Many women complain of pelvic heaviness sensations or a feeling of heaviness in the lower abdomen. Here’s an explanation of these potentially worrying sensations, especially if they appear suddenly.
What is pelvic heaviness?
Pelvic heaviness refers to a feeling of heaviness in the lower abdomen experienced by a woman. This discomfort is generally located in the lower part of the abdomen and can occur at any age.
Other physical issues may also accompany this sensation of heaviness. These include pain, a swollen and hard belly like that of a pregnant woman, occasional urinary leaks or even genuine urinary incontinence, and constipation.
Finally, this heaviness can sometimes indicate an underlying gynecological condition related to the urinary or genital systems. Further examination is then necessary.
Causes of heaviness in the lower abdomen
The pelvic cavity contains the pelvic organs (bladder, vagina, uterus, and rectum). Imagine it as a balloon open at the bottom. Two forces act on its contents: gravity and abdominal pressure.
To counter these forces and keep the organs in place, two mechanisms work together:
- The pelvic floor supports the organs when it is sufficiently toned.
- A set of fascia and ligaments suspend and stabilize these organs.
Pelvic floor weakening and organ prolapse
However, these mechanisms can weaken after complicated childbirths (mechanical effect) or after a certain age (hormonal decline). The pelvic floor then no longer properly supports the genital organs, allowing them to descend.
Organ prolapse can affect one or more genital organs:
- Cystocele (bladder).
- Hysterocele (uterus).
- Rectocele (rectum).
- Elytrocele (posterior part of the vaginal wall).
There are 4 stages of severity (according to Baden-Walker), depending on the extent of the prolapse.
Risk factors for prolapse
Other factors also increase the risk of prolapse:
- Obesity (weight loss is then preferable);
- Constipation (straining on the toilet);
- High-impact sports (running, trampoline) or those causing strong abdominal pressure (gymnastics, crossfit);
- Chronic cough;
- Lack of pelvic floor training after childbirth;
- Working in a standing position (teachers, sales assistants…);
- Carrying heavy loads (manual labor, caregivers…);
- Hereditary factors.
Other Causes of Pelvic Heaviness
Besides prolapse, other factors can also cause a heavy feeling in the lower abdomen.
Pregnancy
As it grows, the uterus puts increasing pressure on the abdominal organs (bladder, intestines, etc.), leading to sensations of heaviness and discomfort.
Menstrual Cycle
Heaviness occurring at the same time in the cycle is quite common before or during your period. If the discomfort is one-sided and happens mid-cycle, it is often due to ovulation.
However, if the pain is persistent or severe, it could indicate a more serious condition (ovarian cyst, urinary infection, etc.).
Menopause
Menopause causes a significant hormonal upheaval that can lead to urinary issues and pelvic heaviness.
After a Meal
Experiencing lower abdominal pain but no period? A digestive problem or transit issue might be the cause.
How to Relieve Pelvic Heaviness?
If pelvic heaviness causes pelvic pain or becomes chronic, talk to your gynecologist. For example, if you often experience lower abdominal pain outside of pregnancy or during intercourse.
The diagnosis will include a medical interview, a gynecological exam, and possibly a pelvic ultrasound.
Effective Treatment for Lower Abdominal Heaviness
Depending on the severity of the prolapse and the discomfort caused, three treatment options are available.
Pelvic Floor Training and Rehabilitation
First, pelvic floor training improves awareness and muscle tone of the pelvic floor. It also helps adjust abdominal pressure and posture.
Note that after childbirth, social security covers 8 pelvic floor training sessions with a specialist. Choose between a physiotherapist or a midwife.
While training does not reverse advanced prolapse, it stabilizes it and makes it more manageable. It mainly relieves symptoms and sensations of heaviness.
Finally, you can also train at home and actively strengthen your pelvic floor with a Emy pelvic floor trainer.
Biofeedback makes pelvic floor strengthening exercises more engaging and effective. Through its mobile app, Emy motivates and supports you to make lasting progress.
Pelvic Heaviness: User Testimonials
Here are some experiences shared by women who agreed to testify and demonstrate a quick improvement and long-lasting relief from their symptoms thanks to pelvic floor training with Emy.
“After surgery for organ prolapse, the heaviness returned and terrified me. With Emy at home, alongside my physiotherapy, my pelvic floor regained strength: no more pain, leaks, or fear of another surgery!”
Eve, 62, living with prolapse - Read her story“Postpartum, I felt a vaginal ‘dropping’ sensation, my menstrual cup slipped, and I had leaks despite seeing the midwife. Emy, with its medical protocols, toned my pelvic floor in just a few weeks: less pelvic heaviness and back to normal.”
Sarah, 29, new mum in postpartum - Read her story“Diagnosed with rectocele after childbirth: constant weight in the lower abdomen. Combining physiotherapy and Emy, the heaviness faded quickly and my prolapse disappeared on examination. Now just one weekly session is enough!”
Jennifer, experiencing postpartum rectocele - Read her story“Prolapse with leaks and lower back pain caused by daily heaviness. Emy helped me target my pelvic floor: less heaviness, less pain, and a real sense of lightness every day.”
Joyce, 64, living with prolapse and daily pain - Read her story“Intimate discomfort, heaviness, and bowel difficulties with my rectocele. Emy and its app gave me precise feedback: targeted exercises, improved digestion, and intimate comfort finally restored.”
