Vaginal pressure/heaviness in pregnancy and postnatal

Disclaimer: the information provided in this information sheet is for educational purposes only and does not substitute for professional medical advice.

We see a number of pregnant and postnatal women in our clinic attending for the sensation of vaginal heaviness or pressure, some of which can actually palpate a vaginal lump or bulge (often feeling this in the shower). Social media tells us that these signs and symptoms are more than likely a pelvic organ prolapse (POP). This may be true, however there are also other causes of vaginal heaviness and bulging. Mostly, the underlying cause of these symptoms whether it be a POP or for other reasons, can be managed conservatively and are not too scary once identified and a treatment plan is put into place.

The table below outlines some potential causes for symptoms of vaginal pressure/heaviness and bulging. Please note that this table is not exclusive, and we recommend follow up with your GP or Pelvic Health Physio for complete assessment.

 

Signs and symptoms	POP	Vulval varicosity	Variation of the norm
Sensation	Heaviness/dragging sensation in the vagina. Can come and go. May be worse at the end of the day. Mostly better in the morning after resting.	Pressure/swelling and/or pain in the genital/low back region. Pain worse after sitting or getting out of bed in the morning. Often worse towards the end of the day.	No pain. Sometimes a general feeling of vaginal irritation. Vague symptoms.
Visual	Golf ball/egg at vaginal entrance	In some women (not all) visible purple varicose veins around the vulva/vagina/back passage; Vulval swelling	Lump underneath the urethra (where the pee comes out)
Palpation (what you might feel)	Soft moveable lump or bulge; may be able to push it back into the vagina	Swollen genital area. Itchiness around the genitals	Hard lump just inside and at the front of the vagina
Causes	Compromised pelvic organ support from current/previous pregnancies or birth. Long history of constipation/straining for bowel movements.	Pregnancy: Increased blood volume during pregnancy. Increased pressure on the genital area.	Normal vaginal tissue changes after a vaginal birth. Vaginal opening more apparent after birth (ie you can see more!).

 

If you suspect you may have some degree of pelvic organ prolapse, vulval varicosities or have a sensation of heaviness or pressure and are not sure what it is, don’t hesitate to contact us to book an appointment with one of our highly trained and experienced pelvic health physiotherapists.

They will have a chat with you about your relevant health history, concerns and goals. From there, they will discuss appropriate and relevant assessment options and what each assessment technique will be able to identify. After determining the most likely cause or diagnosis, they will discuss options for treatment, self care and strategies to manage your symptoms and carry out and implement what you feel is appropriate and manageable.