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1128665 tn?1269273471

Taking Pelvic Organ Prolapse Out of the Closet

Pelvic organ prolapse. Pessary. Urogynecology. Terms that all women should be familiar with, terms that few women are. Pelvic organ prolapse is an extremely common female health issue that has probably been around since women started having babies yet sadly remains in the closet. Frankly, women are just too embarrassed to talk about it. We need to change this dynamic. We need to change it now.

Every year hundreds of thousands of women are diagnosed with POP, and countless more suffer silently with symptoms that they can’t make any sense out of; is it a digestive thing, is it a colon cancer thing, is it a female hormone fluctuation thing? When we don’t know what to tie symptoms to, our minds can be our worst enemies, imagining the most negative scenario.

Half of all women over the age of 50 suffer from at least one type of pelvic organ prolapse (there are 5 types), many women in their 20s, 30s and 40s have POP as well. The 5 types of pelvic organ prolapse are cystyocele (bladder), rectocele (large bowel), enterocele (intestines), vaginal vault (vagina caves in on itself after uterus is removed-hysterectomy), and uterine (uterus). When the PC or pelvic floor muscles weaken, one or more of these organ/tissue areas drop down into the pelvic cavity below their normal positions.

Each of these 5 types of POP has its own symptoms, but in general symptoms can include:

Pressure, pain, or “fullness” in vagina or rectum or both.
Feeling like your “insides are falling out”.
Urinary incontinence.
Urine retention (you have to pee, you just can’t get it to come out).
Fecal incontinence.
Constipation.
Back/abdominal pain.
Can’t keep a tampon in.
Painful intercourse.
Lack of sexual sensation.

There are multiple causes of POP; it is likely that most women have more than one cause that fits their health pocket and lifestyle. The most common causes of POP are

Vaginal childbirth-complications from large birth weight babies, forceps deliveries, multiple childbirths, improperly repaired episiotomies. (It is also possible for women who have never given birth to have POP; there are many non-childbirth related causes.)
Menopause-age related muscle loss due to drop in estrogen level; this impacts strength, elasticity, and density of muscle tissue.
Chronic constipation-IBS (irritable bowel syndrome), poor diet, lack of exercise can all cause constipation.
Chronic coughing-smoking, allergies, bronchitis, and emphysema can create chronic coughing.
Heavy lifting-repetitive heavy lifting at work, lifting children, weight trainers.
Joggers, marathon runners-constant downward pounding of internal structures.
Genetics, having a family member with POP means you are more likely to have POP issue.
Neuromuscular diseases such as MS or muscular dystrophy or a condition like Marfans (collegan deficiency).

There is hope for women with POP; there are both non-surgical and surgical treatments that can be utilized to control, improve, or repair this health issue. The most positive direction we can take is to increase awareness so women start recognizing POP symptoms when they occur. Women who have been diagnosed with POP need to come out of the closet with their diagnosis and treatment paths and share that information with other women, their mothers, their daughters, their sisters, their friends. The sooner we take POP out of the closet, the sooner women will be able to start identifying it and seek professional diagnosis and treatment.

                         NO ONE CAN HELP US AS MUCH AS WE CAN HELP OURSELVES
22 Responses
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Avatar universal
https://hersfoundation.org ...
Helpful - 0
Avatar universal
I am so glad you are seeking help for you problems.  Ask your Dr to send you to a Urogynecologist and take your time to find out all you need to know about your condition and also what options there are.

Most women feel panicky when they find out they have prolapse and problems vaginally plus the wider symptoms and issues including sex, and relationships as well.  I also felt the same as you.  Identify exactly what is going on first and consider as well if a pessary would be an option.  Discuss this with your Dr and Urogyne.  You may need womens physio as well.

Let us know how you get on.
Helpful - 0
Avatar universal
Please tell me you'll see this, I really hope so.

I'm 26, 4 months PP with my first child. Was induced with pitocin, 8 hr labor, 20 min delivery, everything seemed fine. I did strain all my muscles down there during delivery and it took me a couple weeks to feel not sore.

