Certain women are at genetic risk and have inherently poor strength of connective tissue
Women can make lifestyle choices that can reduce her risk. In general, decreasing pressure on the pelvic floor walls is wise.
This can be done by:
- Maintain normal weight or losing weight if overweight. Overweight women are at a significantly increased risk.
- Avoid constipation and chronic straining during bowel movement. A diet with plenty of fiber and fluids, as well as regular exercise is important for maintaining regular bowel function. If constipation persists despite these measures, further evaluation and treatment is recommended.
- Seek medical attention to evaluate and treat a chronic cough which increases abdominal and pelvic pressure.
- Avoid heavy lifting and learn how to lift safely by using leg and arm muscles as much as possible.
- Do not smoke
- Avoid repetitive strenuous activities.
- Practice pelvic floor muscle exercises “KEGELS” regularly. Once prolapse has developed, Kegels will not correct the problem but may prevent the prolapsed from getting worse.
There has been considerable discussion about whether a cesarean delivery (C-section) might reduce the chance of developing prolapse later in the life. Operative vaginal deliveries (forceps or vacuum deliveries) may increase the risk of pelvic floor injury and increase woman’s risk of developing prolapse. Route of delivery is very important and a complicated topic, which one should address with their obstetrical provider. It is clear that being pregnant alone, regardless of the type of delivery, contributes to the development of pelvic floor disorders. However, it is important to remember that there are women who have never been pregnant who leak urine and stool or have prolapse – and women who have delivered many times who do not.
There is no clear answer to this question at this time.