How To Stop Prolapse From Getting Worse

What is pelvic organ prolapse?

Whilst a lot of women know that they will transition into  menopause, most are not aware of Pelvic organ prolapse or shortly POP.  POP happens when the muscles and tissues that are supporting your pelvic organs such as rectum, uterus, and bladder are to weak to support and hold them in their correct place in your pelvic region. This results in one or more of the pelvic organs dropping or pressing into or out of the vagina.

Unfortunately, seen that everything even closely related to our sexual organs is socially categorized under taboo topics, this topic also one topic many are tight lipped about.  As a result many women suffer in silence and face this issue alone.

What Causes POP?

As we mentioned before, POP happens when the muscles and/or connective tissues of the pelvis get weaken and are not as strong as they used to be; this can happen for several different reasons, among which the most common risk factors are:

• Long-time pressure on your abdomen – this pressure can come from pressure from chronic coughing, obesity, etc.

• Vaginal childbirth – during childbirth there are a ton of changes in our body and giving vaginal childbirth can stretch and strain the pelvic floor. Multiple childbirths as well as giving birth to a baby weighing more than 8 pounds can also contribute and increase your risk of getting POP latter in life.

• Hormonal changes during menopause – according to research is done and published in Urogynecological Risk Assessment in Postmenopausal, “Loss of the female hormone estrogen during and after menopause can raise your risk for pelvic organ prolapse.”

• Aging – referring to our previous source, the Prevalence of Symptomatic Pelvic Floor Disorders in U.S. Women, POP most commonly occurs in older women, “about 37% of women with pelvic floor disorders are 60 to 79 years of age, and about half are 80 or older.”

• Family history – if someone in your family had it, the risk of you getting it is also higher.

Symptoms Of POP

There are several symptoms that can indicate you have POP.some of them are more obvious than the others. Nevertheless, if you are experiencing any of these symptoms you should discuss them with your gynecologists:

• Feeling of discomfort, pressure, aching or fullness in your pelvis; this intensifies especially during physical activities or sex

• Feeling of pressure which gets worse when you are standing or coughing or as the day goes on

• Having leaks of urine, problems having a bowel movement or similar urinal issues

• Seeing or feeling like something is coming out of your vagina, like a bulge

• You have issues inserting tampons

Non Surgical Treatment

Depending on your symptoms as well as their severity, your age, your health history, your sexual activity and the type of prolapse you have, your doctor may suggest different types of treatment. According to Sherrie J Palm, “Becoming aware of your body and the sensations that are created by POP will be of great assistance in monitoring your path to pelvic floor health.” The treatments, she also adds, “can be reasonably effective for women in early stages of POP.” Some of the treatments available today, which your doctor will probably suggest are the following:

1. Pessary – most likely the first treatment that your doctor will suggest is pessary; this is a removable device – elastic or rigid which gets inserted into your vagina to support your uterus. This is a safe, non-surgical option that is used to decrease the frequency and severity of prolapse symptoms and to avert or delay the need for surgery. The type and size will be adjusted to your needs and you don’t need to worry about its visibility, if it is properly fitted and inserted, it won’t be noticeable.

2. Kegel assist devices – Kegel assist devices such as Elvie or kGoal are new devices that are inserted into the vagina and help you measure the strength and effectiveness of a workout by sending information to a smartphone app. The sensors inside these devices detect the direction of muscle movement to ensure that women are lifting up on the muscles rather than pushing them down. Besides these, there are also the traditional Kegel devices such as weighted cones, biofeedback devices, pelvic toners, etc., who assist women in their Kegel exercises and help them strengthen the pelvic floor muscles.

3. Kegel Weights–  Adding weights to you Kegel can give you quicker results in a shorter period of time. The Kegel exercise was developed in 1948 by Dr. Arnold Kegel, promote general pelvic floor health and maintenance and seen as a POP treatment for some women. These exercises can be done discretely anytime and anywhere. They come in different weight. Start with the lightest weight. Follow the instructions in the package.

4. IncoStress – one of the most commonly prescribed or recommended solutions that many doctors suggest. According to their official site, “IncoStress can assist with the gentle support of a mild cystocele and or rectocele. It can be used during the night time to support the internal organs from descending.” Moreover, it is “the only patented medical device which controls incontinence instantly and may also be used as a pelvic floor muscle trainer.” However, before deciding on this, you should consult your doctor, to make sure that this is the best option for you as “IncoStress is not suitable for uterine prolapse.”

