Pelvic organ prolapse (POP) was a hush-hush topic until fairly recently. Of the roughly 10% of women who experience some degree of pelvic organ prolapse, many fail to pursue any treatment at all. Others are ushered through major surgeries – like complete hysterectomies – by doctors who aren’t entirely familiar with the options.
Now, a general broadening of the women’s health arena, and the emergence of specialties such as women’s health physical therapy (WHPT), are creating an environment where women feel more comfortable being open about their symptoms with health care providers. It’s also easier than ever to find valuable information about the topic online.
General practitioners and gynecologists are better trained in how to screen for POP symptoms and treatment is often as simple as incorporating a few exercises into your daily routine.
Symptoms Of Prolapsed Pelvic Organs
The condition occurs when a general weakening of pelvic muscles and/or connective tissues in the pelvic area cause organs to shift, or sag, in position – putting pressure on and sometimes inside the vagina.
This sagging – or prolapsing – ranges from very mild to very severe. It is most often caused as the result of pregnancy and childbirth, although women who have never been pregnant can also experience varying degrees of pelvic prolapse.
Some women are more prone to developing pelvic organ prolapse than others. Women most prone to POP include those who:
- Have experienced vaginal delivery.
- Are of a more advanced age.
- Are obese.
- Experience chronic coughing or constipation.
- Have a family history of POP.
- Are Caucasian or Hispanic.
- Have had pelvic surgery.
- Perform regular heavy lifting.
There are three types of prolapse, and each one affects a different part of the vagina:
- Cystocele and urethrocele. The first (cystocele) is diagnosed when the bladder pushes into the front wall of the vagina. If the protrusion is caused by the urethra, rather than the bladder, it is called a urethrocele prolapse.
- In this type of prolapse, the rectum bulges or protrudes into the rear wall of the vagina, and typically causes difficulty with defecation.
- Uterine prolapse. Sometimes, the uterus itself drops down into the top of the vagina. It can be mild, making the cervix seem more pronounced, or it can be more serious, where the uterus can be felt or seen coming through the lower vagina. Post-hysterectomy, women can experience what is called vaginal vault prolapse, where the top of the vagina begins to sag – sort of like a sagging sock – onto the lower part of the vagina.
In mild cases, symptoms may include things like:
- A heaviness or a feeling of pressure or “bearing down.”
- Lower back pain or pressure.
- Leg fatigue.
- Incontinence (stress incontinence being the most common – occurring when you laugh, exercise, jump or lift heavy objects).
- Constipation or difficulty with bowel movements.
- Discomfort or pain during any sexual activities involving penetration.
If you experience any of the above symptoms, schedule an exam with your gynecologist. A routine pelvic exam is the only way to confirm whether you have POP or not.
Treatment for POP – Surgery Is Not Your Only Option
While there are surgical fixes for prolapsing pelvic organs – it is rarely your only option. Invasive procedures should be avoided whenever possible as some of the surgical procedures have been fraught with post-surgical complications. Thus, women should first seek more natural solutions – such as pelvic floor physical therapy, which is often partially- or completely covered by health insurance providers.
The procedures for pelvic prolapse symptoms typically look something like this:
Kegel exercises. In some cases, you may be experiencing prolapse and not even know it yet. Your doctor may recommend Kegel exercises (Click Here for a detailed tutorial) that will help to strengthen pelvic floor muscles.
Pelvic physical therapy. This specialized form of therapy works to strengthen the pelvic floor and core muscles via a range of tools. Depending on your particular symptoms and degree of POP, the therapist will work with you on exercises, electrical stimulation and even lifestyle and dietary changes that can relieve or correct the side effects of pelvic prolapse.
Vaginal Pessary. In some cases, a vaginal pessary can be worn, which provides support for the upper-vaginal walls, preventing the more debilitating aspects of prolapsed pelvic organs.
Only after more natural, and less-invasive, methods have proven unsuccessful should women proceed with a surgical fix.
Don’t let the symptoms of POP keep you in discomfort or hold you back from the life you want to live. Contact Overlake OB/GYN to schedule an exam. We’ll work with you to find the most natural and straightforward means possible to restore pelvic health.