Exercise key to a healthy pelvic floor

the urethra. The most common type of prolapse actually involves both the bladder and urethra.

❚ Prolapse of the middle part of the pelvic area: when this occurs, the uterus or womb can descend into the vagina. This type of prolapse can be so severe that the cervix (the neck or entrance to the womb) can protrude out of the vaginal entrance.

❚ Posterior prolapse (affecting the back part of the pelvic area): when this occurs, part of the bowel or bowel wall protrudes into the vagina, interfering with bowel function. This is known as a rectocele or enterocele.

Although most forms of prolapse are related to pregnancy and childbirth, we don’t fully understand why some women will be affected, while others won’t. Factors that make a prolapse more likely to occur include:

❚ Multiple pregnancies.

❚ Vaginal deliveries as opposed to caesarean sections.

❚ Very large babies, or difficult births (like forceps or ventouse extractions).

❚ Increasing age – as mentioned, once levels of oestrogen decrease with the menopause, tissues in general become looser, increasing your chance of being affected by a prolapse.

❚ Aside from pregnancy, anything that increases pressure on the pelvic floor can lead to a prolapse – this can include obesity, constipation because of the constant straining to pass a bowel motion, or a long-term cough. ❚ Family history – it is thought that you are more likely to get a prolapse if your mother or sister had one, though the exact reason for this isn’t fully understood.

Many women will never get any symptoms from their prolapse, and it may just be picked up when they have a smear test or sexual health check-up with their doctor. If this is the case, there is no need to panic but it would be worth doing some of the basic exercises discussed below to try to prevent things getting any worse.

However, for other women symptoms can be really troublesome and have a major impact on their life. These might include:

❚ Urinary symptoms – such as needing to pass urine all the time (a symptom known as frequency); having difficulty holding on to your

Most women won’t require surgery, and can manage their symptoms conservatively.