If you are one of the 9 out of 10 women with some degree of pelvic organ prolapse, you may be wondering, “can I have sex with a prolapse?” or “will sex make my prolapse worse?”
So let’s talk about sex…with prolapse.
What exactly IS prolapse?
Prolapse occurs when one or more of the pelvic organs (vagina, uterus, cervix, bladder, or rectum) descends into the vaginal canal. This is often due to weak or inadequately supported pelvic floor muscles and is quite common following a vaginal delivery.
And there is hope! With the support of a pelvic floor PT and pelvic floor programs like SLAM, you can learn how to fix prolapse without surgery.
Can you have sex with uterine prolapse or a prolapsed bladder?
Understanding this from an anatomical perspective might make you wonder if having sex is safe for someone with prolapse. Dr. Jennifer McGowan, a pelvic floor physical therapist, explains that if there is no pain with sex, penetrative intercourse is fine.
“You can still very much enjoy your sex life even if you are dealing with prolapse,” she says. “It may even bring some prolapse relief.” (More on that in a minute.)
According to McGowan, if you are experiencing pain with intercourse, it’s less likely that it is the prolapse itself causing pain, but rather over tight pelvic floor muscles. A tight (hypertonic) pelvic floor is common among postpartum women, and it is possible to experience it alongside prolapse.
Surprising benefits of sex with pelvic organ prolapse
A study on pelvic organ prolapse (POP) type indicates it does not affect sexual function. In many cases, penetrative intercourse can even improve prolapse symptoms. Here’s why:
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Increased blood flow
Sexual arousal increases blood flow to the pelvic area. This brings more oxygen and feel-good hormones to the area, which aids in healing.
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Support for the vaginal canal
Most people with vaginal prolapse feel better after penetrative intercourse due to the relief the support brings to the vaginal wall.
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Orgasms help release feel-good hormones
Orgasms release oxytocin and dopamine hormones throughout the body. They help you feel attachment and love as well as pleasure, reward, and desire. Other hormones, such as endorphins, serotonin, and prolactin are also released during orgasm. They naturally increase pain relief and decrease stress.
Risks of sex with prolapse:
The risk of having sex with a prolapse is minimal. However, sometimes women find themselves bearing down during sex or while orgasming. McGowan recommends focusing on proper breathing, or core breathing, to avoid bearing down.
Proper core breathing is so important! Your core is a pressure system. As you breathe in your diaphragm flattens, gently pushing air down into the lungs as your belly expands. Your pelvic floor relaxes. As you exhale, the diaphragm recoils and the pelvic floor gently lifts. Proper breathing will also help your body to relax, which of course has its own benefits when it comes to sex.
How will sex feel to my partner if I have a prolapse?
Simply, it should feel good! Although you may feel self-conscious or worried about your partner, which is normal, know that they won’t feel or notice the prolapse.
Does sex cause prolapse?
In short, no. Sex is very unlikely to cause prolapse. The organs in your body are flexible and designed to move and accommodate different positions.
In fact, Dr. McGowan says, “Prolapse doesn’t usually occur from one thing anyway. It is typically micro-traumas to the body that lead to prolapse over time.”
Pelvic organ prolapse, in any variation, is most commonly caused by:
- Childbirth
- Heavy lifting
- ObesityExcessive regular straining while trying to complete a bowel movement.
Will sex cause my prolapse to worsen?
No. Sex should not cause prolapse to worsen. To reiterate, as long as there is no pain, sex should be fine – and may even help relieve symptoms.
What are the best sex positions with prolapse?
Dr. McGowan states, “there is no “best position” for sex with prolapse because every person is unique.” She does, however, have a few tips to consider when having sex with prolapse:
- Sex in a lying down position (versus upright or standing) minimizes gravity pulling straight down, therefore bringing awareness to the prolapse.
- Try placing a pillow under your hips. The increased angle adds some gravity, helping accommodate the prolapse and make room for sex.
- Keep the communication open. Talk with your partner about what feels good and what doesn’t. It should be enjoyable for both of you.
Should I avoid certain sex positions with prolapse?
Avoid positions where gravity isn’t on your side. Depending on the type of prolapse, this may mean avoiding sex in a standing position or being on top because they can lead to discomfort.
Bottom line, sex with a pelvic organ prolapse is completely possible. It won’t affect the prolapse, and it’s unlikely your partner will notice it. Keep the lines of communication open with your partner and you can have a satisfying sex life.
If you have further questions, or are experiencing pain with sex, please reach out to a medical professional or a pelvic floor physical therapist for help.