Ghislaine, 53, dealing with constipation and rectocele - Read her story
Wearing a pessary
You can also choose to wear a pessary. This small vaginal device provides support to descending organs. It temporarily relieves pelvic issues in a transitional way.
Since inserting a pessary can be tricky at first, ask for a specialized consultation with a healthcare professional to learn how to use it properly.
Surgery
Finally, if pelvic floor training is not enough, surgery is the last resort.
The surgery involves re-suspending the organs within the pelvic cavity.
FAQ – Pelvic Heaviness
What are the common causes of pelvic heaviness in women?
Pelvic heaviness is a feeling of weight or pressure in the lower abdomen, pelvic area, or pelvic floor. This sensation is common in women and can stem from various causes, often related to an imbalance of the pelvic floor.
The main causes include:
- Pelvic floor muscle relaxation, often due to pregnancy, vaginal childbirth, age, or menopause;
- Pelvic floor disorders such as genital prolapse (descent of the uterus, bladder, or vagina);
- Certain gynecological conditions, for example, endometriosis, which can cause chronic pelvic pain;
- Excessive abdominal pressure linked to constipation, digestive bloating, heavy lifting, or inappropriate physical activity;
- Hormonal factors, especially during the menstrual cycle, postpartum period, or hormonal changes.
👉 Pelvic heaviness is often related to multiple factors, both physical and sometimes emotional (stress, fatigue), which affect the body and pelvic organs.
What symptoms can be associated with pelvic heaviness?
The feeling of pelvic heaviness can be accompanied by various symptoms whose intensity varies depending on the cause and situation.
The most common signs are:
- A pelvic pressure felt when standing or at the end of the day;
- Discomfort in the pelvic floor or vaginal area;
- Pelvic pain, sometimes dull or chronic;
- A sensation of a lump or descent in the genital area;
- Abdominal cramps, pulling sensations in the lower abdomen or belly;
- Urinary issues such as leakage, difficulty urinating, or incontinence;
- Discomfort during sexual intercourse (dyspareunia).
These symptoms can be worsened by physical effort, stress, constipation, or prolonged standing, and relieved by rest or certain postures.
Is pelvic heaviness normal during pregnancy or after childbirth?
Yes, pelvic heaviness is common during pregnancy and after childbirth, especially in the weeks following birth.
During pregnancy, the uterus enlarges, the baby's weight increases, and this puts significant pressure on the pelvic floor, ligaments, and muscles. This pressure can cause a feeling of heaviness, particularly late in the day or during the third trimester.
After vaginal childbirth, the pelvic floor has been heavily strained. A sensation of Postpartum pelvic floor heaviness is common and generally temporary. It is part of the female body's recovery process.
👉 However, if the discomfort persists, worsens, or is accompanied by significant pain, it may indicate a pelvic disorder requiring medical attention.
How long can pelvic heaviness last after a vaginal delivery?
The duration of pelvic heaviness after childbirth varies depending on the woman, the number of pregnancies, the condition of the pelvic floor, and whether there are any complications.
Generally:
- the sensation gradually decreases over a few weeks;
- pelvic floor recovery usually spans 6 to 8 weeks, sometimes longer;
- pelvic floor training, supervised by a midwife or physiotherapist, helps strengthen muscles and relieve heaviness.
If the heaviness persists for several months after delivery, it may suggest an early prolapse, muscle weakness, or another issue requiring medical consultation.
How can you recognize a pelvic organ prolapse?
Pelvic organ prolapse, also called genital prolapse, refers to the slipping down of one or more pelvic organs (uterus, bladder, rectum).
Common signs include:
- a feeling of a lump or weight in the vagina;
- a sensation that “something is dropping” in the pelvic floor area;
- persistent pelvic heaviness, worsened when standing;
- urinary or digestive issues (constipation, difficulty urinating);
- sometimes discomfort during sexual intercourse.
The prolapse can be mild or more advanced. Only a gynecological clinical exam can provide an accurate diagnosis.
When should you see a doctor or gynecologist for persistent pelvic heaviness?
It is recommended to consult a doctor or gynecologist when:
- pelvic heaviness lasts over time or becomes chronic;
- pain intensifies or becomes disabling;
- urinary, sexual, or digestive symptoms appear;
- discomfort affects quality of life;
- the sensation occurs outside of pregnancy or long after childbirth.
👉 A consultation is especially important in case of unusual bleeding, sharp pain (medical emergency), or suspicion of gynecological conditions (infection, endometriosis, rarer cancers).
What medical exams (clinical exam, ultrasound, urine test) help with diagnosis?
The diagnosis of pelvic heaviness involves several complementary steps:
Clinical examination
Performed by a doctor or gynecologist, this exam assesses the pelvic floor, vagina, uterus, and checks for prolapse.
Pelvic ultrasound
This visualizes pelvic organs (uterus, ovaries, bladder) and helps identify any gynecological or abdominal cause.
Urine tests
Useful in case of urinary symptoms to rule out infection or bladder issues.
Depending on the situation, other exams may be considered in a hospital or specialized clinic. The treatment will then be tailored to the identified cause. : pelvic floor training, targeted exercises, pessary, medical treatment or, more rarely, surgical intervention.
Source
The Pessary: Information Sheet for Patients with Pelvic Organ Prolapse, Haute Autorité de Santé (HAS), April 2022, Patient Sheet (HAS), link
