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Posterior vaginal prolapse – everything you need to know about rectoceles

Posterior vaginal prolapse – everything you need to know about rectoceles


Rectoceles 101: You’re not alone 

Let’s drop an all-too-common scenario on you, ladies: 

After the birth of your child, you’re getting a six-week check-up of your lady parts. Suddenly, your midwife or gynae cheerfully announces that you’re the owner of something called a ‘rectocele’ – otherwise known as a posterior vaginal prolapse. 

Although quite common, very few women recognize the symptoms straight away. To 'momsplain' the definition, pelvic organ prolapse is when one or more of the organs in the pelvis slip down from their usual position, and bulge into the vagina. In the particular case of rectoceles, it’s when your rectum gets pushed right against your vaginal wall. 

After receiving this prognosis, you say to yourself, “Oh great! Well, that’s just what I need in my life!” *Sigh* 

However, please don’t beat yourself up – they’re more common than you may have guessed, especially for women who’ve experienced vaginal deliveries during childbirth. And because small rectoceles often don’t cause any symptoms, it’s difficult for health experts to determine precisely how often they occur. As many as 40% or a whopping 80% of adult women may be affected in their lifetimes – although the intensity widely varies. 

The good news is that prolapses aren’t life-threatening, but can be a bother and source of discomfort in your day-to-day life. So, considering so many of us ladies have ill-positioned rectums, we’re sharing everything you never ever wanted to know about rectoceles. 

Recognizing the signs of rectocele 

Right now, you’re probably saying, “How the heck could that many women have rectoceles! I’ve never even heard of them!” Well, according to the American Society of Colon and Rectal Surgeons, the key reason behind this is lack of noticeable symptoms. Even those women who do show symptoms, these are usually mild. 

Here are some of the signs to look out for when it comes to recognizing rectal prolapse: 

  • Difficulty with evacuation during a bowel movement, feeling like you haven’t totally evacuated, or sometimes even needing to insert a finger into your vagina to help ease evacuation
  • A general feeling of heaviness around your lower tummy and genitals
  • A dragging discomfort or heaviness inside your vagina 
  • Feeling or seeing a bulge or some tissue protruding out of your vagina 
  • Discomfort or numbness during sex 

The cause and effect 

Oh, the joys of owning a vagina, so conveniently located near the anus! 

Universal causes of rectal and vaginal prolapse can vary, but generally, it results from pressure on your pelvic floor. Some of the causes of increased pelvic floor pressure include: 

  • Frequent straining with bowel movements or chronic constipation 
  • Chronic cough or bronchitis 
  • A weakening of the muscles associated with aging, as rectal prolapse is more common in people ages 65 years and over 
  • Repeated heavy lifting
  • Structural problems with the ligaments that tether the rectum to its surrounds 

There are also effects that come with pregnancy and childbirth. The muscles and connective tissue that work to support your vagina become weakened and stretched throughout the journey of pregnancy, labor, and delivery. As well, the more pregnancies you have, the greater your chance of prolapse. 

What can be done to prevent it? 

According to the good folks over at the Mayo Clinic, there are certain lifestyle choices that can ease the symptoms of rectoceles – even work to prevent them! To reduce your risk, try to: 

  • Do your darn pelvic floor exercises regularly! Using a Kegel trainer like Elvie Trainer strengthens your pelvic floor and keeps all those organs in place. We use a technique called ‘Biofeedback’, which is a special form of pelvic floor physical therapy aimed at improving your techniques during Kegel training and show how your muscles improve and strengthen over time. 
  • Treat and prevent constipation. You can do this by drinking plenty of fluids and eating high-fiber foods. 
  • Avoid heavy lifting and be sure to lift correctly. Use your legs instead of your waist or back. 
  • Control your coughing. Avoid smoking if you can and seek treatment for any chronic cough or bronchitis you may be showing signs of. 
  • Get help from a women’s health physio. Physical therapy can offer long-term relief from prolapse symptoms by strengthening core muscles. These exercises, when used in addition to Kegels to strengthen the pelvic floor, can help to improve your symptoms. 

When to get help 

Well, there you have it, ladies. Much like “mommy bladder”, rectoceles are a pretty common occurrence during womanhood. The good news is that you’re not alone, and you’re not unusual for having one. There are solutions available to make the situation more manageable and don’t hesitate to get advice or a treatment plan from a health expert. 

After all, no one really wants their vagina and rectum to be on such intimate terms.