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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!

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