-babies and have lots of other things that they need to deal with – babies, general recovery, tiredness – and don’t tend to focus on themselves. Likewise, the menopausal time – busy careers, ageing parents, teenagers – again, they put themselves, perhaps, not first.”

Early assessment and treatment is important to prevent the condition and symptoms worsening, Steventon said.

“Talking to a GP as the first port of call is a great option to start with,” she said. “Find a healthcare professional you feel comfortable talking to about it. With good and appropriate care, you can lead a very normal life with it.”