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Pelvic Organ Prolapse - A Medical Problem Few Women Talk About

by SRC Health on August 27, 2020  in staff picks

Pelvic Organ Prolapse and often abbreviated to POP, is unfortunately still an issue not discussed openly and frequently enough.

Here is a list of common phrases women use to describe pelvic organ prolapse:

  • “I Have A Lump Down There
  • “I have a dragging sensation in my vagina especially when I stand for extended periods” or
  • “I feel a vaginal lump when I shower or wipe after passing urine”

Pelvic Organ Prolapse Symptoms include:

  • a heavy sensation or dragging in the vagina
  • a feeling that something is ‘coming down' in your vagina or a lump in the vagina
  • a lump bulging out of your vagina that you can see or feel
  • discomfort or pain during intercourse
  • your bladder not emptying as it should
  • urine stream that is weaker
  • recurring urinary tract infections
  • difficulty emptying your bowel.

There’s no need to panic, and although the earlier your doctor, pelvic health physiotherapist or gynaecologist can diagnose the type and severity of your pelvic organ prolapse, the sooner you can begin to treat the condition and get back to a life with fewer symptoms.  

What is Pelvic Organ Prolapse?

POP is a “vaginal lump” resulting from bladder, uterus, or rectum falling through the vaginal opening. This occurs due to pelvic floor weakness which can be caused due to several factors:

  • vaginal deliveries
    • childbirth is the main cause of a prolapse but certainly not the only cause
    • the baby can stretch and tear the supporting tissues and pelvic floor muscles and the more vaginal births you have, the more likely you are to have a prolapse
  • ageing and menopause
    • average age women start to notice pelvic floor pain, which include prolapse as well as urinary and faecal incontinence, is 56; by 80, half of all women have one or more symptoms.1
  • obesity
  • constipation
  • heavy lifting
  • having a persistent cough

How Common is Pelvic Organ Prolapse?

Many women first hear about Pelvic Organ Prolapse from their mothers, some having ‘reconstructive surgery’ due to their organs ‘moving around’ and needing to be ‘put back in place’. Unfortunately, close to 50% of these women then experience it for themselves after childbirth2. Unlike the previous generation, women are talking about it and writing about it, like this best seller “The Day My Vagina Broke: What They Don't Tell You about Childbirth” by Stephanie Thompson or the other great book on the subject “Pelvic Organ Prolapse: The Silent Epidemic” by Sherrie Palm.

According to research conducted by Elvie.com - a women’s health tech company that manufactures Elvie Trainer - an award-winning pelvic floor muscle training device:

  • Almost half of women report symptoms of a pelvic floor weakness such as weeing involuntarily when they cough, laugh or sneeze.
  • 57% of women never tell anyone about their pelvic floor pain
  • 72% - will never seek treatment for their pelvic floor pain.

Because few women talked about pelvic organ prolapse in the past, everyone thought they were the “only one” resulting in lack of support and POP being a stigmatised condition. Although not dangerous, pelvic floor weakness erodes confidence and everyday joy. Women stop exercising because it tends to worsen the condition – especially exercises involving impact like running or jumping or weight bearing activities involving weights, sit-ups or squats. Many women avoid sex, afraid that prolapse or incontinence will repulse their partners.

Impact of Pelvic Floor Weakness

“In the U.S. more pads are sold for incontinence than menstruation…it is a problem because we don’t have enough trained experts [in pelvic floor issues] to handle the aging population…It’s a very new field in the US…In France, women receive ten sessions [with a physical therapist] starting in the hospital after every vaginal delivery.”1

Without treatment any type of prolapse can become painful if the organs pull on ligaments and it can become dangerous if the prolapse causes a blockage in the tubes between bladder and kidney.

“Urinary incontinence is one of the top reasons people end up in nursing homes - people don’t want to deal with the smell,” said Cheryl Iglesia, director of MedStar Washington Hospital Centre’s Section of Female Pelvic Medicine and Reconstructive Surgery and a professor of gynaecology and urology at the Georgetown University School of Medicine, noting that it is often the last straw for caregivers.”1

Things are now changing rapidly in the positive direction:

  • Actresses, pelvic health specialists, women’s health physical therapists are talking about pelvic floor pain on social media
  • New pelvic floor muscle training devices and smartphone apps providing discreet options are hitting the market and it is now much easier to get the right information and be proactive about looking after your pelvic floor.
  • There is a growing number of qualified women’s pelvic health experts passionate about assisting women with pelvic floor pain

The number of support groups around the world for Pelvic Organ Prolapse is also growing, here are just some useful links:

- https://www.pelvicroar.org/

- https://www.letstalkmenopause.co.uk/

- https://adoreyourpelvicfloor.co.uk/courses/adore-your-floor-course/

- https://www.ucsfhealth.org/clinics/pelvic-floor-rehabilitation-program

- https://www.augs.org/

- https://www.bladderandbowel.org/

- https://www.voicesforpfd.org/pelvic-organ-prolapse/

- https://www.continence.org.au/who-it-affects/women/prolapse

- https://www.pelvicorganprolapsesupport.org/

- There are many more support groups both local and international on Facebook.

