First For Women

Is it safe for me to be intimate?


Q: I’ve just been diagnosed with mild bladder prolapse. I’m feeling anxious and self-conscious about having sex again, and my husband is worried it will hurt. Is it safe?

A: Yes! It’s estimated that up to 50% of women experience some degree of pelvic organ prolapse, which occurs when one or more pelvic organs collapse into the vaginal walls. The condition is caused by weakened pelvic floor muscles, often due to childbirth, hysterecto­my, weight gain and/or aging, and it results in pressure and discomfort in the vagina. I tell my patients with this condition that sex is perfectly safe, shouldn’t be painful and won’t worsen the prolapse.

Maintainin­g a robust sex life may even keep the prolapse from worsening, as orgasms strengthen the pelvic floor while also boosting healing blood flow to the area. Just be sure to communicat­e openly with your husband. And to ease your anxiety, try positions that may be more comfortabl­e, such as lying on your back with a pillow placed under your hips for easier penetratio­n. The bonus of this position is that when you lie on your back, gravity helps the prolapsed soft tissue recede, so it’s generally not felt by your partner, especially when the case is mild, as yours is.

More keys to preventing prolapse from worsening: Avoid heavy lifting and jogging or other high-impact exercises, as well as straining during bowel movements. Your doctor may have already suggested it, but my patients have had success when fitted with a pessary, a rubber or silicone device that’s inserted inside the vagina to help support the pelvic organs during daily activities. Some can even be left in during sex. Also smart: seeing a pelvic floor physical therapist for further treatment and strategies to prevent your condition from worsening.

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