HOW DO I KNOW IF I HAVE PROLAPSE?
Often it's not until women experience the prolapse symptoms, that they begin to learn what prolapse is. Unfortunately, in our society, pelvic health concerns like pelvic organ prolapse are not openly talked about. This leaves women feeling scared and alone. As an integrated pelvic floor physiotherapist, I am here to help share information about pelvic health and provide women with the answers they are looking for. In this article I'll talk about what prolapse is, prolapse symptoms, and how it is diagnosed.
WHAT IS PROLAPSE?
Pelvic organ prolapse is the symptomatic descent of one or more of the anterior vaginal wall (that supports the bladder), the posterior vaginal wall (that supports the bowel), and the apex of the vagina (cervix/uterus) or vault after a hysterectomy. The way we talk about prolapse has changed over time. In the past, anterior wall prolapse was referred to as a cystocele, posterior wall prolapse was named a rectocele, and an apical prolapse was termed a uterine prolapse. New medical terminology requires a woman to have symptoms as well as increased movement of the vaginal walls for prolapse to be diagnosed.
WHAT CAUSES PROLAPSE?
There can be different causes of pelvic organ prolapse. Some of the most common are:
- Pregnancy, due to the increased weight on the pelvic floor
- Birth, in particular vaginal delivery where forceps assistance was utilised
- Menopause, due to changes in hormones
- High impact exercise (e.g. heavy weights, running) due to increased pressure on the pelvic floor
Some women have a genetic predisposition to pelvic organ prolapse, meaning their genetic make up increases the likelihood that they will experience prolapse.
HOW IS PROLAPSE DIAGNOSED?
The best way to know if you have Pelvic Organ Prolapse, is to have an assessment conducted by a Pelvic Floor Physiotherapist. To have an accurate understanding of the degree of prolapse, an internal vaginal examination needs to take place. From this assessment the physiotherapist will be able to tell you:
- The degree of vaginal wall movement, and therefore give you a 'stage' of prolapse if you wish - some women find knowing this information valuable, whilst others say that it has them feel anxious. It's important to feel into what knowing this information will give & decide for yourself if you sense it would be empowering, or have you feel less at ease.
- The strength, endurance, and co-ordination of the muscles of the pelvic floor
- The integrity of the connective tissue and pelvic floor muscles that support the pelvic organs
New medical terminology suggests that in order to confirm that a woman has prolapse, the woman must feel symptoms of prolapse. Depending on what part of the vaginal wall is affected, symptoms can vary.
WHAT ARE PROLAPSE SYMPTOMS?
The following prolapse symptoms are common:
- A heaviness or dragging sensation in the pelvis
- A bulging sensation within the vagina
- A feeling that 'things are falling out'
- Low back pain
- A deep 'thudding sensation' during penetrative sex
- Difficulty initiating or completing a bowel motion
- Needing to support the vaginal wall with a thumb/finger to empty the bowel
- A need to 'double void' - going to the toilet to urinate, then needing to revisit the bathroom shortly afterward due to incomplete bladder emptying
- Symptoms that feel worse at the end of the day, or after exercise
If increased vaginal wall movement AND prolapse symptoms are present, it is likely prolapse is present. Whilst knowing this information can help you know how to move forward in managing and healing prolapse, it can feel very confronting and overwhelming to learn that prolapse is present. Having a diagnosis of prolapse isn't always the lifetime sentence women fear that it is. Prolapse is certainly something that can be managed, treated, and often resolved.
I HAVE PROLAPSE, NOW WHAT?
Being informed that you have pelvic organ prolapse can feel devastating. Often this information is not shared with the sensitivity and compassion that it deserves. Even if we don't have the words for it, women intuitively sense that the pelvic space is a sacred part of our body. Learning that there are changes to our pelvic health can have a huge impact on us - physically, emotionally, energetically and spiritually. In future articles I'll share more information about pelvic wellness, pelvic organ prolapse, and taking an integrative approach to healing prolapse. My book Body Conscious: A woman's guide to holistic pelvic wellness and feminine embodiment, shares all of this information in depth. You can learn more about the book here.
If you would like to explore a body connection practice that will help you embody a holistic approach to pelvic wellness, I invite you to share in this Deep Core & Pelvic Floor Embodied Understanding practice. You can access the practice by filling in the form below.