Let’s talk about yet another area of pelvic health that does not get enough airtime. Specifically, we’re diving into a topic that’s more common than you might think—rectoceles (aka that thing your butt might be doing that no one warned you about).
First Off: What Is a Rectocele?
A rectocele happens when the wall between your rectum and vagina weakens causing the rectum to bulge from behind into the vaginal space. The result? A feeling of pressure, difficulty pooping, or a sense that things just aren’t where they used to be. Many times rectocele’s result from pelvic floor dysfunction where the muscles around the rectum do not support and do not lengthen when they need to.
One of the many consequences of rectoceles being something we do not talk about is that we tend to feel like the only one going through this when we feel the symptoms or get a diagnosis. And you know what’s far worse than having a rectocele? Having a rectocele and feeling all alone on this journey. However, rectoceles are more common than you’d think, especially after childbirth, during menopause, or if you’ve been doing heavy lifting (including, say, toddlers or gym weights) for years. You aren’t alone, you aren’t dirty, and there’s absolutely nothing to be embarrassed about.
But Wait—What’s Pelvic Floor Dysfunction?
Glad you asked! Let’s circle back and go over the basics of the pelvic floor quickly! Your pelvic floor is a group of muscles that act like a hammock for your bladder, uterus, and rectum. When those muscles get weak or tight or just plain tired, you get what we call pelvic floor dysfunction. That might show up as:
- Leaking pee when you sneeze/laugh/do jumping jacks (thanks, gravity!)
- Difficulty pooping or feeling like you need to “splint” (we’ll get to that)
- Pressure or heaviness in your pelvis
- Sex that feels… not great
Splinting? Like a Cast for Your Butt?
Kind of! Some people with rectoceles find they need to press on the back wall of their vagina (either inside or just at the perineum – that middle ground between the vaginal and rectal opening) to help pass stool. While not necessarily glamorous, it’s surprisingly effective. And if you’ve been doing it, you’re not alone—it’s a known workaround, not a weird quirk. And if you find that splinting helps but rather not use your fingers, there are also splinting tools specifically designed for this purpose. They look a bit like funky shoe horns and can be absolutely perfect for splinting.
So, What Can You Do About It?
Here’s the good news: you’ve got options.
- Pelvic Floor Physical Therapy: A trained pelvic floor PT can help you learn how to relax, strengthen, and coordinate your pelvic muscles. (Spoiler alert: Standard kegels are not always the answer!) They will also teach you how to manage the pressure in your abdomen and lift appropriately so that your pelvic floor isn’t being overloaded.
- Diet & Poop Habits: Constipation makes rectoceles worse. Keeping your stool soft but formed with fiber, hydration, and—if needed—a gentle laxative that can help you avoid straining. Using a step stool to elevate your feet while you poop can also be a game changer!
- Pessaries: These nifty little devices sit in your vagina and help support your pelvic organs. They’re like a sports bra for your pelvic floor. There are countless options available and a provider trained in pessary fittings can help you find the style best suited for your body.
- Surgery: If things are really out of place and interfering with your life, surgical repair is an option. But many people manage symptoms without needing surgery. Even if you know you are going to have a surgical repair of your rectocele, it’s still incredibly important to cover the basics: training the muscles to work properly, avoiding constipation and straining, and knowing how to lift properly. This will help make sure the bothersome rectocele doesn’t make a reappearance after surgery.
Bottom Line (Pun Absolutely Intended)
Rectoceles and pelvic floor dysfunction aren’t taboo, shameful, or even all that rare—they’re just one of those body things that we don’t talk enough about. But talking about it is the first step to getting help and feeling like yourself again (from the bottom up!).
If you’ve been dealing with pelvic pressure, trouble pooping, or you just know something’s off “down there,” talk to your doctor—or better yet, find a pelvic floor specialist. You don’t have to tough it out alone.
Your butt (and your bladder and your vagina) will thank you.