Preventing Pelvic Organ Prolapse Guest Blog Written by: Elizabeth Carrollton
It is likely that pelvic organ prolapse (POP) will become a problem for half of all women who have given birth and in some who haven’t. In most women, this common pelvic support disorder will show up during or after menopause, but some women will experience POP symptoms at an earlier age. However, taking good care of your pelvic health can significantly reduce your risk of developing POP, and if prevention fails, there are many treatments that can help, ranging from conservative options to surgery.
What is Pelvic Organ Prolapse?
Pelvic organs, such as the uterus, bladder, small intestine and bladder, are kept in place primarily by support provided by the pelvic floor, which often becomes stretched and weakened over a woman’s lifetime. In pelvic organ prolapse, that pelvic floor damage has progressed to the point that the organs are no longer adequately supported, allowing one or more of them to drop out of normal position. Symptoms of POP can include urinary or bowel dysfunction, pelvic pain or pressure, bulging in the vagina or protrusion of tissues through the vaginal opening.
Pregnancy and childbirth are the primary risk factors for POP. Women who have difficult deliveries or large babies may develop pelvic organ prolapse after childbirth and are at increased risk of being affected later in life than women who have uncomplicated deliveries. Women who are overweight, work in occupations that require heavy lifting and those who participate in high-impact sports are also at greater risk.
Protecting pelvic health can help prevent pelvic organ prolapse. Physiotherapy during and after pregnancy that focuses on enhancing pelvic floor strength and tone can significantly reduce prolapse risk. Regular Kegel exercise is important for prevention, especially during pregnancy, after delivery and during the years leading up to menopause.
If you’re overweight, you’re placing undue stress on the pelvic floor, especially if the excess weight has settled around your waistline. Maintaining a healthy body weight can lower risk. Frequent straining with constipation is a risk factor, so increase fiber in your diet to prevent it. Good nutrition is important, ensuring that the body has the nutrients necessary for proper muscle maintenance and function.
If you’re already showing the signs of pelvic organ prolapse, many of those prevention methods are also used in conservative POP treatment. Physiotherapy has been shown to enhance pelvic floor function, improving symptoms in many women. Weight loss can reduce symptoms, as can treating or preventing constipation. Avoiding caffeine and spicy foods can reduce incontinence, and using a support device in the vagina, called a pessary, can reduce pelvic pressure and pain.
Surgery has helped many women with severe symptoms. However, it is an option that must be approached with caution, since there are risks. Transvaginal mesh procedures merit particular concern, since they have been labeled risky by the FDA and have caused serious complications in thousands of women. Most common is mesh erosion, which can lead to organ perforation, mesh protrusion through pelvic tissues and infection. There have been several recalls for transvaginal mesh products, including implants made by Boston Scientific, C.R. Bard and Johnson & Johnson, and hundreds of lawsuits have been filed by injured women. Please be sure to always discuss all treatment options and the risks associated with each with your doctor.
Elizabeth Carrollton writes to inform the public about defective medical devices and dangerous drugs for Drugwatch.com.
Harvard Medical School: What to do About Pelvic Organ Prolapse: http://www.health.harvard.edu/fhg/updates/update0805c.shtml
Prevention of pelvic organ prolapse: a summary of the evidence: Dr K. K. O’Dell: http://www.ihe-online.com/index.php?id=2448
A randomized controlled trial of pelvic floor muscle training for stages I and II pelvic organ prolapse: http://www.ncbi.nlm.nih.gov/pubmed/18806910
Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women: http://www.ncbi.nlm.nih.gov/pubmed/18843750
FDA Safety Communication: UPDATE on Serious Complications Associated with Transvaginal Placement of Surgical Mesh for Pelvic Organ Prolapse: http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm262435.htm
FDA: Medical Devices: Implants and Prosthetics: Pelvic Organ Prolapse: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/UroGynSurgicalMesh/ucm262299.htm
About three years ago as I uncomfortably existed in what I all my “new” body…the body that has pelvic organ prolapse, I would sit with my two and four year old daughters and watch “So You Think You Can Dance.” A very long time ago I was a dancer and it seems my little girls are innately interested. Not only do they take dancing lessons but they love to watch the show. I must admit I do as well. The show speaks to my very personal dreams and aspirations. As a little girl my fantasy was to be a student at the National Ballet of Canada and I relished each June when our costumes arrived at my neighbourhood dance studio and I was closer to being on stage performing. I was by no means a “star” student destined for a future in dance but I did have a natural rhythm and a love of dance. I have to admit that a few times when I was watching So You Think You Can Dance I would close my eyes and imagine that feeling that I used to have…the feeling that I was soaring…the feeling I used to get when I knew the dance routine so well that I lost myself in the music and I felt free. My body did almost everything I needed it to do and I was invincible. A few years have passed and we haven’t watched the show in a while because we are a little too busy between school and all of the dance classes the girls take. Just recently one of my “dance mom” friends reminded me that there was an adult dance class. It definitely peaked my interest and this in itself is monumental. There was a time that I would have cringed at the very thought. There was a time that I needed to be in self-preservation mode. I considered this opportunity with a grew deal of thought and discovered I was thinking about the many reasons why it would be a good idea. Time has been on my side. I also have been doing my kegels and the “Pfilates” program. So I thought why not and I went! Guess what? It was so much fun! I giggled at the joy of doing a “step ball change.” I loved stretching and learning some new dance steps. I decided to opt out of a jump and a kick…no big deal! I came home feeling pretty great. The best part is that I feel much more motivated to continue strengthening my pelvic floor. I need it to be as strong as it can be…so I can dance!!!
