Pelvic Organ Prolapse and Sex
Pelvic Organ Prolapse (POP) can be a debilitating condition with life-altering effects including intimate relationships. Sexual health has important positive impacts on our overall wellbeing, physical and mental health, but what happens when sex seems impossible?
In Australia, it’s estimated that at least half of women who have had more than one child experience pelvic organ prolapse.
Pelvic organ prolapse occurs when one of the pelvic organs sags and may bulge or protrude into the vagina. There are several types and grades of prolapse with many women being asymptomatic. Others report vaginal pressure or heaviness, a vaginal bulge that can be seen or felt, irritation, sexual problems or incontinence.
Not exactly a recipe for sexual excitement!
The 2 biggest concerns when it comes to sex and prolapse
Body image and sexual self-image are the biggest causes of a reduced sex life. Women with pelvic organ prolapse can feel undesirable, embarrassed, ashamed and insecure.
They are also concerned about what their partner may see or feel during sex because they may not even want to see or feel their genitals.
54% of mothers aren’t confident to discuss sex-related problems. Women with POP find it difficult to speak to their partner about:
- Sexual pain/discomfort
- Incontinence during sex
- Different sexual activities such as oral sex. Is it a yes or a no-go?
- Fear of the unknown. Will sex make the prolapse worse? Will I be incontinent?
- Pessary use during sex
Is sex with prolapse possible?
Sex includes a plethora of activities. Sex is not penetrative intercourse. There are many ways to remain intimate and sexually active in your relationship with prolapse.
You can even use sex toys! 26% of your body’s surface is erogenous zones. There’s a huge array of toys on the market today to explore the endless possibilities your body has to offer.
Sex with a pessary
Sex with a pessary is possible. Only some pessaries are removable so if intimacy is important to you and your relationship, where possible, request a removable pessary.
In one study of sexually active pessary users, 70% removed their pessary for sexual intercourse, often due to partner preferences. It is clear from several studies that the partner’s opinion on sex with a pessary was highly influential. Often it’s removed because the partner can feel it or is concerned that it will hurt the woman.
Whether you want to remove the pessary or not is up to you as a couple considering pain reduction, pleasure enhancement and comfort.
What’s the best approach to sex with prolapse?
If it’s been a while since you have been intimate, sex can be stressful. Take the stress out of sex with:
It’s time to have that awkward conversation! Grab a drink and sit down with your partner and talk about:
- How you see yourself as a sexual person
- How important intimacy and sex are to you
- What your biggest concerns are when it comes to having sex
- What your boundaries are, what you are willing to do and try and what you don’t want to do
This awkward conversation is going to help remove your anxiety because you and your partner have developed a game plan to move forward.
Touch is important for connection and increasing sexual desire. Consider touch variations of pressure, vibration, temperature and location.
Non-genital touch sessions are great to start with by taking the pressure off a session heading too far or in a direction you aren’t ready for.
Genital touch doesn’t need to be skin-to-skin. Keep your underwear on until you feel comfortable to remove them.
Try lots of different positions until you find the ones that work best for you. Missionary is often thought of as male-dominant because they are on top, but you can take control from the bottom. For example, telling your partner to straighten their legs and support themselves on their elbows will automatically limit movement. Consider positions where gravity is working with you not against you.
Tools of the trade
- Lubricant: grab a good lubricant that’s going to last. Silicone-based are thicker and longer lasting than water-based. My favourite is Lucy Lube. It’s TGA approved and surprisingly thick for a water-based. Don’t be shy to reapply!
- Ohnut: a set of 4 rings that act as a buffer and are used to stop penetrative pain. It’s great for easing back into penetrative intercourse and if you do wear a pessary during intercourse and YOU find it more comfortable but your partner complains they can feel it, the ohnut may be enough of a buffer to prevent them from touching it.
- Squirt blanket: If incontinence is a concern grab a squirt blanket and a towel. Use the waterproof blanket to protect your bedding and a hand towel in case you need to wipe. These versatile blankets can be used during your period, if you use a natural lubricant or whilst doing some food play.
Confidently get back in the saddle and enjoy your sexual health and all its benefits.
After additional information? Grab a copy of your FREE Sex and Prolapse Fact Sheet here.