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Symptoms, Their Causes & Cures: Vaginal Bulge

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Vaginal Bulge

WHEN TO SEE YOUR DOCTOR

* You feel an unusual heaviness or pressure inside your vagina.

* You feel something protruding from the vaginal opening.

What Your Symptom Is Telling You

Chances are, if you have a vaginal bulge, you've also had children, maybe several of them, says David Soper, M.D., a gynecologist at the Virginia Commonwealth University/Medical College of Virginia in Richmond. Over the years, gravity, childbirth and the tissue-thinning processes of menopause can weaken the ligaments and muscle supports that hold your pelvic organs in place. And when the organs begin to drift downward, the condition is called prolapse.

It's a very gradual process, and though a bulge inside your vagina feels very scary, it's not dangerous. It's just very uncomfortable, it can interfere with sexual intercourse and it's hard to live with, says David Chapin, M.D., a gynecologist and instructor in obstetrics, gynecology and reproductive medicine at Harvard Medical School and director of gynecology at Beth Israel Hospital in Boston.

The vagina begins to turn inside out, and depending on the location and degree of prolapse, the bladder, rectum and uterus may come along with it. Most commonly, the bulge is the front wall of the vagina that has given way, says Dr. Chapin. The sensation is something like feeling an egg at the opening of the vagina, he says. The bulge or protrusion can get as big as a fist, or even the size of a grapefruit.

Sometimes a prolapse can make it hard to retain urine when you sneeze, laugh or cough. And if the rectum has "fallen," you may have problems passing stool.

Symptom Relief

There are several solutions to the problems of prolapse, and your doctor can help you determine which is right for you.

Befriend that fiber. Although it won't correct the prolapse, eating a high fiber diet to keep stool soft will make moving your bowels easier, says Roger Smith, M.D., a professor of obstetrics and gynecology at the Medical College of Georgia Hospital and Clinics in Augusta. He recommends lots of fruits and vegetables, with a fiber supplement like Metamucil or Citrucel as needed.

Make multiple "rest stops." Your bladder will be less likely to leak from the pressure of the prolapse if you keep it empty, Dr. Smith says. Remind yourself to urinate regularly, even if you don't feel the urge.

Let it be. If your prolapse is mild enough that it's not causing major problems, it may be appropriate to simply leave it alone, Dr. Chapin says. Talk it over with your doctor.

Repair the foundations. Your doctor may advise you to have surgery for your prolapse. It would involve repairing the front and back walls of the vagina. If the uterus is involved, your doctor may recommend a vaginal hysterectomy, which removes the uterus without an abdominal incision.

Wear a pessary. If surgery is not an option for you, your doctor may prescribe a pessary—a plastic or rubber diaphragm-like device worn inside the vagina to hold up the collapsing structures. Pessaries must be changed every few months, and though they may cause odor and small ulcerations of the vaginal lining, they are safe to use, Dr. Chapin says.

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