Causes of Uterine Prolapse

I am 45 years old. Recently, while showering, I noticed a protruding mass at the vaginal opening, and after walking for extended periods, I feel a sensation of heaviness or downward pressure in my lower abdomen. After visiting the hospital for evaluation, my doctor diagnosed me with uterine prolapse. What causes uterine prolapse?

Causes of Uterine Prolapse

Obstetric injury is the primary cause of uterine prolapse. During childbirth—particularly in cases of difficult labor, prolonged second stage of labor, operative vaginal delivery (e.g., forceps or vacuum-assisted delivery), or delayed delivery—perineal lacerations or overstretching may occur. This can lead to tears in the pelvic fascia and levator ani muscles, resulting in weakened or defective pelvic floor tissues, widening and opening of the urogenital hiatus, and subsequent downward displacement of the uterus into the vagina under elevated intra-abdominal pressure before full postpartum recovery.

Secondly, genital prolapse—including uterine prolapse—is commonly observed in postmenopausal women. This occurs due to declining ovarian function and consequent estrogen deficiency during menopause, leading to degeneration, weakening, laxity, and atrophy of pelvic floor muscles and supporting fascial structures, as well as reduced muscle tone. These changes predispose affected women to uterine prolapse, urethral prolapse, or other forms of pelvic organ prolapse. Similarly, some younger postpartum women who breastfeed for prolonged periods may experience transient ovarian suppression, resulting in diminished elasticity and tensile strength of uterine support structures and mild uterine prolapse.

Elevated intra-abdominal pressure is an important contributing or exacerbating factor for uterine prolapse—especially when it occurs in individuals with prior obstetric injury or reduced tone of pelvic supportive tissues. To minimize risk, avoid prolonged standing or engaging in heavy physical labor, thereby reducing chronic abdominal pressure. We hope this information is helpful to you!