What Is Pelvic Organ Prolapse?

What Is Pelvic Organ Prolapse

When Jenni was 29, she had her first child. A beautiful baby boy, she was ecstatic, and completely in love, despite the long labor she had suffered. But after several weeks, Jenni began to suspect something was wrong. She had expected to feel some discomfort after childbirth, (especially after pushing for several hours), but still, something didn’t feel right.

At her 6-week appointment, her doctor told her everything was looking good, but a few weeks later, Jenni felt a heaviness and in the shower, she felt a small bulge at the opening of her vagina while washing.

“I was horrified,” she said. “I thought something was truly wrong with me.”

Right away, Jenni called her doctor and explained her symptoms.  Her doctor calmly told her she may have a prolapse, a condition where the pelvic floor becomes too weak to hold up the surrounding organs, and caves into itself.

“It’s very common,” he told her, and after an appointment to confirm, he gave her a referral to a women’s health physical therapist.

Jenni’s story is not uncommon. Many women live with pelvic organ prolapse, which is caused by a weakening of the pelvic floor.  Some see symptoms after something like childbirth, but many women may not even realize that they are susceptible until later in life, with the symptoms appear.  

Unfortunately, many women believe this is a normal part of aging, or are too embarrassed to talk to anyone about it, including their doctor. Unlike Jenni, these women suffer in silence and live in discomfort for years, limiting their activities and even their social and personal life because of the symptoms. 

But pelvic organ prolapse is a treatable condition. Read below for answers to some of the most common questions we hear about pelvic organ prolapse. 

What is Pelvic Organ Prolapse anyway?

Before we get into the ins and outs of prolapse, let’s briefly review the pelvic floor and it’s function.  The pelvic floor muscles are a vital part of a woman’s anatomy.  This web of muscles is shaped sort of like a basket and holds up three key organs:  the bladder, rectum, and uterus.  When the tissues and the muscles become too weak, one or more of these organs can fall into the vaginal area, and may even protrude out of the vagina.  This is a pelvic organ prolapse. 

Why does pelvic organ prolapse happen?

Pelvic organ prolapse happens due to a weak pelvic floor. There can be many causes of this, including vaginal childbirth, long-term pressure on your abdomen (from a chronic cough, or straining during a bowel movement), giving birth to a large baby (over 8.5 pounds), aging, or even hormonal changes during menopause.  Sometimes symptoms show up early on, but for many, they may not realize that they have a weak pelvic floor until later in life, when symptoms start progressing. 

What are the symptoms of a pelvic organ prolapse?

The symptoms of pelvic organ prolapse may differ in both type, and severity, depending on how severe the prolapse is.  Many women with pelvic organ prolapse report feeling a general discomfort in the vaginal area.  They may feel a heaviness or pressure, or an achy feeling in the vagina, especially after standing for long periods of time, during sex, or with lots of physical activity.  Some women may also suffer from urinary incontinence. More severe sufferers may see or feel one of their pelvic organs bulging out of the vagina, or have a feeling like they are sitting on a ball 

Is pelvic organ prolapse dangerous?

Pelvic organ prolapse is not a life-threatening condition, but that doesn’t mean it shouldn’t be treated.  Pelvic organ prolapse can cause a lot of physical discomfort, and can negatively impact a person’s quality of life. There are many ways to treat pelvic organ prolapse so there’s no reason anyone should let it go untreated.

How is pelvic organ prolapse diagnosed?

A physician must diagnose pelvic organ prolapse. Because some symptoms of pelvic organ prolapse may disappear when lying down for a physical exam, your doctor may perform different tests to see if they are able to detect the prolapse. Asking you to cough, or performing a pelvic exam while standing in order to see to see the protruding organ are common techniques for detecting pelvic organ prolapse. Your doctor may use other tests too, such as an ultrasound, an MRI scan of the pelvis, or bladder health tests, if you’re experiencing incontinence.

Is pelvic organ prolapse reversible? 

There are many ways to treat pelvic organ prolapse, and in many cases, symptoms can be greatly improved, but pelvic organ prolapse will never go away on its own.

If you’ve recently had a baby and have been diagnosed with pelvic organ prolapse, there is a good chance that your symptoms may improve with time.  Hormones can play a big part of changing the pelvic floor too, so waiting for them to return to normal after baby is born, and after breastfeeding may provide some relief.  In addition, your body takes some time to recover after carrying a baby for 9 months and then giving birth, so you need to allow it time to recover. There is a good chance that with time, and the proper pelvic floor exercises, your symptoms will greatly improve. 

