Peranakan jatuh or rahim jatuh (a prolapsed womb) is a type of pelvic organ prolapse, where the womb, bladder or bowel bulges into the vagina because the pelvic floor muscles have weakened. Signs include a feeling of heaviness or pressure in the vagina, a bulge or lump you can feel or see, leaking urine when you cough or sneeze, and constipation, although some women have no symptoms. It is common after childbirth and the menopause, and in women over 50. Treatment depends on how severe it is and ranges from pelvic floor exercises (senaman Kegel) and a vaginal pessary to surgery. See a doctor if you notice a lump in or around your vagina.
What is peranakan jatuh (rahim jatuh)?
Peranakan jatuh and rahim jatuh are Malay terms for a prolapsed womb. Doctors call this group of conditions pelvic organ prolapse.
According to the NHS, pelvic organ prolapse is when the womb, bladder or bowel bulge into the vagina. It can happen when the pelvic floor muscles, the layer of muscles that supports these organs, weaken. It is common in women over 50, but it can affect anyone with a vagina. Treatments and lifestyle changes can help manage it.
How common is it in Malaysia?
Many Malaysian women are not aware of prolapse or that it can be treated:
- In a 2023 survey of 400 Malaysian women by Universiti Teknologi MARA, most had an inadequate level of awareness of pelvic organ prolapse. Only 68% said they would seek treatment if they had symptoms, and the most common reason for not seeking treatment was not knowing that medical treatment is available. Embarrassment about seeing a doctor was another concern.
- In a study of 424 pregnant women at a Malaysian tertiary centre, 46.1% had at least one pelvic floor symptom during pregnancy, and of these, 41.1% had symptoms of prolapse.
Prolapse is a common medical condition, and help is available.
Tanda peranakan jatuh: what are the symptoms?
Pelvic organ prolapse may not cause any symptoms. According to the NHS, if you do have symptoms, they can include:
- a feeling of heaviness, discomfort or pressure in your lower tummy or vagina;
- feeling or seeing a bulge or lump inside, or coming out of, your vagina;
- pain, discomfort or numbness during sex;
- problems pooing, such as constipation;
- problems peeing, such as feeling like your bladder is not emptying fully, needing the toilet more often, or leaking a small amount of pee when you cough, sneeze or exercise.
Sometimes a prolapse is only found during tests done for another reason, such as cervical screening (Pap smear). If needing the toilet more often is your main symptom, see also our guides to kerap kencing and UTI symptoms.
What do the stages of prolapse mean?
Many people search for pictures of the early stages of rahim jatuh. In practice, only an examination by a doctor can confirm a prolapse and how severe it is. According to the NHS, if you are diagnosed with a prolapse, it may be given a number from 1 to 4 depending on how severe it is, with 4 being a severe prolapse.
The stage, together with which organ has prolapsed and how much your symptoms affect you, helps decide your treatment.
Punca rahim jatuh: what causes it?
According to the NHS, pelvic organ prolapse can happen when the pelvic floor muscles weaken. It is more common as you get older, particularly after the menopause. It can be caused by:
- pregnancy and childbirth;
- being overweight (see our guide to losing weight safely);
- long-term constipation and straining;
- a persistent cough, which puts pressure on the pelvic floor (see our guide to long-lasting coughs);
- pelvic surgery, such as a hysterectomy.
Some health conditions can also make a prolapse more likely, including joint hypermobility syndrome, Marfan syndrome and Ehlers-Danlos syndromes.
When should you see a doctor, and what happens?
See a doctor at a klinik kesihatan or a GP if:
- you have a lump in or around your vagina;
- you have any other symptoms of pelvic organ prolapse.
According to the NHS, the doctor will ask about your symptoms and examine you, so you will need to undress from the waist down. You may lie on your side with your knees pulled up towards your chest, or be examined standing up. The doctor will feel for any lumps and may gently insert a speculum to see if there is a prolapse. If you have bladder problems, you may be referred to hospital for more tests.
If you feel shy, you can ask for a female doctor and for a chaperone (someone you know, a nurse or a trained member of staff) to be in the room.
Senaman Kegel: how to do pelvic floor exercises
Pelvic floor exercises, often called senaman Kegel, strengthen the muscles that support your womb, bladder and bowel. You can feel your pelvic floor muscles if you imagine stopping yourself peeing and passing wind. According to the NHS:
- Squeeze your pelvic floor muscles quickly, trying not to pull your tummy in.
- Hold the squeeze for 2 seconds.
- Relax the muscles.
- Repeat 10 times.
