A prolapsed cervix is a health condition in which the lower part of a woman’s uterus extends further into the vagina than it should. In severe cases, the cervix may extend so far that it actually comes out of the vaginal opening. The condition is sometimes also referred to as a uterine prolapse. It can affect any woman, but some are generally considered to be at higher risk. Depending on the severity, treatment may range from watchful waiting to lifestyle changes to surgery.
The cervix is the bottom opening of the uterus. In most women, the cervix and uterus are normally held in place at the top of the vaginal canal by the pelvic muscles. When these muscles are injured or become weak, a prolapsed cervix can result.
Certain women may be at greater risk for weakened pelvic muscles and resulting uterine prolapse, including those who have given birth vaginally, especially to large babies, and those with lower levels of estrogen. Vaginal childbirth often increases the risk of a prolapsed cervix because it exerts a lot of pressure on the pelvic muscles, stretching them out. A lack of estrogen in the body, often a part of the normal aging process, may lead to muscle weakness in many places in the body, including in the muscles that normally hold the uterus in position. Other conditions that may play a role in uterine prolapse include being overweight, lifting heavy objects, straining to go to the bathroom often, coughing a lot or having a pelvic tumor.
Some women may have no symptoms of a prolapsed cervix, especially if it is minor. If symptoms do occur, they may include a feeling of pressure in the vagina, pain during sex, problems urinating or backache. Women with severe cases may also feel or see the uterine tissue coming out of the vaginal opening.
When women have few or no symptoms, health-care providers often recommend watchful waiting, which generally involves regular exams to check to make sure the prolapsed cervix isn’t worsening. If symptoms get worse, healthcare providers may recommend more active treatments. In less severe cases, this may include lifestyle changes such as Kegel exercises to help strengthen the weakened pelvic muscles or weight loss to reduce the strain on the muscles. A vaginal pessary, a device inserted into the vagina to help hold the cervix and uterus in place, may also be recommended. When these more conservative treatments don’t work or the prolapsed cervix is severe, surgery to repair the weakened muscles or remove the uterus entirely in a hysterectomy may be recommended.