Do you have “POP”?

Not the kind of “POP” that you drink but rather Pelvic Organ Prolapse

Oddly enough, the first time I had ever heard the word prolapse was when my husband, a rancher, was helping a cow calve and she had prolapsed. If you are unfamiliar with what this is, it is when one of the pelvic organs (bladder, uterus, rectum) descends down into the vaginal canal (or rectum) and in some cases protrudes outside the body. Now, it is not the actual organ you are seeing but rather the wall of the vagina (or rectum). If you are a cow, they usually just push it back inside and sew the cow up (she then will have a C-section if she is bred again)…thank goodness we are not cows!

Side note: I asked our vet why cows do not have pelvic floor issues (that we know of) and he said it is because they are quadruped and gravity is not challenging their pelvic floors like bipedal humans. Makes sense!

Research has shown that up to 50% of women have a pelvic organ prolapse. You can have different degrees of prolapse and oftentimes, a woman with a lower degree may not even know she has one.

 

The different grades of “POP”

• Grade I-the prolapse is halfway to the vaginal opening
• Grade II- the prolapse is to the vaginal opening
• Grade III- the prolapse is halfway past the vaginal opening
• Grade IV-the prolapse is at its maximal descent

What might you feel if you have a POP?

• A bulge in the vagina
• The sensation of heaviness or dragging
• Difficulty emptying your bladder or intermittent stream of urine
• Difficulty having a bowel movement or incomplete bowel emptying
• Discomfort with intercourse or vaginal penetration
• Or sometimes it is just that your tampon fits differently or you cannot insert it as far

Why does “POP” happen?

The honest answer, we do not really know. When we carry and have babies, the connective tissue is challenged and it can become “loose”. This decreased support can allow your pelvic organs to creep down. Genetics may also play a role. If you are extra curious, you can chat with the women of your family to see if they struggled with this.

Can I Make it Worse?

If you have a POP, it’s important to know your pelvic floor and how it is functioning. When asked to perform a kegel, 50% of women were actually bearing down instead of lifting the pelvic floor. This bearing down can make your POP worse. Having your pelvic floor assessed by a pelvic floor physical therapist or assessing it yourself if you know what your looking for can be helpful.

Avoiding constipation is also a biggie. Make sure you are getting enough fiber and drinking your fluids to prevent constipation.

It is important to also know how to manage your pressure. When you go to lift something, cough, or strain, you are increasing the pressure inside your belly which in turn can put more pressure down on your pelvic floor. If you aren’t managing this increase in pressure down on your pelvic floor, you may experience more symptoms related to your prolapse.

Do I need surgery?

The short answer…NO! In more severe cases, surgery may be an option but there are many things to try before going this route. Some women learn to manage it for many years before they decide that surgery is the next step. I feel it is important to take more conservative steps first before going this route but it is your choice, gal!

How can I help myself?

Know Your Pelvic Floor

It is important to know how well your pelvic floor is functioning. Is it weak? Do you over contract your pelvic floor. Here is a chart to provide some insight into how your pelvic floor may be working.

 

Over-Active Pelvic Floor	Under-Active Pelvic Floor
Are you a stressed-out, type-A kind of gal	Are you a pretty relaxed, easy-going person
Difficulty starting to pee or you have a 2nd pee	Difficult time feeling a Kegel
Do you experience constipation	You experience urine leakage
Pain with sex	Tampons sometimes fall out
Leaking with sneezing or with stressful activities like jumping or running	Sex just doesn’t feel the same
Have difficulty feeling your pelvic floor relax during a kegel	Heavy feeling in your vagina

 

Seeing a pelvic floor physical therapist is a great option if you are not sure how your pelvic floor is functioning. If you do not have access to a pelvic floor physical therapist, performing a self-check on yourself is always an option. This can be done externally with a mirror or phone or internally with a finger.

Manage Pressure

Some of the myths hanging around on the street are you should avoid high-pressure situations at all costs such as lifting heavy things. Unfortunately, that just isn’t everyday life. You may have to lift your children or carry a million bags of groceries into the house.

The other thing to note is pressure is not a bad thing, it’s what helps provide stability to our core so that we can use our limbs freely. The problem lies in how we manage the pressure. Are we bearing down on our pelvic floor when we lift our child? What does our positioning look like when we are pushing a stroller or carrying our child. Are we holding our breath because we are stressed.  All these things can be modified to decrease the pressure.

Pessary

A pessary is a medical-grade silicone product that provides support to a POP. It is usually fit by a urogynecologist or a gynecologist. There are many shapes and sizes to choose from depending on your body. A pessary is an excellent device for some people, both short and long term. You can chat with your doctor if you feel you may want to try a pessary.

There are also some over-the-counter options such as Poise Impressa which is inserted like a tampon or also the sea sponge which you can wash and reuse it.

The biggest thing is you are not alone! There are a lot of women living with POP and doing an excellent job managing it. It is important to note that it is not always about decreasing the grade of POP but rather the symptoms you are experiencing. With help, many women can live a long fruitful, symptom-free life!

Please reach out to me with any questions!

-taryn