- Yes, you can have sex with pelvic organ prolapse: according to Dr Marine Lallemant, a gynaecologist specialising in pelviperineology, vaginal penetration is not contraindicated in cases of prolapse.
- Prolapse may, however, change desire, comfort and self-confidence: foreplay, choice of positions, lubricant and talking with your partner all help in regaining a fulfilling sex life.
- A pelvic floor assessment and pelvic floor rehabilitation with a healthcare professional, continued at home, are among the routes to greater intimate comfort.
Pelvic organ prolapse, also called genital prolapse, is the slipping of one or more organs of the lesser pelvis (bladder, uterus, rectum) towards the vagina. As Dr Marine Lallemant points out, it is a far more widespread condition than people think. According to a literature review conducted within the International Consultation on Incontinence, prolapse affects 3 to 6 % of women when based on reported symptoms, and up to 50 % when based on gynaecological examination. But can you keep a fulfilling sex life with a 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, an obstetrician-gynaecologist specialising in pelviperineology, vaginal penetration is not a contraindication in cases of prolapse. That said, with a prolapse or urinary leaks, each phase of the sexual response may be disrupted.
Is having sex with a prolapse dangerous?
Sexual intercourse with a prolapse remains possible: penetration is not contraindicated. The sensation of a "bulge" in the vagina is often less pronounced when lying down, which explains why some positions are more comfortable than others. And according to Dr Lallemant, sexual intercourse does not make the prolapse worse. If pain appears, talk to your doctor or midwife.
What impact does prolapse have on sex life?
Prolapse and urinary leaks can lead to urine leakage or pain during intercourse. These symptoms also weigh on the emotional state: 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 discomfort linked to the bulge in the vagina, or by the fear of pain or of leaking. A sense of frustration, guilt or shame can then set in and make it harder to flourish sexually.
How does the sexual response work in women?
The human sexual response follows a four-phase cycle: excitement, plateau (pleasure), orgasm (not systematic) and resolution. Unlike men, women have no refractory period and can have several orgasms in succession.
Vaginal penetration is not essential to feel sexual pleasure. The key organ is the clitoris: under arousal it fills with blood, and orgasm runs through it, whether the stimulation is direct or indirect (through the vaginal walls). A satisfying encounter is not limited to orgasm anyway: closeness, tenderness and sensuality count just as much. One piece of advice: 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 vagina. Other men mention a loss of sensation on penetration, linked to the loss of tone in the pelvic floor muscles. With age, male sexual dysfunction can also affect a couple's sex life: all the more reason to talk about it together.
How can you improve your sex life with pelvic organ prolapse?
Why talk to a healthcare professional about it?
The first step is to seek advice, alone or better still as a couple, to take the drama out of it and lift the taboo around prolapse and urinary leaks. There is nothing shameful about these symptoms. A gynaecologist, a midwife, a sex therapist or a psychologist can support you.
Which positions are best for sex with a prolapse?
Lying positions, with the pelvis slightly raised (a cushion under the buttocks, for example), are often the most comfortable. Take the time to try things out, adjust the rhythm and range of movement, and don't hesitate to change position if discomfort appears.
Why take your time over foreplay?
To rediscover desire and encourage arousal, make the most of foreplay: caresses, massage, clitoral stimulation. In cases of vaginal dryness, a water-based lubricating gel or a local hormonal treatment prescribed by your doctor will help with lubrication.
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 intercourse, others must be removed beforehand, explains 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 the pelvic floor help restore confidence?
A pelvic floor assessment helps to understand where the symptoms come from. In the vast majority of cases, pelvic floor rehabilitation with a specialist physiotherapist or a midwife is beneficial for strengthening the pelvic floor.
To continue the exercises at home, alongside 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 leaks. It captures pelvic floor contractions and, through biofeedback, lets you see directly in the app whether you are engaging your pelvic floor. The progressive mini-games make the 5 to 20-minute sessions more playful and help you stay motivated over time. The probe can be used in several positions, including standing.
It is worth noting that 2 out of 3 women who use Emy Trainer over the long term for their pelvic floor rehabilitation reported a significant improvement in their prolapse-related symptoms (according to a survey of users).
Read all testimonials from our users
How to have sex after a prolapse or an operation?
When can intercourse resume after prolapse surgery?
After prolapse surgery, the delay before resuming penetrative intercourse is set by your surgeon, to allow the tissues to heal. Once that period has passed, resuming happens gently, with lubricant and at your own pace.
What tips make intercourse easier with a 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 and what is not.
- Use lubricant if needed.
- Follow sessions of pelvic floor rehabilitation to improve your intimate comfort.
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 talking with your partner make intercourse more comfortable.
- A pelvic floor assessment and pelvic floor rehabilitation with a professional, continued at home if needed, help restore 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
