Can postpartum constipation cause uterine prolapse?

Written by Du Rui Xia
Obstetrics
Updated on January 29, 2025
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If there is severe constipation after childbirth, and it is not corrected in time, long-term constipation can lead to uterine prolapse in women.

Postpartum constipation increases abdominal pressure, which affects the recovery of pelvic floor muscles, causing the loss of support in the pelvic floor muscles and thus leading to uterine prolapse. However, the main factor contributing to uterine prolapse is not constipation but the damage caused by childbirth, which is the primary cause.

After childbirth, the pelvic floor muscles are weakened. Whether standing, bearing weight, or holding breath for a long period, thereby increasing abdominal pressure, can lead to the inability of the pelvic floor tissues to support and stabilize the internal organs of the pelvis, resulting in a prolapse.

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Obstetrics and Gynecology
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What are the symptoms of uterine prolapse?

Patients with mild uterine prolapse generally do not exhibit symptoms. Severe prolapse can cause pulling on the ligaments and fasciae, resulting in pelvic congestion, with patients experiencing varying degrees of soreness in the lower back or a sensation of heaviness. Symptoms become noticeable after standing for extended periods or after fatigue but significantly lessen after resting in bed. It is crucial for patients experiencing uterine prolapse to seek timely medical examination at a hospital to determine the severity of the condition. Patients with mild uterine prolapse can also use traditional Chinese medicine or acupuncture and other physical therapies to promote the recovery of pelvic floor muscle tension and relieve local symptoms. If the prolapse is severe, surgical treatment may be necessary, and it is generally advised to avoid cold and fatigue.

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Can you have intercourse with uterine prolapse?

Generally, it is possible, but it specifically depends on the condition of the disease. In severe cases of uterine prolapse, the entire uterus can protrude outside the vaginal opening, obstructing the passage for intercourse, making intercourse impossible. In mild cases of uterine prolapse or bulging, although it does not significantly affect intercourse, it can affect the quality of intercourse and cause abnormal sensations. Uterine prolapse is classified into three grades: first grade where the cervix is just above the hymen, second grade where both the cervix and part of the uterine body prolapse outside the vagina, and third grade where the entire uterine body is prolapsed outside the vagina. If suffering from uterine prolapse, it is recommended to seek active treatment, as early-stage uterine prolapse can be improved through physical therapy and exercise.

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How to treat uterine prolapse and urinary incontinence?

Uterine prolapse is mostly caused by childbirth injuries, long-term increase in abdominal pressure, or the degenerative changes and poor development of pelvic floor tissues. Mild uterine prolapse generally does not have noticeable symptoms. Severe uterine prolapse often accompanies anterior vaginal wall prolapse, which can lead to urinary retention and stress urinary incontinence, commonly referred to as leakage of urine. In cases of uterine prolapse with urine leakage, treatment requires enhanced nutrition, appropriate arrangement of rest and work, avoidance of heavy physical labor, and maintaining smooth bowel movements. Active treatment of chronic negative pressure increase diseases, such as constipation and chronic cough, is necessary. When uterine prolapse results in urine leakage, surgical treatment is generally required. Pelvic floor tissue repair is done, and in severe cases, hysterectomy is necessary along with the repair of the anterior and posterior vaginal walls for effective treatment.

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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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Does uterine prolapse affect pregnancy?

Uterine prolapse, as long as it does not affect sexual intercourse, generally does not impact the ability to conceive. Uterine prolapse can be classified into three degrees. First-degree uterine prolapse does not affect pregnancy since it allows for normal sexual activity. However, in the case of third-degree uterine prolapse, the uterus has prolapsed out of the vagina and sometimes cannot be repositioned, thus interfering with sexual activity and affecting the ability to conceive. Therefore, whether uterine prolapse impacts pregnancy depends on the patient's condition, as well as whether they have normal menstruation or normal endocrine function.