Do your prolapse symptoms get worse before your period?
Do you notice your prolapse symptoms flare up around your period? You’re not imagining it – and you’re definitely not alone. Many women with pelvic organ prolapse feel there’s a real, connection between hormonal fluctuations throughout the menstrual cycle and prolapse symptom severity. But this doesn’t mean that your prolapse has got worse.
In this blog, I’ll look at the menstrual cycle, possible links to symptom bother and how tracking your cycle can help make symptoms more predictable. It’s important to note that cycles and symptoms are individual so your cycle may increase bother or you may not notice any change in your prolapse symptoms.
Understanding the menstrual cycle
Understanding why prolapse symptoms fluctuate with your menstrual cycle starts with recognizing how hormone levels change throughout the month – and how these changes can impact your pelvic floor and surrounding tissues.
During the menstrual phase (days 1-5)- lower estrogen and progesterone which may make the tissues of the vaginal wall feel less supportive or more sensitive to sensations
During the follicular phase (days 1-13)- estrogen is rising and tissues may feel more robust and less sensitive
During the ovulatory phase (days 12 – 16) – changes to the cervix and may notice some increased pressure
During the luteal phase (days 15-18) – high progesterone and decreasing estrogen – may notice some constipation which may impact symptoms
Why hormones may impact your prolapse symptoms
Estrogen and the pelvic floor
Estrogen is crucial for maintaining the strength and integrity of pelvic floor tissues. Research shows that vaginal estrogen treatment has beneficial effects on symptoms associated with pelvic floor dysfunction, highlighting how important this hormone is for tissue health.
When estrogen levels drop (such as during menstruation or approaching menopause), the supportive tissues around your pelvic organs may become less robust, potentially leading to increased prolapse symptoms including:
- Increased sensation of heaviness or pressure
- More noticeable vaginal bulging
- Changes in urinary symptoms
- Heightened awareness of pelvic floor dysfunction
Progesterone and the pelvic floor
Progesterone, which rises significantly during the luteal phase (after ovulation), affects smooth muscle tissue throughout your body. This can impact prolapse symptoms in several ways:
- Digestive Changes: Progesterone can slow gut motility, leading to constipation. Research suggests that increased intra-abdominal pressure from constipation may contribute to pelvic floor stress and worsen prolapse symptoms.
- Tissue Softening: Higher progesterone levels can make tissues more pliable, potentially affecting the structural support around prolapsed organs.
- Cervical Changes: During ovulation, the cervix becomes softer and may feel heavier or more prominent, which can be particularly noticeable for women with uterine prolapse.
Ways to manage cyclical prolapse symptoms
Track your cycle and symptoms to more accurately predict
Knowledge is power when it comes to managing cyclical symptoms. Understanding your unique pattern can help you prepare for and manage symptom flares more effectively.
What to track:
- Daily prolapse symptom severity (1-10 scale)
- Menstrual cycle days
- Bowel movement patterns and consistency
- Sleep quality and stress levels
- Physical activity and exercise intensity
How this helps: After 2-3 cycles, you’ll likely notice patterns that allow you to anticipate symptom changes. This predictability can reduce anxiety and help you plan modifications to your routine during more challenging times.
Consider your period products
The right menstrual products can make a significant difference in comfort levels, especially when dealing with prolapse symptoms.
For Tampon Users:
- Choose shorter, wider tampons rather than long, thin ones
- Consider organic, chemical-free options like Flo Applicator tampons (organic bamboo and cotton)
- Try &Sisters eco-applicator tampons with biodegradable cardboard applicators
- Change frequently to avoid additional weight and pressure
Alternative Options:
- Period underwear: WUKA, Modibody, and Nixibody offer excellent protection without internal insertion
- Menstrual discs: May be more comfortable than cups for some women with prolapse
- Pads: High-quality, breathable options can provide security without adding internal pressure
Note: Some women with prolapse find menstrual cups uncomfortable or difficult to position correctly. Don’t feel you must use cups just because they’re popular – choose what works best for your body.
Know and manage symptom triggers
Since you now understand how hormonal changes affect your symptoms, you can take proactive steps to help reduce their bother and support your cycle:
For Constipation Management (especially important during luteal phase):
- Increase fibre intake gradually starting mid-cycle
- Add a small amount of prune juice daily during luteal phase
- Maintain consistent hydration (aim for pale yellow urine)
- Use a squatty potty or footstool for optimal toileting position
- Consider magnesium supplementation (consult your healthcare provider first)
For Exercise and Activity:
- Have workout options for higher symptom days – this may be reducing load or volume in the gym or focusing on positions that help de-load the pelvic floor eg hip thrusts, bench press etc
- Focus on gentle movement like walking, swimming, or yoga
- Pay attention to proper lifting mechanics, especially during menstruation
- Consider using a support garment during higher symptom periods
For Sleep and Stress:
- Prioritise sleep hygiene, especially during luteal phase when progesterone can affect sleep quality
- Practice stress management techniques like deep breathing or meditation
- Reduce caffeine and alcohol, which can worsen both hormonal fluctuations and sleep quality
When to seek expert help
While cyclical changes in prolapse symptoms are common and often manageable, if you are experiencing the following, a chat with your GP or seeing a pelvic health physio can be super useful:
- Severe symptom flares: If your symptoms become significantly worse during certain cycle phases and don’t respond to self-management strategies
- New or different symptoms: Any sudden changes in your prolapse symptoms, regardless of cycle timing
- Impact on daily life: If cyclical symptoms are preventing you from participating in normal activities
- Urinary or bowel changes: New incontinence, difficulty emptying your bladder or bowels, or pain with elimination
- Perimenopause considerations: Changes in pelvic floor function during menopause can lead to pelvic organ prolapse progression, so increased symptoms during perimenopause should be evaluated
Need help with navigating symptoms and exercise?
Find my online strength training and pelvic health programme here
Interested in 1:1 coaching? Click below to book a Pelvic Health Pow Wow or check out my coaching progranme PROJECT STRONG
Beth Davies is a highly experienced personal trainer and coach specialising in female pelvic health, pelvic organ prolapse and exercise. Her programmes educate, empower and support women back to training or their active life, eliminating symptoms and building strength and confidence. She has been featured in women’s lifestyle magazines and websites, including Stylist, Metro, Woman & Home and Marie Claire UK
Beth’s training and coaching for women with pelvic organ prolapse provides face-to-face personal training in Leamington Spa, Warwickshire, and online across the UK and Europe.