There is a women’s health condition that is so rarely talked about that many women suffering from it do not even know that they have it.
Vague symptoms like low back pain, discomfort or a feeling of pressure in the vagina, urinary issues, constipation, and painful sex may be brushed off as a normal part of the aging process by some. While you may be suffering from pelvic organ prolapse, which is a treatable condition!
Topics such as sexual dysfunction and urinary and bowel issues are embarrassing. If your provider does not ask specific questions that may pertain to pelvic organ prolapse, it is doubtful that most women will mention these non-life-threatening yet uncomfortable complaints.
What Exactly is Pelvic Organ Prolapse?
Pelvic organ prolapse occurs when the muscles surrounding the organs in your pelvic cavity and pelvic floor weaken as you age. A traumatic childbirth that overstretches the vagina can also lead to pelvic organ prolapse.
The organs that can be affected are your bladder, vagina, uterus, and rectum. A prolapse is a bulging of any of these organs down into or out of your vagina (yikes!).
Fortunately, most women do not experience a severe prolapse (out of the vagina) but rather the initial stages of a prolapse with less dramatic symptoms.
When a low-grade prolapse occurs, you may feel the following symptoms:
- Uncomfortable feeling in the vagina
- When sitting, it may feel like you are sitting on a ball or lump
- Painful sex
- Inability to fully empty your bladder and frequency to urinate
- Constipation
- Pelvic pressure
- Low back or pulling sensation in the low back
If you feel any of these symptoms, it is best to talk to your women’s health provider sooner rather than later, as the prolapse can worsen over time.
Multiple vaginal or traumatic births, hysterectomy, and low estrogen from early menopause can contribute to this condition.
Are There Different Types of Pelvic Organ Prolapse?
Women often develop pelvic organ prolapse of only one or two of the internal organs in this area.
Any type of prolapse can be troubling and should be evaluated by your medical professional. Many times, you do not know which organ is affected until you have an internal exam by your provider.
Types of pelvic organ prolapse are:
- Cystocele (bladder prolapse) – the most common type of prolapse
- Rectocele (rectal prolapse)
- Uterine prolapse
What Can Be Done for a Pelvic Organ Prolapse?
First of all, don’t be shy about discussing this somewhat awkward condition with your provider. Although most gynecologists are familiar with pelvic organ prolapse, not all treat this condition. Also, do not allow your PCP to brush off the problem as an aging issue that you should live with.
Some specialists deal with pelvic organ prolapse specifically and can give you numerous options to help manage or resolve the issue. Urogynecologists are specially trained women’s health providers who diagnose and treat pelvic organ conditions such as prolapse of the bladder, rectum, and uterus.
What Are the Options for Treatment of Pelvic Organ Prolapse?
Your provider will outline a treatment plan based on the severity of your prolapse.
Providers may prescribe one of three options for pelvic organ prolapse:
- Pelvic floor physical therapy- Believe it or not, some physical therapists are specifically trained in the exercise necessary to alleviate pelvic organ prolapse. Most of us have heard of Kegel’s exercises to strengthen the muscles of the vagina. Pelvic floor PT will review and monitor your progress from Kegels and help you build up the core muscles surrounding your pelvic organs to help to keep the prolapse from worsening.
- Pessary- When I think of pessary, old ladies “back in the day” come to mind. However, this old-school device to hold pelvic organs in place is still very much in vogue and is a simple solution to managing pelvic floor prolapse. For a pessary, you need to be fitted by a trained women’s health professional for a removable ring that you can insert in your vagina (similar to a birth control vaginal ring or diaphragm).
- Surgery– Know that numerous surgical options are available for those with a severe prolapse or who prefer a surgical option over the non-invasive options listed above. The main goal of prolapse surgery is to repair the weakened parts of your pelvic floor through reconstruction.
My Encounter with Pelvic Organ Prolapse
At age 40, I had the unfortunate experience of having my ovaries surgically removed as part of my breast cancer treatment. My doctor warned me that I was now at risk for numerous health issues since I no longer was excreting the necessary protective estrogen to support many of the female functions in my body.
One issue I was NOT warned about was the increased risk of pelvic organ prolapse from early menopause.
After finishing my breast cancer treatment, I went about my busy life, which included helping my husband rehab an 1820s farmhouse. One day, several years after my cancer recovery, I felt a tearing sensation inside my pelvic cavity as I was moving heavy rocks. It was not overly painful and was more of an ache. Over time, I noticed that my lower back would ache when standing. Sitting would relieve the feeling.
Eventually, I felt uncomfortable while sitting in a hard chair. I can only describe it as I was perched on a small ball or marble near my vaginal opening. Also, sex was uncomfortable at times, but this was not unusual for me since my oophorectomy (ovary removal). Lifting objects (or little kids) especially aggravated my symptoms.
I mentioned these symptoms to my gynecologist, who suspected a prolapse. A referral to a urogynecologist confirmed a moderate uterine and bladder prolapse. I am now a proud (hah) owner of a pessary that I can remove for sex.
These days, my symptoms have pretty much resolved, and I rarely even think about my prolapse.
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