What is the cause of prolapse and what treatments are effective?
Prolapse occurs when the ligaments that support the pelvic organs are damaged. This may happen during childbirth or there may be an inborn weakness of the pelvic support tissue that worsens as a normal part of the ageing process. Treatments for prolapse that have been shown to be effective in some women include hormone therapy, pelvic floor exercises, vaginal support pessaries and surgery. Of these treatments, the available evidence suggests that surgery is the most effective. It would be preferable, however, if greater emphasis was put on prevention of prolapse problems. This could be achieved by educating young women about the value of pelvic floor exercises and teaching them how to do them. Ideally these exercises should be performed regularly from the teenage or early adult years onwards.
I have endometriosis but it is not causing any problems at the moment. Is there any reason why I should consider having it treated?
Yes, you should consider having your endometriosis treated rather than letting it progress, as it tends to worsen in most women without treatment. Once it has progressed, it is more difficult to treat by surgery or drugs. There is, however, one circumstance in which it may be safe to ignore this advice—if your endometriosis is mild and is known not to have progressed for some years. In these circumstances, regular check-ups with ultrasound assessment are advisable.
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