10 June 2020

What is a Pelvic Organ Prolapse?

June is Pelvic Organ Prolapse (POP) Awareness month ….. Do you know what a pelvic organ prolapse/POP is??

Basically it is when the fascia and ligaments in your pelvic floor muscles relax and your pelvic organs move out of place.  It feels like your pelvic organs are bulging into each other.  You can get different types and different levels of a prolapse which I will explain below.

How do you know if you have a POP?

It is worth being aware of the different sensations you can have if you have a POP. Anyone can have one but some women could be more at risk especially if you are menopausal or have had babies.  Maybe your pelvic floor muscles don’t feel the same anymore, look at the different symptoms:

  • A heaviness pushing down in the pelvic floor
  • A feeling that something is ‘out of place’ or protruding in your pelvic area
  • A dragging or uncomfortable sensation in the pelvis or lower back pain
  • Painful sex
  • Hard or sore when trying to insert a tampon
  • Inability to empty the bowels properly
  • A feeling of needing to protect your bowels when going to the loo

Different types of POP

There are different types of a prolapse with different organs protruding:

  • Bladder prolapse or Cystocele – this is when the bladder ‘falls into’ the vagina and the front pelvic floor muscles feel some pressure
  • Rectocele – where the rectum ‘falls into’ the vagina. Where you feel like the bulge is further back
  • Womb / Uterine prolapse – when the uterus feels like it is protruding down towards your vagina
  • Vaginal Vault prolapse – this is when women have had a hysterectomy where the uterus has been removed. This is when the vagina has descended from its optimal position.

There are also different levels of severity of a prolapse.  It can range from a mild organ descent to one where it feels like the organs are hanging down, out of the entrance of the vagina.

The main drivers behind a POP

The main drivers of a POP is a lack of fascial support or intra-abdominal pressure.  Intra-abdominal pressure is when there is too much bearing down on the pelvic area – which often comes from constipation or holding the breath when lifting or pushing anything with exertion.

Women who have had a baby vaginally and maybe had quite a lot of trauma to the birth canal and pelvic floor during birth could perhaps get symptoms.  Maybe nothing was ever done after having a baby and you got back to lifting heavy weights or running and then a few years later started to feel something wasn’t right or you found you started to leak – it is worth getting it checked out.

During and after the menopause women lose the elasticity in their pelvic floor muscles & connective tissue in the pelvis due to the decline in estrogen.  This is a time when it is important to do the pelvic floor muscles and learn to breathe to connect the deep core abs muscles, the diaphragm and the pelvic floor muscles.  This can be a time when women do experience a prolapse.

What can you do?

1st – if it doesn’t feel right then ask your GP to check and/or refer you to a woman’s health physio (WHP).  They will do an internal and assess what level and type of prolapse you may have.  Then give you the right exercises to do.

2nd – re-train the pelvic floor muscles.  They, like ALL muscles need to get a full range of movement to strengthen so it is all about doing the close and lift on the exhale and then relaxing them on the inward breath.

3rd – do the ‘knack’ ie ‘squeeze before your sneeze’!  The quick pre sneeze or cough engagement before you add pressure down onto the pelvic floor.

4th – learn to breathe properly so you do the full range of movement in the pelvic floor.  This is really important for lifting or doing a lot of exercise with exertion.

5th – manage your constipation – again either see a nutritionist (ask me as I have contacts) to learn the right foods for you to eat to help manage the constipation.  Or increase the amount of water you drink, have prunes or dates everyday and maybe look at taking a Magnesium Citrate supplement (ask me which is a good brand).

6th – get a pessary fitted – they act as a support in the vagina.

Post birth it is important to do the right pelvic floor exercises – ENGAGING and then RELAXING the pelvic floor with the breath.  If anyone ever feels it isn’t quite right in the pelvic area then ask to see a women’s health physio for an assessment.  Avoid any crunches/sit ups or heavy weighted exercises as it puts more pressure down on the pelvic floor and if not focusing on the breathing when lifting it could put more pressure on the pelvic area.

Most importantly is to know that there are things you can do. Always go and see someone about it and if you feel you haven’t been listened to then get another opinion or book in to see a women’s health physio privately (again I have details).

As a Holistic Core RestoreⓇ coach then I can also work with you on a 1:1 or in a group Everywoman course. I can help you manage your intra-abdominal pressure through your breath, hence supporting the pelvic floor.  Or I can direct you to the right people if you need an internal examination.  Always ask rather than stewing on it.  Never be ‘fobbed off’ with ‘you’ve had a baby that’s why it feels odd’ or ‘its normal in your menopause’.  Talk to me and I can advice you who to see – you can do something about it.

 

Pictures of different levels of PF prolapse

Find out more

Come along to a class or contact me for more information.