- Yes, you can have sex with pelvic organ prolapse: according to Dr Marine Lallemant, a gynaecologist specialising in pelvic floor medicine, vaginal penetration is not contraindicated in case of prolapse.
- Prolapse can, however, affect desire, comfort and self-confidence: foreplay, choice of positions, lubricant and dialogue with your partner help regain a fulfilling sex life.
- A pelvic floor assessment and pelvic floor rehabilitation with a healthcare professional, followed up with maintenance exercises at home, are among the paths to regaining intimate comfort.
Pelvic organ prolapse, also called genital prolapse, corresponds to the slipping of one or several pelvic organs (bladder, uterus, rectum) toward the vagina. As Dr Marine Lallemant reminds us, it is far more widespread than people think. According to a literature review conducted as part of the International Consultation on Incontinence, prolapse affects 3 to 6% of women based on reported symptoms, and up to 50% when based on gynaecological examination. So, can you keep a fulfilling sex life with prolapse? Dr Marine Lallemant answers your questions.
Can you have sex with pelvic organ prolapse?
Of course, you can have sex with pelvic organ prolapse. For Dr Marine Lallemant, a gynaecologist and obstetrician specialising in pelvic floor medicine, vaginal penetration is not a contraindication in case of prolapse. However, in the case of prolapse or urinary leakage, each phase of the sexual response can be disrupted.
Is sex with prolapse dangerous?
Having sexual intercourse with prolapse remains possible: penetration is not contraindicated. The sensation of a "bulge" in the vagina is often less pronounced in a lying position, which explains why some positions are more comfortable than others. And, according to Dr Lallemant, sexual intercourse does not worsen pelvic organ prolapse. If pain appears, talk to your doctor or your midwife about it.
What is the impact of prolapse on sexuality?
Prolapse and urinary leakage can lead to urine leaks or pain during intercourse. These symptoms also weigh on emotional well-being: nervousness, anxiety, sometimes low mood.
You may experience a drop in sexual desire, a decrease in the number and quality of orgasms. Intercourse may be limited by the discomfort linked to the bulge in the vagina, or by the fear of pain or of a leak. Feelings of frustration, guilt or shame may set in and make flourishing in your sex life more difficult.
How does the sexual response work in women?
The human sexual response follows a cycle in four phases: excitement, plateau (pleasure), orgasm (not systematic) and resolution. Unlike men, women do not have a refractory period and can have several orgasms in a row.
Vaginal penetration is not essential to feel sexual pleasure. The key organ is the clitoris: when aroused, it fills with blood, and orgasm goes through it, whether stimulation is direct or indirect (through the vaginal walls). A satisfying encounter is not limited to orgasm either: complicity, tenderness and sensuality count just as much. A tip: free yourself from performance pressure.
And the partner, what do they feel?
Some patients report a drop in desire or erectile difficulties in their partner when he sees the bulge at the level of the vagina. Other men mention a loss of sensation during penetration, linked to the loss of tone of the pelvic floor muscles. With age, male sexual dysfunctions may also affect the couple's sex life: all the more reason to talk about it together.
How to improve your sex life with pelvic organ prolapse?
Why talk to a healthcare professional?
The first step is to seek a consultation, alone or, even better, as a couple, to defuse the issue and lift the taboo around prolapse and urinary leakage. These symptoms are nothing to be ashamed of. A gynaecologist, a midwife, a sex therapist or a psychologist can support you.
Which positions should you favour to have sex with prolapse?
Lying positions, with the pelvis slightly raised (a cushion under the buttocks, for example), are often the most comfortable. Take the time to experiment, to adjust the rhythm and amplitude of movements, and don't hesitate to change position if discomfort appears.
Why take your time with foreplay?
To rekindle desire and favour arousal, insist on foreplay: caresses, massages, clitoral stimulation. In case of vaginal dryness, a water-based lubricant or a local hormone treatment prescribed by your doctor make lubrication easier.
Can you have sex with a pessary?
The pessary is a device placed in the vagina to support the organs. Some pessaries are compatible with penetrative sexual intercourse, others must be removed before intercourse, specifies Dr Lallemant. Ask your gynaecologist or midwife whether yours can stay in place during intercourse and, if needed, how to remove and reinsert it yourself.
Can strengthening your pelvic floor help regain confidence?
A pelvic floor assessment helps understand the origin of the symptoms. In the vast majority of cases, pelvic floor rehabilitation with a specialised physiotherapist or a midwife is beneficial to strengthen the pelvic floor. On prescription, these sessions can be partly or fully covered by national or private health insurance in many countries — check with your healthcare provider.
To continue exercises at home, as a complement to this follow-up, Emy Trainer is a connected pelvic floor probe, a CE-marked medical device intended for pelvic floor rehabilitation as part of the management of urinary leakage. It captures the contractions of the pelvic floor and, thanks to biofeedback, lets you see directly in the app whether you are activating your pelvic floor. The progressive mini-games make the 5- to 20-minute sessions more enjoyable and help you stay motivated over time. The probe can be used in several positions, including standing.
It is also worth noting that 2 out of 3 women who use Emy Trainer long-term for their pelvic floor rehabilitation report a significant improvement in their prolapse-related symptoms (based on a survey conducted among our users).
Read all testimonials from our users
How to have sex after pelvic organ prolapse or surgery?
When can you resume intercourse after prolapse surgery?
After prolapse surgery, the waiting time before resuming intercourse with penetration is set by your surgeon, the time needed for the tissues to heal. After this period, resumption is gentle, with lubricant and at your own pace.
What tips make intercourse easier with prolapse?
- Empty your bladder and bowels before intercourse.
- Don't neglect foreplay.
- Favour lying positions, with the pelvis raised.
- Take your time and adjust the rhythm of your movements.
- Communicate with your partner about what is comfortable or not.
- Use lubricant if needed.
- Do pelvic floor rehabilitation sessions to improve your intimate comfort.
FAQ — Sexuality and pelvic organ prolapse
Can sexual intercourse worsen pelvic organ prolapse?
No. According to Dr Marine Lallemant, sexual intercourse does not worsen prolapse, and vaginal penetration is not contraindicated. If pain or unusual discomfort appears, consult your doctor or your midwife.
What position should I adopt to have sex with prolapse?
Lying positions, with the pelvis slightly raised, are generally the most comfortable, as the discomfort linked to prolapse is often less pronounced when lying down.
Can you have sex with a pessary?
Yes, with some pessaries. Other models must be removed before intercourse: your gynaecologist or midwife will tell you what applies to yours.
Does my partner feel the prolapse during penetration?
Every situation is different. Some partners don't notice anything, others mention a different sensation. The most important thing is to talk about it together and prioritise what feels good for both of you.
Should I see a doctor if intercourse becomes painful?
Yes. Painful intercourse is not inevitable: a gynaecologist, a midwife or a physiotherapist can look for the cause and offer suitable care.
Key takeaways
- You can have sex with pelvic organ prolapse: penetration is not contraindicated and pleasure is not limited to it.
- Foreplay, lying positions, lubricant and dialogue with your partner make intercourse more comfortable.
- A pelvic floor assessment and pelvic floor rehabilitation with a professional, complemented at home if needed, help regain confidence.
Sources
- Incontinence 7th Edition, Linda Cardozo, Eric Rovner, Adrian Wagg, Alan Wein, Paul Abrams, 2023, ICI-ICS International Continence Society, Bristol UK – link
- Epidemiology and outcome assessment of pelvic organ prolapse, Matthew D Barber, Christopher Maher, November 2013, International Urogynecology Journal 24(11):1783-90 – link
