Uterine descent – causes and symptoms

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Weak connective tissue, a vaginal birth or a menopause-related hormone deficiency. These are the most common reasons for why a pelvis gives way and the uterus drops down. We explain what can be done and the importance of pelvic training.

What is uterine descent?

We talk of a descent when an organ in the pelvis slips down from its normal position. This can be the uterus, bladder or bowel. Uterine descent is always combined with a prolapse of the pelvic floor.

Which symptoms appear?

If the uterine descent is mild, the woman often doesn’t notice it herself. It will be detected by her gynaecologist during a routine examination. However, if the descent is severe, the following symptoms may appear:

  • Pain during intercourse
  • A feeling of heaviness in the lower abdomen
  • The general sensation of a foreign body in the vagina or, when seated, the feeling of sitting on a tennis ball
  • In extreme cases, the uterus may even protrude from the vagina

What are the causes of uterine descent?

The condition is usually due to excessive pressure on the pelvic floor, such as during vaginal births, as mentioned above, or chronic coughing or constipation. It can also be due to a predisposition where the weak connective tissue is congenital. Uterine descent can also be caused by a hormone deficiency during menopause. Lifestyle is an additional key factor, as the causes also include excess weight, heavy physical work or untrained pelvic floor muscles. For this reason, people who do a lot of heavy lifting and carrying should train their pelvic floor well.

Which treatments are used?

  1. Pelvic floor training primarily
  2. Pelvic floor physiotherapy including electrostimulation or biofeedback: this is carried out by physiotherapists to complement pelvic floor training, especially when women have difficulty feeling their pelvic floor. A probe is inserted into the vagina.
    In the case of biofeedback, the probe gives visual information on how strongly or weakly the woman tightens her pelvic floor. With electrostimulation, electrical impulses intensify the muscle training.
  3. Pessaries: these are cubes or rings made of rubber or silicone that are inserted into the vagina like a tampon and provide support for the uterus.
  4. Oestrogen is given in the case of deficiency
  5. Surgery is offered in extreme cases

Depending on the cause of the uterine descent, it is just as important that the patient changes their lifestyle habits and loses weight or practises more exercise, for example.

Pelvic floor training for uterine descent

Especially with a mild or moderate descent, pelvic floor training can alleviate symptoms and discomfort. The training can also have a prophylactic function by preventing the uterus from slipping (further). When doing pelvic floor exercises, avoid stomach crunches and preferably exercise lying down.

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