Can you get pregnant with uterine prolapse?

Written by Shen Li Wen
Obstetrics and Gynecology
Updated on September 18, 2024
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When women experience uterine prolapse, if it is only mild or moderate, it usually does not affect their ability to become pregnant normally. In most cases, when the woman lies down, the protruding part of the uterus might naturally retract, or it can be manually pushed back into the vagina. During intercourse, after ejaculation, the cervix may still be immersed in semen, allowing sperm to pass through the cervix smoothly, and the woman can become pregnant normally. However, in cases of severe uterine prolapse, such as when the entire uterus descends outside the vagina, and cannot be repositioned back into the vagina even when lying down, during intercourse, the ejaculated semen may not sufficiently immerse the cervix, and sperm may not be able to normally enter the cervix and uterine cavity. Additionally, many women with severe uterine prolapse might experience cervix erosion, bleeding, and infection due to friction, which can produce inflammatory cells that hinder the normal passage of sperm, leading to difficulties in conception.

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Written by Shen Li Wen
Obstetrics and Gynecology
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The main causes of uterine prolapse

The causes of uterine prolapse in women are complex, with the most common being pregnancy and childbirth, especially multiple childbirths, which can lead to damage to a woman's pelvic floor muscles. Some women experience this during vaginal delivery using instruments such as forceps or vacuum extractors, which can injure the pelvic muscles and lead to uterine prolapse. Some women may engage in heavy physical labor too soon after childbirth before their pelvic floor functions have recovered, affecting the recovery of pelvic tissue tension and leading to uterine prolapse. Additionally, uterine prolapse may also occur in women who are overweight, suffer from internal medical conditions such as chronic cough, ascites, or constipation, which increase the pressure inside the abdominal cavity.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Can you have sexual intercourse with uterine prolapse?

When a woman experiences uterine prolapse, it generally does not affect normal sexual activity, as symptoms might improve in a supine position, regardless of the type of prolapse. For instance, with moderate uterine prolapse, where the cervix protrudes beyond the vaginal opening, it might retract back into place when lying down. However, during sexual activity, cleanliness and hygiene should be considered. When uterine prolapse is severe, part of the uterus may be exposed at or outside the vaginal opening. Prolonged walking or other activities can cause friction, leading to possible cervical erosion and infections. Therefore, during intercourse, actions should not be too rough as it may exacerbate erosions or cause bleeding.

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Written by Liu Jian Wei
Obstetrics and Gynecology
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Uterine prolapse is classified into several degrees.

The current grading of uterine prolapse commonly used in China can be divided into mild, moderate, and severe. The grading is based on the position and severity of the prolapse. Generally, mild indicates that the prolapse of the uterus has not exceeded the external orifice of the vagina. Moderate indicates that part of the uterus has prolapsed beyond the vaginal orifice, and the most severe suggests that the uterus has completely prolapsed to the external orifice of the vagina. Therefore, a gynecological examination is needed in the clinic for assessment.

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Written by Xu Xiao Ming
Obstetrics and Gynecology
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What causes uterine prolapse?

The most common causes of uterine prolapse can be categorized into three types. The first type is childbirth injury, which is the main cause of uterine prolapse. During childbirth, especially with vaginal surgical assistance or prolonged second stage of labor, uterine prolapse can occur. The second cause is long-term increased intra-abdominal pressure, such as chronic coughing, habitual constipation, prolonged standing, or weightlifting. These factors can contribute to uterine prolapse. The third type involves poor development or degenerative changes in the pelvic tissues. This mainly refers to uterine prolapse due to congenital deficiencies in pelvic floor development. Generally, childbirth injuries are the most common cause.

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Written by Hou Jie
Obstetrics and Gynecology
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What are the symptoms of uterine prolapse?

Mild uterine prolapse may have no clinical symptoms, while severe cases can feel a sense of falling and lower back pain, along with a mass protruding from the vagina. This mass may increase and the sensation of falling becomes more pronounced with long periods of standing, vigorous activity, or increased abdominal pressure. If there is a bulge in the anterior vaginal wall or the bladder, with the urethra and the posterior angle of the bladder becoming sharp, it can lead to difficulty urinating or urinary retention. If a urinary tract infection occurs subsequently, symptoms such as frequent urination, urgency, and painful urination may arise. If the bulge in the bladder coincides with a urethral bulge and a complete protrusion of the anterior vaginal wall, where the posterior angle of the urethra and bladder disappears, urinary leakage can occur during coughing, straining, or other activities that increase abdominal pressure, leading to what is called stress urinary incontinence.