Pelvic relaxation occurs when the ligaments and muscles that make up the pelvic floor weaken. The pelvic floor then sags, pressing against the vaginal wall. This usually develops due to childbirth, support problems, and aging.
The floor of the pelvis holds the bladder and uterus. When the pelvic floor is damaged or stretched, the bladder and uterus might descend to the vagina and can even bulge through the opening of the vagina. When the uterus sags, it is considered uterine prolapse. When the bladder sags, it is called either a cystocele or bladder prolapse. It is possible for organs like the intestine or rectum to sag due to a weak pelvic floor.
Symptoms and Causes
Pelvic relaxation can be caused by childbirth, constipation, obesity, heavy lifting, or a chronic cough. This condition can develop post–menopause, when less estrogen is present in the body, causing a loss in muscle tone. Minor cases of pelvic relaxation might not exhibit symptoms. But severe cases of pelvic relaxation can be accompanied with an ache in the groin, lower back, lower abdomen, or vagina. Pressure or heaviness in the vagina, problems having bowel movements, and recurring infections of the urinary tract are all symptoms that can arise. Another symptom is difficulty controlling the bladder, which increases with activities like sneezing, coughing, or heavy lifting.
Diagnosis and Treatment
Bladder tests and a complete examination of the pelvis can help determine if pelvic relaxation is present. Kegel exercises and supplements containing estrogen can improve symptoms of pelvic relaxation by strenghtening the muscles in the pelvic floor. A doctor can also recommend a pessary, which is a device shaped like a ring, to be inserted in the vagina. This device prevents the bladder and uterus from sagging into the vagina. Although it is not always necessary, surgery can fix a sagging uterus or bladder. A hysterectomy can also be performed, which removes the uterus. A doctor might recommend maintaining a regular weight, refraining from activities that exert the pelvic floor, and eating a diet that is high in fiber, which can ease the passing of stool.
Prognosis and Prevention
Kegel exercises can correct minor cases of pelvic relaxation. More serious cases do not typically improve with exercise or supplements containing estrogen but can be improved through surgery or an insertion of a pessary.
Maintaining a normal weight, refraining from lifting heavy objects, and avoiding bowel movement strains limit exertion on the pelvic floor and can prevent pelvic relaxation.
Cystocele: Protrusion of the bladder in the vagina
Cystourethrocele: Protrusion of the neck of the bladder in the vagina
Enterocele: Sagging of the intestine in the vagina
Kegel exercises: Exercises that strengthen the muscles in the pelvic floor and improve bowel and bladder control
Pessary: A device shaped like a ring that is inserted in the vagina to prevent organs from sagging
Rectocele: Protrusion of the rectum against the wall of the vagina
Uterine prolapse: Protrusion of the uterus in the vagina
Vaginal prolapse: Protrusion of the upper part of the vagina into either the bottom part of the vagina or the vaginal opening