Cervix feeling a bit low
DEAR DR MITCHELL,
I have never given birth or been diagnosed with a collapsed pelvic floor, but my cervix always feels low and it always seems very close to right inside the opening of my vagina. Do you think this will cause problems for me when trying to get pregnant?
The problem that you have explained with the cervix feeling low in the vagina may be due to an elongated cervix, pelvic floor weakness or prolapse, or an abnormal growth on the cervix.
In some women the cervix is sometimes elongated and is felt low down in the vagina. In most cases it is the anterior lip of the cervix that is longer. In some women, there may be abnormal growth or polyps on the cervix which may feel flat on inserting the finger into the vagina. In most cases that abnormal growth is non-cancerous and can be easily removed, but in a few cases it may be linked with cancer of the cervix and this will need to be properly evaluated and managed by taking a biopsy, or by complete removal of the affected area.
Pelvic floor prolapse is sometimes seen in women who do not have children. It may be as a result of change in the nerves that supply the pelvic floor, caused from diabetes mellitus. This is sometimes seen in women who have had diabetes mellitus for several years. Lifting excessive weights can also damage the pelvic floor and result in prolapse of the pelvic floor with the bladder, rectum, uterus and cervix coming down. Women with a chronic or persistent cough from bronchial asthma, smoking, emphysema or other chronic obstructive airway diseases can also suffer from prolapse of the uterus and cervix. A woman who is overweight with a large anterior abdominal wall is also at increased risk of prolapse. Chronic constipation with straining to pass faeces can also result in prolapse of the cervix and the uterus.
An abnormal growth in the ovaries with excessive accumulation of fluids in the abdomen (ascites) can also push the pelvis down and lead to prolapse of the cervix.
It is important to have a detailed and proper evaluation done by your gynaecologist to determine if you indeed have prolapse, and to try and determine if there is any underlying cause that can be detected so that measures can be put in place to correct it and certainly to prevent worsening of the situation. Pelvic floor exercises (kegel exercises) can be done to help strengthen the muscles and alleviate the problem. Kegel exercises can be done three times per day.
1. Make sure your bladder is empty, then sit or lie down.
2. Tighten your pelvic floor muscles. Hold tight and count three to five seconds.
3. Relax the muscles and count three to five seconds.
4. Repeat 10 times, three times a day (morning, afternoon and night).
Any precipitating factors that are reversible should be addressed. Simply reducing heavy lifting and treating a chronic cough and constipation can certainly prevent worsening of the situation. Weight loss will definitely help in reducing this problem.
Women with pelvic floor prolapse can become pregnant since this does not cause infertility. However, delivery should be by caesarean section since pushing during labour, as well as forceps and vacuum delivery can contribute to significant worsening of the problem.
Consult your doctor who will advise you further. Best regards.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
DISCLAIMER:
The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.