Breathe normally while you do them, and aim to gradually increase each hold to 10 seconds. Include both short and long squeezes. You may need to do the exercises for a few months before you notice a difference, so do them every day. When you need to lift something, such as your child or shopping bags, tighten your pelvic floor muscles before and during the lift.
For prolapse, the NHS recommends physiotherapy and pelvic floor muscle training, usually with a specialist women's health physiotherapist.
Cara merawat rahim jatuh: what treatments are there?
According to the NHS, treatment depends on which organs have prolapsed and how severely. Your doctor will also consider your age, your overall health, and whether you plan to have children in future. If you have no symptoms, or the prolapse is not bothering you, you may not need medical treatment.
| Treatment | What it involves |
|---|---|
| Pelvic floor muscle training | Physiotherapy and exercises, usually with a specialist women's health physiotherapist |
| Vaginal support pessary | A plastic or silicone device inserted into the vagina to help support the pelvic organs |
| Hormone treatment | A cream applied to the vagina, or tablets or a hormone-releasing ring inserted into the vagina |
| Surgery | If the prolapse is severe, surgery to lift and support the pelvic organs may be an option |
You and your doctor will decide together on the best option for you. The NHS notes that surgery using a supportive vaginal mesh is no longer done on the NHS unless there is no alternative, so ask your surgeon which type of operation they recommend and why.
What can you do to help?
The NHS suggests these steps to help with pelvic organ prolapse:
- maintain a healthy weight;
- eat more fibre, drink plenty of water and do gentle exercise like walking regularly to avoid constipation;
- avoid physical activities that put a lot of strain on the pelvic floor, such as heavy lifting, running and trampolining;
- do regular pelvic floor exercises;
- do not smoke: stopping smoking means you are less likely to have a persistent cough that puts pressure on your pelvic floor.
If you are pregnant or have recently given birth, see also our guide to signs of labour.
Frequently asked questions (FAQ)
What is peranakan jatuh (rahim jatuh)?
Peranakan jatuh or rahim jatuh is the Malay term for a prolapsed womb. It is a type of pelvic organ prolapse, where the womb, bladder or bowel bulges into the vagina because the pelvic floor muscles have weakened. It is common in women over 50 and can be managed with treatment and lifestyle changes.
What are the signs of rahim jatuh?
It may cause no symptoms. When it does, signs include a feeling of heaviness, discomfort or pressure in the lower tummy or vagina, feeling or seeing a bulge or lump in or coming out of the vagina, pain or numbness during sex, constipation, and problems peeing, such as leaking when you cough or sneeze or feeling your bladder has not emptied fully.
What causes peranakan jatuh?
It happens when the pelvic floor muscles weaken. According to the NHS, causes include pregnancy and childbirth, being overweight, long-term constipation and straining, a persistent cough, and pelvic surgery such as a hysterectomy. It is more common as you get older, particularly after the menopause.
Can senaman Kegel lift a fallen womb?
Pelvic floor muscle training, including Kegel exercises, is one of the treatments for pelvic organ prolapse and can help manage symptoms, ideally with a women's health physiotherapist. You may need to do them for a few months before you notice a difference. A more severe prolapse may need a vaginal pessary or surgery.
Can rahim jatuh be treated without surgery?
Yes. If the prolapse is not bothering you, you may not need treatment. Other options include pelvic floor exercises with a physiotherapist, a vaginal support pessary, and hormone treatment applied to the vagina. Surgery may be an option if the prolapse is severe.
Can peranakan jatuh happen after giving birth?
Yes. Pregnancy and childbirth are among the main causes. In a Malaysian study of 424 pregnant women, 46.1% had at least one pelvic floor symptom, and of these, 41.1% had symptoms of prolapse. Regular pelvic floor exercises are one of the things the NHS recommends to help with prolapse.
When should I see a doctor?
See a doctor at a klinik kesihatan or a GP if you have a lump in or around your vagina, or any other symptoms of prolapse. You can ask to be examined by a female doctor and to have a chaperone in the room.
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor. Health supplements are not intended to diagnose, treat, cure or prevent any disease.
References
- Pelvic organ prolapse — NHS
- 10 ways to stop leaks (pelvic floor exercises) — NHS
- Abdullah B, et al. Awareness of pelvic organ prolapse and attitude towards its treatment among Malaysian women. Med J Malaysia. 2023;78(6):768-773
- Nur Farihan M, et al. Prevalence, knowledge and awareness of pelvic floor disorder among pregnant women in a tertiary centre, Malaysia. Int J Environ Res Public Health. 2022;19(14):8314
