The symptoms of pelvic support problems depend on which organ is involved.  They can cause the feeling of heaviness or fullness, or as if something is falling out of the vagina.  Sometimes it presents itself as a pulling or aching feeling in the lower abdomen or pelvis.  And in some cases, leakage of urine, problems with sex, or problems having a bowel movement is the symptom of pelvic prolapse.

A cystocele occurs when the bladder drops from its normal place into the vagina.  Some cystoceles cause urine to leak when you cough, sneeze, lift objects, or walk.  There are many reasons why a woman may leak urine.  You should see a doctor if leakage of urine is a problem for you. 

A vaginal vault prolapse with enterocele involves the vagina and small intestine.  Sometimes after hysterectomy (removal of the uterus) the top of the vagina loses its support and drops.  An enterocele is a type of support problem that forms when the small intestine drops through supporting tissue and bulges into the vagina.  To diagnose an enterocele, your doctor may examine you while you are standing.

A rectocele is caused by a weakness of the back wall of the vagina.  A large rectocele may make it hard to have a bowel movement, especially if you are constipated. 

Uterine prolapse means that the uterus drops down into the vagina.  Mild degrees are common and do not need surgery.  Women with more severe forms often will have a feeling of pelvic pressure or a pulling feeling in the vagina or lower back.  The cervix (the opening of the uterus) may even stick out from the vagina.  This may cause discomfort or problems with sex.  Uterine prolapse most often occurs when other pelvic organs are also out of place. 

Proper diagnosis is key to the treatment of pelvic support problems.  Your doctor will take your complete medical history, do a thorough exam, including a vaginal and rectal exam.  You may be examined while lying down, sitting or even standing.  You may also be asked to strain and/or cough during the exam.  Your bladder functions may also need to be tested (cystometrogram). 

Many women do well without surgery.  Some are relieved by exercising.  Kegel exercises tone your pelvic muscles and strengthen the muscles surrounding the openings of the urethra, vagina and rectum.  They must be done correctly to work. Making changes in diet, such as cutting down on caffeine, which acts as a diuretic, making you urinate more often.  Caffeine can be found in coffee, tea and soft drinks.  A diet high in fiber may help bowel function and prevent constipation avoiding problems with a rectocele.  Losing or keeping your weight under control is important to the support tissue of the organs.  Not smoking and avoiding lifting or straining helps as well.  Medications both for urinary and bowel function are available.  Hormonal treatment also may help strengthen vaginal tissues.  The use of a device called a pessary may be inserted into the vagina to support the pelvic organs.  When a pessary is used, it must be removed, cleaned and reinserted on a regular basis.  Your doctor will be able to fit you with the right one for you.

Pelvic support problems may also be corrected surgically.  The surgery can be done either through the vagina or abdomen depending on your type of support problem.  As always, discuss this with your physician.