Understanding Pelvic Organ Prolapse And How To Manage It
One of the many roles of the pelvic floor is to support our pelvic organs: bladder, rectum, and uterus (for some of us). Pelvic organ prolapse is when one or more of these organs descend into the vaginal canal due to a loss of integrity of their supporting structures (pelvic floor muscles, ligaments and fascia).
The most common prolapse diagnoses are:
Cystocele: bladder prolapse
Rectocele: rectal prolapse
Uterine Prolapse
And they are graded on a scale from 0 (none) - 4 (complete)
There are several ways that the soft tissues in the pelvis can become lax: prolonged strain during pregnancy and childbirth (even if you deliver via c-section), hormonal changes with menopause or breastfeeding, chronic pressure from improper lifting mechanics, breathing patterns, or constipation, or connective tissue disorders like Ehlers-Danlos Syndrome.
Symptoms include:
Pelvic heaviness or pressure
A bulge that can be felt inside or at vaginal entrance
Urinary incontinence or retention
Difficulty emptying bowels
Discomfort during sex
And symptoms often worsen after bowel movements, prolonged standing, lifting, and at the end of the day.
The good news is that there are several non-invasive options to treat prolapse. Research shows that strengthening combined with pressure management can reverse a prolapse up to one grade and completely resolve symptoms!
So if you have been diagnosed and/or are having any symptoms of prolapse, you do NOT need to live with it for the rest of your life! And surgery is DEFINITELY NOT the only (or best) option!!
Strengthening takes time and consistency, so in the meantime, if you are experiencing symptoms with your exercise routine or daily activities, you may try a supportive device called a pessary. These can be prescribed and fitted by an OBGYN, or you can purchase a generic version that is meant to be worn for short periods.
If you need more specific guidance to manage your prolapse, make an appointment with a pelvic floor therapist!
Temporary pessaries:
Pressure management tips:
Avoid straining or bearing down into your pelvis when pooping, lifting, or changing positions
Breathe with your diaphragm, not your chest and neck
EXHALE with EXERTION and engage your pelvic floor and deep core musculature to support you from the bottom up when lifting
Written by Jade Jette, PT, DPT