The process of childbirth—especially if a woman has many children and they are more than 8 lbs at birth—causes weakness in the pelvic area. Many women won’t notice any difference immediately, but, over the years, and under the influence of gravity and aging, problems develop.
The most commonly occurring problem is called uterine prolapse. In this condition, the uterus actually slips from its supports and begins to move down in the vagina, until it actually protrudes out through the vulva. The protrusion will be worse after women sufferers from this condition are on their feet for long periods of time. Some women can relieve the symptoms temporarily by literally pushing the uterus back up. (Most women will notice the prolapse before the uterus actually protrudes. They typically experience pressure and heaviness in the pelvic area and they often describe the experience of “feeling something” when they insert a finger in their vagina.)
The second most commonly occurring problem is vaginal cystocele or rectocele. During childbirth, as the baby moves through the vagina, the strong tissue surrounding the vagina is stretched and even split. The most common areas damaged are the wall between the vagina and the bladder, and the wall between the vagina and the rectum. The “splits” in the strong tissue—or fascia—are actually hernias, and can begin to bulge just like a typical hernia might.
A woman with a cystocele (a defect in the wall between the bladder and the vagina) will experience a bulging sensation in the top of her vagina when she inserts a finger in her vagina. Again, if the problem is not addressed, the bulge can actually begin to protrude through the vulva. Along with the discomfort of a cystocele, women frequently lose urine when they cough or sneeze.
A rectocele is best described as a hernia that occurs between the rectum and the vagina. Again, a woman will feel a bulge, this time in the back of the vagina. Sometimes the bulge actually protrudes to the outside.
Another common symptom associated with a rectocele is obstipation (similar to constipation). The symptoms of obstipation are an inability to move stool out of the rectum unless a finger is inserted into the vagina and the stool is actually pushed out. (The stool is being caught in the pocket formed by the hernia.)
Along with the above issues, women who have had vaginal deliveries often feel “loose” or “open” in the vaginal area, and complain that intercourse is not as satisfying to either partner.
Even women who have had hysterectomies can develop prolapse, known as vaginal vault prolapse, years after their hysterectomies. Again, these women experience pelvic pressure and heaviness and often feel something extruding from the vulva. Women who have had vaginal hysterectomies are especially susceptible to vaginal vault prolapse.