If you know about pelvic organ prolapse, then it is probably because you have one, or know someone who has. You’re not alone. Around 50% of women who have birthed children experience some level of prolapse. For most women their prolapse happens (or becomes more noticeable) during the menopause transition.
If you have never heard of pelvic organ prolapse, again – you are not alone. Although pelvic organ prolapse (POP) has been around since the start of time, it has been part of secret women’s business since living memory. There is a tendency to not ‘scare’ women who are having children, so POP is often politely ignored.
Until it happens. Then it can hardly be ignored.
So what is pelvic organ prolapse?
The word prolapse literally means ‘to fall out of place’. You can also experience a prolapsed disc in your back. But for POP, it means that the internal organs of the bladder, bowel and uterus move. For the bladder and bowel, prolapse can mean that they fall into the vagina wall. And for the uterus, it can fall down into the vagina. For all three prolapses, the internal organs can exit the body through the vaginal opening.
This can be as uncomfortable as it sounds.
A prolapsed bladder and bowel can affect continence, making it difficult to fully void. This can lead to a host of concerns, including recurrent infections. Although POP is not necessarily painful, any protrusion from the body is very, very uncomfortable.
POP can feel different at different times of the day and with different activities. For example, prolapse symptoms may feel more noticeable at the end of the day, or after a very active day. Many women explain this feeling as a heavy and dragging feeling.
How to work out if you have a prolapse
There is only one way to get a full diagnosis of pelvic organ prolapse – by seeing a pelvic health physiotherapist. An appointment with a pelvic health physiotherapist will include questions about your medical, continence and reproductive history, as well as an internal examination. It may also include an ultrasound.
This examination helps the pelvic health physiotherapist to fully assess what kind and stage of prolapse you have and best advise you on treatment.
There is a lot that can be done to help the prolapse
Having a strong and reflexive pelvic floor is a key ingredient to managing prolapse. However, there are also other options that can support pelvic floor muscle training such as pessaries and oestrogen cream.
There is also a lot that you can do to help manage or avoid POP.
- Avoid straining on the toilet, which puts a lot of pressure on the pelvic floor. Eat plenty of fibre, drink plenty of water or use over-the-counter options to help manage constipation.
- Strengthen your pelvic floor muscles. A pelvic health physiotherapist will also be able to check to see if you have contractions. This is more than just squeezing everything on. After a contraction, you need to relax the muscle too.
- Strengthen your butt muscles. Strong glute muscles help not only your pelvic floor but also your back.
- Sit down to cough.
- Exhale when lifting something heavy – this could be at the gym, or a child or grandchild.
Don’t be ashamed.
You may feel uncomfortable talking about something as personal as POP – but it’s important to get help. Left alone, POP symptoms can get worse and affect your quality of life. You’re not meant to suffer in silence. Incontinence is one of the key reasons that women live in care facilities as they age.
Reach out to your GP and ask for a referral to a pelvic health physiotherapist, even if it is just to check that everything is just fine.