Four years ago as I sat at the computer in the wee hours if the morning trying to learn any information that I could about pelvic organ prolapse but there was not a lot to go on. I gathered some definitions from a few medical websites ad stumbled across a few graphic images that left me in tears and terrified about my future. When I came across Sherrie J. Palm and her book POP The Silent Epidemic I was so very thankful to find her. I felt compelled to reach out to her in my desperation to feel connected with another woman living with this condition. For much too long I had felt like I was the only one living with POP and that nobody understood. I continue to view Sherrie Palm as a Guru. Her advocacy, knowledge of POP, and vision have paved the way for women such as myself to garner the courage to share our stories.
My personal experience is that of being a thirty-eight year old mother of two baby daughters who was diagnosed with pelvic organ prolapse. After a year of waiting to see a specialist I was encouraged to stave off surgery and get as far along in my life as possible. This fuelled my passion to share my story and advocate awareness for this health issue I had not heard about until I was diagnosed. The heart of my story lies in the time it took to rebuild my life through a very unexpected wellness journey. My quest to live in a body I described as literally falling apart included seeing multiple doctors, trying to find a pain management support group, speaking with a psychologist, finding a life coach, visiting a naturopath, regular pelvic floor physiotherapy and Chinese acupuncture appointments, and learning to meditate all while raising my 14 month old and 3 year old daughters and working full time. While not every pathway supported my journey and wellness I can honestly say I don’t regret trying many avenues to support my health. I learned a lot along the way and if it weren’t for trying I never would have known what worked for me and what did not.
The amazing news is that in the 6 years since I have been living with pelvic organ prolapse there have been significant changes. I mean really significant! I am so happy that through my personal advocacy and networking I have met an amazing group of women who have felt a strong calling to support pelvic floor wellness in various capacities including fitness experts and pelvic floor physiotherapists. There are an increasing array of products that support the dignity and lifestyle of women living with POP. There is also an amazing exercise program called “Pfilates” that I believe every woman should do for prevention and maintenance. So while I can have my own set backs from time to time I ultimately have an increasing amount of hope for women living with pelvic organ prolapse. Sherrie Palm states, “POP is seldom life threatening but always life changing.” The impacts are huge and are not only physical but also emotional. Healing is a complex journey yet as more knowledge and options become available women will no longer suffer alone and for as long.
My daughters aged four and five do not know yet that their Mommy lives with a health condition called pelvic organ prolapse or POP. Often referred to as “the silent epidemic” of women, pelvic organ prolapse occurs when the uterus, bladder, rectum, or vagina or a combination of these organs herniate into the vaginal canal. A woman who shares her symptoms with a physician, family member or friend must describe intimate physical details that relate to her anatomy, sexuality, and excretion habits. Not fun yet a devastating reality for millions of women world wide in varying degrees.
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Once upon a time I was an avid runner. I was very confident in my health. I felt strong and unstoppable.
I waited a long time to have a baby. Life circumstances had put that dream on hold for a while. I later found my wonderful husband and we both decided we wanted to begin having a family. We were thirty-five at this time and we were excited to begin having children. Read the rest of this entry »