You’re doing great. (% complete)

The answer

From what Corinne is describing, it seems likely that she has a pelvic organ prolapse, in which one of the organs in the pelvis (the womb, bowel, bladder or top of the vagina) slip from their usual position and bulge into the vagina. The condition is not life-threatening but can cause a sensation of heaviness or dragging in the pelvic area, continence issues, bulging into and sometimes outside the vagina, and discomfort and numbness during sex. In some cases it is asymptomatic and is instead discovered during an internal examination, such as a cervical smear test.

Corinne needs to see her GP, requesting a female doctor (or chaperone if only male physicians are available), as she needs an internal pelvic examination. She may also be asked to provide a urine sample to exclude a urinary infection as she is complaining of stress incontinence. If the diagnosis of prolapse is confirmed, the type will be identified and the severity classified, with one regarded as relatively minor and four being quite severe. Both are important as they help determine which treatment is the most appropriate. Options include: topical oestrogen, pelvic floor muscle training, vaginal pessaries and various surgical procedures.

Lifestyle measures can also help, notably losing weight if body mass index (BMI) is higher than it should be, stopping smoking, tackling a chronic cough, getting any constipation under control, and avoiding heavy lifting and high-impact exercise such as trampolining. Pelvic floor exercises – sometimes referred to as kegels – can also help improve symptoms, particularly in terms of reducing urine leakage.