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Strengthening Sexual Health for Women with Pelvic Floor Weakness

March 23, 2022 | By: Dr. Rebecca Roedersheimer

Many women wonder if it is safe to enjoy sexual intimacy while pregnant with their children. Many of those same women may wonder if they can enjoy sexual intimacy years later after menopause.

Pelvic floor weakness, often referred to as prolapse, is a condition that affects many women who have had children, as well as hysterectomies. It occurs when the muscles and ligaments in the pelvis, which hold the bladder, uterus, and other organs in place, become weak or injured. The pelvic organs then are susceptible to slipping from position and entering the vagina, creating a protrusion that can be uncomfortable and interfere with sexual functioning.

Nearly one-quarter of all U.S. women experience a pelvic floor disorder, such as a pelvic floor weakness. Incidents climb with age; 40% of women who are 60 to 79 years old have pelvic floor weakness. Yet despite how common the condition may be, it remains misunderstood by many women, likely because they live with it in secret; too bewildered or self-conscious to talk about it.

But talking is necessary to expose pelvic floor weakness for precisely what it is: a simple fact of life, like other weakening muscles and drooping body parts. If we can talk with candor about a sagging butt or weakening knees, then why not give the pelvic organs the same recognition? They are, after all, crucially important.

And more important, prolapse can often be treated, even without surgery.

So Let’s Start Talking Prolapse Facts

Four body parts can prolapse in a woman’s body. They are:

  • The uterus: This results when the uterus slips into the vagina and possibly through the vaginal opening (partially).
  • The upper vagina: The upper part of the vagina (inside the body) loses its shape and drops into the vaginal canal, and possibly the vaginal opening.
  • The bladder: This occurs when the muscles between the bladder and the vagina weaken, causing the bladder to bulge into the vagina.
  • The bowel: When the small bowel protrudes into the top of the vagina. This hernia-like disorder is more common among women who have had hysterectomies.

Other contributing risks of prolapse include menopause, obesity, and pelvic surgeries.

Is a Weak Pelvis a Danger to My Sexual Health?

A prolapse is not life threatening, but it can lead to other health conditions that affect bladder, bowel, and sexual functions. Pain and incontinence are among the leading issues, but many women who live with prolapse avoid intimacy for fear of embarrassment and/or because of reduced sensation (from weakened muscles) that makes them feel less sexual.

But treatment options are available. They may include muscle-strengthening exercises, which can be preventive, estrogen replacement therapy, and the insertion of a support device.

Also, there’s no reason to wait to talk about prolapse. Those at risk of the condition should discuss it with their urologist or other specialist in advance, to familiarize themselves with the signs.

If you do experience the signs, such as pain during intercourse, pressure in the pelvis, or a lump of tissue at the opening of the vagina, see a specialist right away. A urologist usually can diagnose the presence of prolapse with one exam and recommend surgical and non-surgical treatments.

Yes, you can have sexual intimacy after prolapse. But first, you have to treat it.

Learn more about prolapse here.

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