For women who experience pelvic organ prolapse later in life, there are ways to treat it so that your symptoms are not as severe.  But the muscles will never completely return to normal after experiencing a prolapse.

How to fix pelvic organ prolapse

There are many ways to treat pelvic organ prolapse, and choosing which one may depend on the severity of the problem, as well as what life stage you’re in.

Many people with pelvic organ prolapse can benefit from seeing a women’s health physical therapist.  These professionals are trained in dealing with pelvic floor dysfunction and can not only provide guidance on the right exercises to do, but can also guide you in learning how to do them correctly. Things like kegels are often hard to teach, but by using biofeedback machines and other helpful techniques, a PT can guide you through the exercises and ensure they are being done effectively.  Over time, these exercises can strengthen the pelvic floor, providing greater control over bladder leaks, and lessening the uncomfortable symptoms of pelvic organ prolapse. 

In addition to physical therapy, many women choose to use a pessary, a small device that is inserted into the vagina and helps hold up the pelvic organs.  This device is prescribed by a doctor and is typically fitted for each patient in the doctor’s office.  It may take several tries to find the right fit. 

If you suffer from constipation, your doctor may prescribe a special diet designed to help your bowels move more regularly, as straining on the toilet can exacerbate symptoms of a prolapse and make them worse.

Finally, if your symptoms are severe, your doctor may recommend surgery to help hold the organs in place.  Talk to your doctor about the pros and cons of surgery, and the risks associated with this type of procedure. 

(Note: It’s recommended that you wait to have surgery until you’re finished having children, as the benefits of the surgery may be undone with childbirth.) 

It can initially be scary to discover that you have pelvic organ prolapse. But so much can be done to treat the condition that you should never put off discussing the problem with your doctor.   

NAFC has many wonderful physical therapists listed in our doctor finder. If you’re experiencing symptoms of pelvic organ prolapse, visit it here to find a specialist in your area and make an appointment to discuss treatment today!

 

 

Our Favorite Way To Improve Your Pelvic Floor Health

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Could Kegels Actually Hurt Me?

Could Kegels Actually Hurt Me?

You’ve seen the claims. A stronger pelvic floor! Fewer Leaks! Better Sex! The kegel craze is hot right now and for good reason. Kegels can do all of these things and we’re a big proponent of doing them for maintaining good bladder health and a healthy pelvic floor. But before you jump on the kegel bandwagon, read this post. Because while kegels can be super effective for all the reasons listed above, they can sometimes cause problems in women who have certain conditions.

Many women suffer from a weakened pelvic floor, the series of muscles and tissues that form a hammock at the bottom of your pelvis, and are responsible for holding many of your organs (including your bladder) in place. A weakened pelvic floor can be caused by many factors, but pregnancy, childbirth, and aging are all high on the list.  This laxity in the pelvic floor can lead to things like incontinence, or even pelvic organ prolapse if not treated properly.  And a great way to treat it (most of the time) is with kegels.   

But not everyone has a weak pelvic floor – some women experience pelvic floor tension, which prevents the pelvic floor muscles from contracting or relaxing at a normal rate, again making them weak, but in a different way.  This can lead to things like constipation, painful intercourse, or the inability to empty your bladder completely.  

People with pelvic floor tension are advised NOT to do kegels, and if you think about it, it makes sense. Trying to tighten something that is already too tight can make your problems worse.

So, how do you know if you should be doing kegels or not?  Our best advice is to see a physical therapist specialized in women’s health.  A trained PT can give you a thorough evaluation and can determine if you have a pelvic floor that’s too tight or too loose.

An added bonus is that if your PT finds you’re a good candidate for kegels, they’ll be able to show you exactly how to do one – something that is actually somewhat difficult for many women.  And, if you’re advised NOT to do a kegel, they’ll be able to help you learn how to relax your pelvic floor and will show you exercises to help with that as well.

It’s also worth noting that while kegels are great for many people, they also aren’t the end all be all move for your pelvic floor. Your muscles are all connected, after all, so concentrating just on kegels won’t be as effective as if you worked your entire core, glutes and thighs. 

Want to find a PT in your area? Try our Specialist Locator

What Is Pelvic Pain Disorder?

What Is Pelvic Pain Disorder?

Pelvic pain is pain that you experience in the lowermost part of your abdomen and pelvis. It can occur in both men and women, however it is more common in women.  Depending on the specific cause of pelvic pain, it can vary in intensity and length.  There are several things that may contribute to pelvic pain.  

