Ask Dr. R – Prolapse before first pregnancy

Hi. I’m really scared and worried. I had sex a week ago and don’t really remember it due to an alcohol blackout (which is horrible in and of itself), but apparently it was for an extended period of time so I think I was pretty dry for the duration. I thought the first couple of days that I had a vaginal infection due to a lot of irritation and pain when urinating. I was constantly searching on the internet for an answer. (I couldn’t get in for a doctor’s appointment until this coming week – on 10/26.) Last Wednesday though, I noticed when I felt into my vaginal area, that it feels as though my vaginal walls have collapsed and it’s near my vaginal opening. I’m almost positive it’s a pelvic organ prolapse, but I haven’t read anywhere that it can be caused due to intercourse. Everything seems to mention childbirth and age being the causes. It must be possible through intercourse too because I think it’s happened to me. I’m horrified at how this will affect my life — quality of life, having kids, having sex. I’m only 36 years old and have not had children yet. Also I haven’t had very many partners and the last time I had sex before this was two years ago. If you would please respond back with any insight and advice, I would really appreciate it. Thanks.

Hello Ms. M,
By now you likely have your answer, as the response to your question failed to post and it’s been some time since you wrote in. Now, prolapse is definitely much more common in women who have given birth, but can and does occur in young, fit healthy women who have never been pregnant. Sex is not a known cause of prolapse – if you DO have prolapse, likely it was happening to you gradually with the sex/irritation/self-palpation of prolapse a coincidence. My youngest “never pregnant” patient with prolapse was a 31 year old, very fit, dancer, yoga practitioner who came in with severe enterocele and uterine prolapse. It can happen to anyone is the point, even if you are thin, young, fit and never stressed your pelvis with a pregnancy.

If you do have prolapse, it needs pessary support to keep it from getting worse, or surgical repair done carefully to resuspend the prolapsed parts without using any permanent graft materials that might complicate a pregnancy. Keep me posted – and for more information, you may want to peruse my book on incontinence, prolapse and vaginal rejuvenation – see http://www.plumbingandrenovations.com.

Best Regards,

Dr. R