5. Hormone replacement therapy – this is one of the medical approaches that many doctors try to focus on because the lack of estrogen is the primary cause of menopausal pelvic organ prolapse, treatment in postmenopausal women. The treatment focuses on increasing the level of oestrogen, and it is worth noting that the treatment is still in research and the evidence of its effectiveness is not quite obvious and strong; this therapy seems to help more on relieving some of the symptoms, like dryness or discomfort during sex rather than fixing the entire issue. That’s why usually it is combined with some other treatment.

6. Electrical stimulation – this treatment is usually used for prolapsed bladder; the doctor will apply a probe to muscles within your vagina or on your pelvic floor and this probe which is attached to a device that measures and delivers electrical currents will deliver small electrical currents that will contract and strengthen the muscles of the pelvic floor.

7. Biofeedback – this type of therapy focuses on teaching patients how to contract their pelvic muscles by showing them how to properly breathe and control their abdominal. This is a painless process that uses special sensors and a computer monitor to display information about muscle activity and provide a “feedback” which helps in understanding how to proceed.

8. Tibial nerve stimulation – An electrode is placed near the nerve at the ankle known as the tibial nerve. A device known as the Urgent PC Stimulator is connected to the electrode and sends mild electrical pulses to the tibial nerve.” By stimulation of these nerves through the electrical impulses you will gradually, over the course of 12 weekly, 30 minutes treatments make changes in your bladder activity.

9. Myofascial release therapy – The myofascial release therapy is done by a therapist (physical, occupational or massage) who places a mild to moderate pressure into an area of tightness and maintaining that pressure for time frames up to or exceeding five minutes per technique; this usually lasts for 1 hour and depending on how severe your symptoms are, you might need few sessions. This technique is used to treat tight pelvic floor muscles.

10. Exercise programs – there are several different programs that focus on providing a different exercises that will help you strengthen your pelvic floor muscles. While maintaining a healthy weight significantly reduces the progression of your POP, you should avoid high impact activities. Even some yoga poses can worsen your condition. Therefore, focus on only programs that are specifically designed for pelvic floor.

11. Urethral injections – the urethral (bulking) injections are considered a gynecological procedure / medical treatment where urethral injections are injected into the mucosa surrounding the bladder neck and proximal urethra to treat involuntary leakage of urine. These need to be done by trained professionals and usually are one of the last resort.

12. Support garments – there are several different garments that you may use in the case with POP; one of them is Hide-a-way which is light-weighted, easy to wear an elastic garment that supports stage 1, 2, or the beginning of a protruding prolapse. Another one is the V-Brace which is also a support garment that provides the same support as placing your hand on the vaginal area and applying upward pressure. Considering that there are several different types of garments it is always best to talk to a specialist before deciding to buy one of them.

Finally

In the early stages, POP can be managed without surgery. Most of the recommendations above can be done at home. In fact, if you suspect that you might have POP, you can start wearing support garments and avoid high impact activities that put pressure on you pelvic floor muscles. If you are overweight and carry excessive amount of abdominal fat  then loosing weight can relieve some of the pressure of your pelvic floor.

Sources
Biofeedback. (n.d.). Retrieved from http://www.pelvicfloorcenter.org/content/biofeedback
Nygaard, I., et al. (2008). Prevalence of Symptomatic Pelvic Floor Disorders in U.S. Women. JAMA; 300(11): 1311–1316.
Palm, S. J. (2009). Pelvic Organ Prolapse: The Silent Epidemic (1st ed.). Strategic Book Publishing & Rights Agency, LLC; 1 edition.
Pelvic organ prolapse. (2019, May 14). Retrieved from https://www.womenshealth.gov/a-z-topics/pelvic-organ-prolapse#11
Pelvic Organ Prolapse. (n.d.). Retrieved from https://www.incostress.co.uk/pelvic-organ-prolapse/
Sengupta, N., et al. (2013). Urogynecological Risk Assessment in Postmenopausal(link is external). Expert Review of Obstetrics & Gynecology; 8(6): 625–637.