Many women experience pelvic pain due to gynecological problems or problems associated with pregnancy.  Some of these include: 

  • Endometriosis

  • Adenomyosis

  • Menstrual cramps (dysmenorrhea)

  • Ectopic pregnancy (or other pregnancy-related conditions)

  • Ovarian cancer

  • Vulvodynia

  • Mittelschmerz (ovulation pain)

  • Pelvic inflammatory disease (PID)

  • Ovarian cysts

  • Uterine fibroids

Some other causes of pelvic pain may be due to:

  • Diverticulitis

  • Appendicitis

  • Fibromyalgia

  • Colon cancer

  • Chronic constipation

  • Inguinal hernia

  • Crohn's disease

How is the cause of pelvic pain determined?

Talking to a doctor is the first step in determining the cause of your pelvic pain.  Your doctor will start off by asking you several questions about the type of pain you are experiencing, and also discuss your medical history to determine the cause.  He or she will also likely perform a physical exam and may perform some tests to figure out what is causing your pain. Depending on what you are experiencing, your doctor may check your blood, urine or stool, perform a pregnancy test, check for STDs, or even perform X-rays or Ultrasounds to better examine some of your internal organs.  

How is pelvic pain treated?

Your doctor will determine the appropriate treatment for your pelvic pain based on the cause, and how serious the pain is. They may recommend medications, or even surgical procedures.  Talk with your doctor about what you are experiencing to find the best solution.

Pelvic Floor Disorders Are Common Among Patients With Multiple Sclerosis

Pelvic Floor Disorders And Multiple Sclerosis

Multiple Sclerosis (MS) is the most common autoimmune disease presently affecting approximately 2 million people worldwide. 

MS is a disease of the central nervous system. The central nervous system is the hub for the autonomic nervous system and the somatic nervous system. These systems regulate many parts of your body’s mechanics. Most notably: blood pressure, heart rate, bowel activity, sexual arousal, skin sensation, and muscle control.  

In patients with MS the immune system attacks the material that insulates nerve fibers. Without insulation the nerves of the central nervous system cannot communicate with the rest of the body.  This faulty communication between the brain and spinal cord often results in muscle weakness, abnormal sensation, psychiatric problems, and difficulty regulating breathing, blood pressure, and temperature.  Loss of bladder or bowel control can be a result of muscle weakness; almost half of MS patients report bladder and or bowel complaints as the first symptoms of multiple sclerosis.

Sixty-eight percent of individuals with MS experience symptoms of one or more Pelvic Floor Disorders (PFD). PDFs are a loss or lack of bladder or bowel control and can include urinary incontinence, urinary frequency and urgency, bowel incontinence, sexual dysfunction, pelvic organ prolapse, and pelvic pain related to a “spastic” pelvic floor.

Among MS patients with PFDs the most common diagnosis are overactive bladder (69%), voiding problems (41%), Sexual dysfunction (42%), and fecal incontinence (30%)[i].  These symptoms represent major detriments to quality of life. 

The good news is that patients with MS can benefit from the same behavior modifications as anyone else with a pelvic floor disorder. Pelvic floor neuromuscular rehabilitation, often referred to as “pelvic floor therapy”, is a behavior modification practice of retraining the pelvic floor muscles using techniques like pelvic floor muscle training, biofeedback therapy and electrical stimulation. 

Modern methods of pelvic floor rehabilitation such as The Pfilates Method™ and The VESy Lab™ utilize movement taken from Pilates and Yoga to provide greater pelvic floor response.  The key to success with pelvic floor rehabilitation is establishing a practice that continues for a lifetime.  Working with a specially trained Physical Therapist provides excellent results and should be considered an element of any care plan for MS patients with bothersome pelvic floor symptoms.

[i] Int J MS Care. 2014 Spring;16(1):20-5. doi: 10.7224/1537-2073.2012-052.

Dr. Bruce Crawford is Dr. Bruce Crawford is a Board Certified Urogynecologist and the creator of the PfilatesTM program of pelvic floor rehabilitation. He has personally trained over 1,500 physical therapists and fitness professionals in North America, Asia, and the UK. Dr. Crawford also originated the VESy LabTM Method of optimizing pelvic floor fitness training.
Dr. Bruce Crawford is Dr. Bruce Crawford is a Board Certified Urogynecologist and the creator of the PfilatesTM program of pelvic floor rehabilitation. He has personally trained over 1,500 physical therapists and fitness professionals in North America, Asia, and the UK. Dr. Crawford also originated the VESy LabTM Method of optimizing pelvic floor fitness training.