Michael E. Toaff, MD, MSc

Uterine prolapse or dropped womb is a condition in which the uterus drops downward in the pelvis below its normal position. The uterus may drop slightly and remain above the introitus (vaginal opening, grade 1). It may drop further so that the cervix or lower portion of the uterus reach the region of the introitus (grade 2). In the most severe form, the cervix or even the entire uterus bulges out of the introitus (grade 3). Uterine prolapse is the indication for hysterectomy in 16% of cases in the U.S.

K.C., a 44 year-old woman, called me from upstate New York. Over the past 15 years her uterus has gradually enlarged to the size of a seven month pregnancy due to the presence of multiple fibroids. She also suffered from asthma and her markedly enlarged uterus was contributing to her breathing difficulties. Her periods had become progressively heavier, leading to anemia.

As I arrived in my office early one morning, I received a phone call from a woman in great distress. D.W., a 43 year old woman, indicated that for the past ten months she had been suffering through increasingly heavy menstrual periods, passing large blood clots. She went on to explain that four months earlier she underwent a D&C (dilatation and curettage) because of this problem.