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I have a fitness-meets-medical question. Does running cause uterine prolapse? Generally, it occurs after child birth, however, I recently heard that skipping or running (or any such activity) while menstruating may lead to uterine prolapse and I've been worried ever since! Can you please clarify this issue for me as I hate missing my running sessions.
— One Worried Runner
What a great question to ask, since many of FitSugar’s readers are runners! To learn what a uterine prolapse is and if running increases your chances of experiencing it, just read more.
To begin, we should define uterine prolapse, as many people may not even know what this is. Uterine prolapse means that one’s uterus has descended from its normal position in the pelvis down into one’s vagina. Normally, your uterus is held in place by the muscles and ligaments that make up the floor of the pelvis. Uterine prolapse occurs when the pelvic floor muscles and ligaments stretch and weaken, which in turn provides inadequate support for the uterus to stay in place. There are varying degrees of prolapse as the uterus can descend into the lower vagina or even through the opening of the vagina.
Symptoms of uterine prolapse include: a feeling of heaviness or pressure in the pelvis, tissue protruding from the vagina, urinary difficulties (including urine leakage, recurrent bladder infections, increased urgency or frequency), pain during intercourse, and constipation. Symptoms may be worsened by prolonged standing or walking. This is due to the added pressure of gravity placed on the pelvic muscles.
There are several factors that contribute to the weakening of pelvic muscles, which can lead to uterine prolapse. These include loss of muscle tone as the result of aging or injury during childbirth, especially if the woman has had many babies or large babies (more than nine pounds). Obesity, chronic coughing and straining, strenuous physical activity, and chronic constipation all place added tension on the pelvic muscles, which may contribute to the development of uterine prolapse. Genetics may also play a role, as women of Northern European descent have a higher incidence of prolapse. UpToDate reports that the majority of patients with clinically significant prolapse will have at least two or more risk factors for the disorder.
Long-distance runners do have a higher propensity toward uterine prolapse. The running likely does not cause weakened muscles and tissues, but it can worsen an already weakened pelvic floor due to the constant impact. Menstruation can also worsen preexisting prolapse symptoms. In my research, I did not find any evidence that exercise (during menstruation specifically) can cause uterine prolapse.
Uterine prolapse may not be something you can prevent, but there are steps you can take to decrease your risk. Practicing Kegel exercises (where one repeatedly squeezes and relaxes the pelvic floor muscles, like when you’re stopping a stream of urine) can help strengthen the pelvic floor muscles. Maintaining a healthy weight and exercising regularly is very important as well. Finally, one should control coughing (quit smoking!) or any other activity that requires a lot of straining, such as heavy lifting.
If you currently do not have any risk factors or symptoms, continuing your exercise regimen (even during your menstrual cycle) should be just fine. But, if you have any of the risk factors or symptoms as listed above or still have some concerns, it may be prudent to discuss this issue further with your primary care doctor.
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