What influence does uterus prolapse have on sexuality?
Depending on its severity, uterus prolapse can cause pain during sexual intercourse. Because the uterus is lower than normal, it can be a barrier to sexual intercourse. Especially if the uterus is already emerging from the vaginal outlet, this is not only a cosmetic problem but also has a negative influence on the woman’s sexuality.
Furthermore, it must be noted that an exposed uterus is very susceptible to damage, as the sensitive mucous membrane dries out in the air. Therefore, mechanical effects on the vagina or uterus can be harmful to the organs. A prolapsed uterus can also trigger feelings of shame in the woman, especially if incontinence occurs as part of an additional bladder prolapse. These feelings of shame also have a negative effect on sexuality.
Therapy
A distinction is made between conservative and surgical therapy. Conservative therapy includes first of all pelvic floor exercises. This is recommended to stabilize the pelvic floor.
The pelvic floor training must be carried out constantly and for the rest of your life, as these muscles can also easily regress. A conservative therapy with estrogen preparations can also be attempted. These are applied locally as suppositories or ointments.
Furthermore, risk factors such as obesity must of course be reduced. Whether surgery is directly necessary in the case of uterus prolapse depends on various criteria. On the one hand, the question is of course what kind of uterus prolapse is present, i.e. how pronounced it is and what the symptoms are.
Then it is important to know how high the patient’s level of suffering is. Age and health condition also play a role. Furthermore, it should of course be taken into account whether there is still a current desire to have children.
The most common operation for a uterus prolapse is the so-called vaginal hysterectomy. This means the removal of the uterus via the vagina. Compared to abdominal hysterectomy, no incision is made in the abdomen and therefore no large operation scar is necessary.
During the operation, the uterus is completely removed and at the same time the bladder is lifted and fixed, thus reducing the symptoms of bladder weakness and the feeling of pressure of the bladder on or out of the vagina (anterior vaginal plastic surgery). Furthermore, the perineal area (between vagina and anus) is also strengthened. This is achieved by uniting the patient’s own muscles and, if necessary, by inserting a plastic net (posterior vaginal plastic surgery).
If a bladder weakness has occurred simultaneously with the uterus prolapse, this can also be corrected during the operation. A TVT (tension-free vaginal tape) is performed. A plastic band is draped around the urethra in such a way that there is no more involuntary urine leakage and that normal bladder emptying is possible.
The risk with such an operation is that the operation itself can also lead to bladder weakness (stress incontinence). It can also lead to relapses, so that a uterus prolapse can occur again. In general, however, the operation is performed in such a way that relapses (recurrences) should be almost impossible.
As a preventive measure, structured pelvic floor exercises have a positive effect on the supporting tissue of the pelvis.Once a uterine prolapse has occurred, it cannot be reversed by exercises, but a further prolapse may be prevented. In practice, this means that women who have risk factors for uterus prolapse should do regular pelvic floor exercises. There are many specific exercises that can be trained to strengthen the pelvic floor.
In addition, any other form of sport, such as fitness classes or jogging, additionally strengthens the pelvic floor muscles and is also recommended. Also because a body weight in the normal range is good for the course of the uterus lowering. Furthermore, exercises for the pelvic floor have a positive influence on incontinence. Studies have shown that women who exercise their pelvic floor suffer less frequently from incontinence.
