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Expert Advice: ‘Is It Safe for Me To Be Intimate With a Mild Bladder Prolapse?’

It depends on the severity of your case, but in many instances, it's safe.

Are you struggling with a pelvic organ prolapse? A prolapse happens when the muscles that support pelvic organs — like the uterus, cervix, and bladder — weaken and stretch, causing the organs to drop into the vagina. (The organs don’t split open the muscles. Rather, it looks like a bulge protruding into the vagina.) While not dangerous, a prolapse can be very uncomfortable. However, that doesn’t necessarily mean you can’t be intimate with your partner. This week, Dr. Barbara DePree answered one of our reader’s questions on the subject.

Meet our expert.

Barbara DePree, MD, is a gynecologist in private practice and director of Women’s Midlife Services at Michigan’s Holland Hospital. A Certified Menopause Practitioner, she is the founder of MiddlesexMD.com, an educational resource for women’s sexual health in perimenopause and beyond. To ask her a question, send an email to health@firstforwomen.com.

Intimacy With a Bladder Prolapse

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 percent 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 partner. 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.

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.

A version of this article originally appeared in our print magazine, First for Women.

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