How to spot postpartum prolapse and what to do about it.
While we all love a cute baby, there’s a lot of unpleasant side affects from pushing one out of your vagina. Pelvic organ prolapse (POP) -- when your organs (bladder, uterus, or rectum) shift in position and then bulge into (or out of) your vaginal canal -- can be one of them. In fact, vaginal birth is one of leading causes of POP.
Say what? I read the part about organs bulging out but what does that really mean? Between the bladder, the uterus, and the rectum lies connective tissue. Think of this connective tissue as bookends, helping to keep the organs in their position. When the connective tissue becomes weak, the bookends fall behind on their job and the books (or organs) begin to collapse into onto another.
Who gets POP?
The truth is, POP Is way more common than you think. In fact, either you or your best friend probably has it (especially if you’ve gone though childbirth or menapause) because 50 percent of women have some degree of POP. Yup, half of us women have experienced this. How do you know if you’re one of them?
Many women don't have any symptoms of POP. And many others suffer silently with symptoms they don't understand. Those who do have symptoms may feel vaginal fullness or pressure or as if a tampon is falling out. This pressure often gets more pronounced later in the day. Some women complain of not being able to fully void their bladder or bowels or of uncomfortable sex. And of course, when you don’t recognize the cause of symptoms, your minds can be your worst enemy, imagining the most negative scenario.
So why does it happen?
One of the jobs of the pelvic floor/core is to balance the pressures above it, namely intraabdominal pressure. Anything that increases the pressure in our abdomen (straining in the bathroom, heavy lifting or over challenging exercise, prolonged coughing) can overwhelm the pelvic floor muscles when they lack coordination and the ability to counter the pressures above it. And your pelvic floor is particularly vulnerable postpartum.
The pelvic floor fatigues long before the heart or lungs during exercise. Pelvic floor damage can happen when the pelvic floor fatigues in a workout. Repeated rises of intra-abdominal pressure or even one sudden, heavy episode may result in POP in some women.
When it comes to postpartum, returning to high impact exercise or lifting heavy weights before regaining pelvic floor muscle strength and postural alignment postpartum results in more strain and damage to pre-weakened muscles, supporting ligaments and connective tissue.
Is there hope for me?
There are both conservative and surgical options for correcting prolapse. Pelvic floor therapy can help balance the muscular support against the internal pressure system above it and also help you learn strategies for protecting yourself during daily habits that can exacerbate the pressure (lifting up baby, going from sit to stand, etc). Pessaries are another conservative option made of medical-grade silicone that you insert into your vagina. It provides support to the connective tissue compromised “bookend.” There are also numerous surgical options can help POP such as abdominal repair, transvaginal repairs, robotic repairs, laparoscopic repairs, etc.
But the most positive approach we can take is to increase awareness to enable women to recognize POP symptoms when they first occur or better yet, ways to decrease the likelihood of it happening. When POP becomes common knowledge, it will become more readily identifiable and women will be able to seek earlier, less aggressive treatment. Knowledge is power; share this information with your girlfriends, sisters, colleagues and family.