The female pelvic organs consist of the bladder, uterus, and rectum. There are ligaments that help keep the pelvic organs in the pelvic cavity, while the pelvic floor muscles provide support from below. If the pelvic floor organs are injured or weakened due to certain causes, the pelvic organs may descend into the vagina or protrude through the vulva. This condition is called uterine prolapse.

Symptoms that often arise include:

• Feeling a lump coming out of the vagina
• Aching in the back or lower back
• Difficulty walking
• Bleeding and urinary disorders
• Bowel movement problems

Causes of Uterine Prolapse:

There are several risk factors that can cause women to experience uterine prolapse:

1. Age - Older women are more susceptible to uterine prolapse. Once they reach the age of 50 and experience menopause, symptoms of uterine prolapse begin to appear. This is because during menopause, the hormone estrogen decreases.
2. Pregnancy - During pregnancy, the hormone estrogen decreases, which results in weakened pelvic floor muscles. The decline usually starts with the first pregnancy, then the second and so on.
3. Childbirth - Women who give birth, whether naturally or by cesarean, are also at risk of experiencing uterine prolapse. This occurs due to damage to the levator ani muscle and the pelvic muscle group during childbirth, which eventually causes the uterus to drop. Prolonged pushing, a baby weighing over 3.5 kg, and a difficult delivery can trigger uterine prolapse.
4. Strenuous  - activity Performing strenuous activities can cause abdominal pressure and lead to uterine prolapse.
5. Heavy activities  - such as lifting water gallons, heavy suitcases, and so on.
6. Lifestyle -  Being overweight and constipation can be a risk factor for uterine prolapse. Constipation makes women strain hard.

Prevention of Uterine Prolapse:

• Regular Kegel exercises
• Pelvic floor muscle exercises aimed at getting the organs that have dropped to return to their original position.
• Avoid lifting heavy objects
• Eat high-fiber foods such as fruits and vegetables to prevent constipation.
• Avoid holding in urine frequently
• Maintain a stable weight, don't be overweight.

Prolapse can be treated with either conservative or surgical methods, depending on the severity level. The doctor will assess the severity level of the prolapse after an examination and provide advice on the treatment, which is as follows:

• Stage 1: The cervix descends into the vaginal canal up to 1 cm above the vaginal introitus/hymen. Usually, conservative methods are used. Women are asked to do Kegel exercises three times a day with 12 repetitions. Followed by regular diet.
• Stage 2: The cervix descends more than 1 cm from the vaginal introitus. Continue Kegel exercises.
• Stage 3: The cervix protrudes more than 1 cm above the vaginal introitus.
• Stage 4: The entire uterus comes out of the vagina.

If it is already in stage III and IV, surgery is needed to repair the sagging vaginal wall or remove the uterus through the vagina.

If experiencing discomfort or feeling a lump descending into the vagina, immediately consult a specialist in Obstetrics & Gynecology, especially in Urogynecology and Vaginal Reconstruction.