My journey with Pelvic Organ Prolapse and my menopausal transition has been challenging in so many ways but alongside it has come personal growth, endurance and strength of body and mind. It’s a journey that I did not expect or want but I believe it has made me more compassionate and understanding of the challenges that many of us face.
My Pelvic Organ Prolapse journey began 28 years ago but I did not realise it. Over a 2 & 1/2 year period I gave birth to two 9lb babies which left me with birthing injuries. I required a forceps rotation delivery of my daughter which resulted in my pelvic floor muscles being torn from my pubic bone (Avulsion), however it took 17 years for this injury to be diagnosed. A year after my son was born I underwent extensive abdominal surgery for severe abdominal muscle separation and a hernia. I also underwent a surgical repair of a second degree tear immediately after his birth.
The leading risk factors for developing Pelvic Organ Prolapse (POP) are childbirth and menopause. In addition to these risk factors were the fact that both my children were large, I was in my early to mid thirties when giving birth and there was a family history of prolapse. Unfortunately I was never made aware that I was at high risk of developing POP, in fact I had never even heard of it, most of us don’t until we receive a diagnosis.
My pelvic floor and core health was never assessed postnatally. There was no discussion about possible symptoms to be aware of as time progressed. These symptoms can include incontinence, both urinary, faecal and flatulence, a stop/start urine stream, incomplete emptying of urine and faeces, constipation, a heavy dragging sensation, a visible bulge at the vaginal entrance and low back pain. I started to gradually experience symptoms, and by the time I was Perimenopausal they had become severe and debilitating. I was also experiencing the double whammy of Perimenopausal symptoms as well. Acid reflux, Acne, Arthralgia, Bloating, Body Composition changes/belly fat, Brain Fog, Breast Tenderness/Soreness, Difficulty Concentrating, Dizziness, Dry Eyes, Dry Skin, Electric Shock Sensations, Fatigue, Gastrointestinal Problems, Headaches, High Cholesterol/Triglycerides, Hot Flashes, Joint Pain, Memory Issues, Menstrual Cycle Changes, Muscle Loss, Musculoskeletal Pain, Sleep Disturbances, Unwanted Hair Growth (Whiskers), Vaginal Dryness, Vertigo & Wrinkles. I experienced these symptoms to varying degrees of severity. There are other additional symptoms that can be experienced as well, it’s not just hot flashes and night sweats! Not everyone will experience symptoms of Perimenopause, but for those of us that do it can be extremely frustrating.
It was not until my symptoms were greatly affecting my quality of life that I finally decided to talk to my GP about it. I had experienced a period that had lasted a month and I was also experiencing repeated back pain and significant vaginal bulging. I wish I had been proactive in my health care much sooner, but like so many mums, I was busy looking after my family, my household and working, I put my needs to the bottom of the list. My GP advised that I was Perimenopausal and that I had Pelvic Organ Prolapse. She sent me to a specialist where various tests were carried out and surgery recommended. I had surgery that included a hysterectomy, my front and back vaginal walls were repaired, my vaginal vault was held up with mesh and my enlarged vaginal entrance reduced. Unfortunately my pelvic floor muscle Avulsions could not be repaired. Pathology tests on my uterus showed Adenomyosis which added to the erratic periods. I have worked consistently since my surgery in 2012 to rehabilitate my pelvic floor to regain strength and function and I will continue to do so for the rest of my life. During the menopause transition the depletion of oestrogen can affect so many areas of the body including the pelvic floor. The muscles and ligaments of the pelvic floor are oestrogen-sensitive, so oestrogen deficiency directly affects their strength.
In more recent years I have developed other health conditions that are associated with the menopausal transition and oestrogen depletion. I developed acute onset Rheumatoid Arthritis, an autoimmune disease, after completing surgery and radiation therapy for noninvasive breast cancer. This year I have also been diagnosed with Osteoporosis, I’m at high risk of fractures, along with prediabetes. I find all of this very frustrating as ever since my surgery in 2012 I have exercised regularly, I eat a healthy diet, I don’t drink alcohol, I have never smoked and I have never been overweight. This is why I have made it my purpose in life now to raise awareness of conditions that impact our physical and mental health, in particular Pelvic Organ Prolapse especially when it coincides with the menopausal transition. The lack of awareness of POP and the consequences of oestrogen depletion during and after the menopausal transition are not well known, yet we all deserve to have knowledge about the possible effects on our bodies. We need to take action to raise awareness of both so that we can all make informed decisions in our healthcare and to ensure that our future generations are not left uneducated, uninformed, unsupported and untreated.
Some of the positive action that I have undertaken to help myself and others is to share my journey with POP so that other women do not feel alone. I help moderate a support group on Facebook where women can share their thoughts, feelings and concerns and where they can then become empowered and advocate for themselves to receive appropriate treatment options for their individual needs and circumstances. I have recently written two submissions to the Australian Parliament, one on Birth Trauma and the other on issues relating to menopause and perimenopause. There is so much we can all do on an individual level to help move women’s health forward and to give it the recognition, research and development that we need and deserve. SRC Health is an amazing entity that is helping to support this endeavour by providing an extensive product range of garments for pregnancy, postpartum and beyond. I was very fortunate to be introduced to their garments by my Pelvic Health Physiotherapist after my surgery. I have been wearing their support wear ever since and I especially love their more recent introduction of SRC Restore. I wear them everyday and love the perineal support they provide. I have been unable to wear a pessary, an internal device used to help provide support to the pelvic organs. Even though my surgery improved my quality of life greatly, it was not able to “fix” everything, so I find the external support of great benefit.
I would encourage every woman experiencing Pelvic Organ Prolapse and the menopausal transition to talk to their healthcare provider, do not suffer in silence like I did. There is so much that can be done to assist in relieving and even eliminating symptoms so that we can live a full and active life. Talk to your daughters, sisters, mothers, aunties, grandmothers, girlfriends, work colleagues about your experiences. By doing this we can help to eradicate the stigma and taboo surrounding women’s health issues.\