Sex & Pelvic Organ Prolapse: Safety, Expectations, & Best Positions 

After making a more comprehensive video all about pelvic organ prolapse recently, I remembered that I used to get a lot of questions in the clinic concerning penetrative vaginal sex and prolapse.
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Common questions included: is it safe, will it make my prolapse worse, what will it feel like for me and my partner, and what positions are best? So, I wanted to make a video addressing those three topics-safety, what to expect, and best positions-in order to help women and people with vaginas who are navigating prolapse gain a better understanding of their bodies, what’s happening during sex with a prolapse, and what options they have to optimize and enjoy their future sexual experiences.
Timestamps / Table of Contents:
✩ Intro: 0:00
✩ Safety: 1:47
In almost all cases, vaginal penetration is completely safe, as it will not cause harm to the organ or organs involved-they can easily move out of the way-nor will it affect the severity of the prolapse-it actually encourages the organs to move up, not down, and a finger, penis, or penis-shaped toy can’t pull any of the organs further out, their shape simply doesn’t allow it!
I would be concerned about someone with a prolapse having vaginal sex if they reported another worrisome symptom, like bleeding or pain, during or independent of sex.
✩ Expectations: 6:12
People with more mild to moderate prolapse-where the organ involved stays within the vaginal canal and does not protrude past the opening-are more likely not to notice their prolapse as much during sex.
Whereas, people with more moderate to severe prolapse-where the organ is visible past the vaginal opening-are more likely to experience some discomfort. Different positions can help mitigate this discomfort, and using lubricant and making sure that the pelvic floor is relaxed before having sex can also both help immensely.
✩ Best Sexual Positions: 11:24
Modified missionary, with the woman’s buttocks elevated and supported by pillows, uses gravity to encourage the prolapse to ascend to a more optimal position. This may be most effective for uterine prolapse and rectocele due to how gravity impacts the organs.
Supported kneeling or modified prone, with the woman laying on her stomach with her pelvis elevated and supported by pillows, also uses gravity to encourage the prolapse to ascend to a more optimal position. This may be most effective for uterine prolapse and cystocele due to how gravity impacts the organs.
Finally, sidelying with the partner entering from behind can be helpful, because it limits how deeply the woman can be penetrated.
✩ Closing Thoughts: 14:16
✩ Outro: 14:49
Remember, materials and content available on this channel, Pelvic Empowerment, are intended as general information only, and should not be substituted for medical advice, prescription, diagnosis, or treatment.
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