Pelvic Floor Weakness Treatments

  1. Pessaries which are an internal support device that women can insert into the vagina to hold their pelvic organs in place. “Pessaries don’t fix prolapses, but they can reduce or lessen the symptoms of prolapse and help you live more comfortably.”3

Women may consider using a pessary based on their doctor’s or Women Health Physio recommendation if:

  • They are pregnant
  • Just had a baby
  • Want an interim solution before having prolapse surgery and
  • Have health conditions that prevent them from having prolapse surgery
  • Want to have a pessary as an additional support aid whilst working towards improving their pelvic floor strength with exercise. In fact, a 2016 Hong Kong study recruited volunteers with pelvic floor weakness and randomly assigned 128 to do pelvic floor exercises daily and 128 to wear a pessary and do the exercises. Both groups reported improvements with the pessary group reporting a much greater improvement—27 points on the symptom scale compared with 5 for the control group, and 30 points on the quality-of-life scale, compared with 4 for the control group.4
  1. Pelvic floor physical therapy can help reduce the tension on the ligaments by strengthening the surrounding area, but the service can still be hard to find depending on where you reside. With the explosion of availability and acceptance of telehealth during the Covid19 crisis this may play a positive role in more women consulting a professional and attending to their pelvic floor pain. Skype, Zoom and Google Meet, may become our greatest tools in treatment availability for pelvic disorders.
  2. Another innovative solution is the use of a specialised compression garment like SRC Restore, made for those that are experiencing symptoms of light Stress Urinary Incontinence (SUI) and mild Bladder and Uterine Prolapse. Tested to assist specifically with Stage 1 or 2 Stress Urinary Incontinence, and with anecdotal evidence to help with Stage 1 Bladder Prolapse or Stage 1 Uterine Prolapse, SRC Restore is now being tested specifically for uterine and bladder prolapse. These shorts are also ideal for wearing during exercise. Here’s a review from a delighted customer:

“I have fallen completely in love with this garment. It is super comfortable so much so I forget I'm wearing it. My lower back is supported and while wearing this garment I no longer need to wear a panty liner, for the leaks. It has given me the confidence to sign up for an exercise class with other mums, without the fear of wetting myself. This is something I would have never done before SRC Restore. I no longer fear coughing, sneezing, or laughing. The garment has also helped me hang on a bit longer when I'm busy with my baby and just can't run to the loo.

It's so nice to go out and know that I won't have damp knickers, and I can just enjoy myself and get on with living my life.

  1. Surgery using the patient’s own tissue or a pelvic mesh to lift and repair the fallen organs is of course the most serious of the pelvic floor weakness treatments and should always be last resort due to the risks and complications associated with any surgery. Pelvic mesh implant recalls and class action law suits5 highlight this need for caution. There are 320,000 surgeries a year for pelvic floor disorder in America alone, 200,000 of which are for prolapse.1

Regardless of the type of pelvic prolapse you may have, please seek assistance from a pelvic health physical therapist, do not resign to living and enduring these conditions. So much can be done. Please check out some of the links above as well as our SRC Restore product with its 100% Money Back Guarantee.

References:

  1. https://www.washingtonpost.com/local/social-issues/a-hidden-epidemic-millions-of-women-suffer-pelvic-floor-disorders-silently/2015/12/22/f5997966-a6d5-11e5-b53d-972e2751f433_story.html
  2. https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.12020
  3. https://www.thewomens.org.au/health-information/vulva-vagina/vaginal-prolapse/more-about-pessaries
  4. https://www.health.harvard.edu/diseases-and-conditions/pessary-and-exercise-relieve-symptoms-for-women-with-pelvic-floor-prolapse
  5. https://www1.racgp.org.au/newsgp/clinical/johnson-johnson-to-pay-millions-to-pelvic-mesh-pat#:~:text=The%20Federal%20Court%20has%20ordered,ranging%20from%20%24555%2C555%20to%20%241%2C276%2C113.
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