Harvard Women's Health Watch

In the journals: Pelvic organ prolapse: Vaginal delivery is not the only cause

In the journals

Pelvic organ prolapse: Vaginal delivery is not the only cause

As many as one-third of women at midlife have some kind of pelvic organ prolapse — a condition in which uterine, bladder, urethral, or rectal tissue protrudes into the vagina. The risk of pelvic organ prolapse increases with age, and it's more common in women who've given birth vaginally. Still, vaginal delivery doesn't explain why many mothers who've given birth vaginally escape prolapse and some childless women develop the condition. So researchers have sought other risk factors. In May 2007, Harvard Women's Health Watch reported that genetics plays a significant role. Now, a report in the May 2009 issue of Obstetrics & Gynecology indicates that several other factors, including lifestyle, may also be involved.

Researchers surveyed 5,489 Swedish women, ages 30 to 78. The 454 women identified as having pelvic organ prolapse and a randomly selected control group of 405 women without the condition answered a 72-question survey that covered educational background, occupation(s), health history, and lifestyle.

Results showed that women with prolapse were generally older and more likely to have borne more children. They were also three times more likely to have a family history of prolapse. But there were other strong predictors as well. Women with prolapse were almost twice as likely to be overweight (a body mass index of 26 to 30) and almost twice as likely to have conditions such as hemorrhoids or varicose veins (indications of weak connective tissue). They were more than twice as likely to have done work that regularly required lifting more than 22 pounds and more than twice as likely to have been chronically constipated or to have experienced hard stools or difficult elimination.

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