Now I'm "falling out" almost. I know I have prolapse, going to in to see doc next week for it. Afraid of what she'll say. You see the horrible ads about bladder and pelvis mesh and slings messing everyone up and it makes me scared she'll say I need surgery. But I want it too, I'm going crazy feeling like things are falling out. It's affecting my marriage, my self-esteem and worst of all my losing my baby weight! I don't know what's safe & what's not!! Can't find any good resources online, no one I know has it, no one has info. It's so frustrating!!!
Helpful - 0
1128665 tn?1269273471
Yes you can feel an ache or it can be pressure of pain-every woman is a bit unique. It is also common for women to have more than one type of POP. A urogynecologist can clarify exactly what is going on.
Sher
Helpful - 0
Avatar universal
Thankyou for answering...so would the vaginal ache be from the prolapse as well?..I know I have a uterine prolapse but I'm pretty sure I may have a slight bladder one as well bcos when I have the ache it feels like I need to push the bulge on my anterior vaginal wall back to get relief...surely is stressful I'm so glad I found this forum
Helpful - 0
1128665 tn?1269273471
Vaginal childbirth is the leading cause of POP, every one increases risk factor. Symptoms  vary from woman to woman as you can see by the list above. Women who have many children also are impacted by heavy lifting because they pick up their kids often and this pushes tissues/organs in the pelvic cavity downward unless you are contracting your pc b/4 you lift (and few do). Rectal pressure is an absolute flag, tailbone can be too, lower left abdomen might be or could be something else. You truly should see a physician for a diagnosis and if you have POP, please seek guidance from a urogynecologist-this is the specialist for POP.

Sher
Helpful - 0
Avatar universal
i have been told i have a prolapse..im 34 years old had 5 babies..mine started with soreness in my lower left abdomen and rectum pressure..every now and then i get a terrible ache feels like on the bone area in my vagina...is this symptoms of a prolapse
Helpful - 0
1128665 tn?1269273471
I couldn't agree more, I feel POP should become common knowledge for all women-it's a work in progress. Been on medical record for over 3000 years and still is little recognized. I'm hopeful that over the next year things will shift significantly, all women should be screened for POP during routine pelvic exams. It is quite likely that you had some level of POP prior to heavy lifting but heavy lifting is most definetly a causal factor. Typically it is years of heavy lifting but isolated situations of something of significant weight can have serious impact to the pelvic floor, especially in menopausal years when our tissue integrity is weak from lower estrogen levels. It is unfortunate that some physicians are so insensitive; I typically tell women this is a red flag to find a new dr.

Please find a urogynecologist; I live close to the area you are from and can make a recommendation not too far from you. You can also find urogyns at the AUGS site and check their ratings on watchdog sites like ratemds.com & healthgrades.com.

Sher
Helpful - 0
Avatar universal
Thank you for this information.  I am trying to navigate through treatment options.  Doctors don't take enouth time to explain options. Which treatment centers have been around the longest and have done more of the prolapse repair procedures than others?  The lack of information on this topic is appalling.  I've been made to feel like a "freak" too, like some of the other women who've commented.  My symptoms developed suddenly after doing some fall clean up chores lifting and moving heavy planter pots and patio furniture.  Felt a searing pain in the pelvic area and had to sit down and rest.  Had pain at night for several weeks, then the feeling that something was "coming out."  My doctor has told me that these symptoms rarely come on in this manner - talk about being made to feel like a freak! Its so unfair, I just want to know what the risk factors are and have them made public, so all women know them and can avoid lifting heavy objects. I've since been told that permenopausal and menopausal women shouldn't lift more than 20 pounds!  No one ever told me this before, and I've never read it in articles about women's health.  
Helpful - 0
Avatar universal
Do you think that you could talk to me over the phone? I am freaking out and would like some guidence I've been to 2 doctors and then say different things, needing someone to help me so I can stop crying.
Helpful - 0
1128665 tn?1269273471
I hear of sling complications on a regular basis, often physicians who are not properly trained or who don't have enough experience do these surgical repairs and it is extremely important for any inserts to be placed correctly and with the right amount of tension-that is why I always recommend urogynecologists, it reduces risk of complication. The urogyns I network with tell me they repair complications like this on a regular basis unfortunately. I would recommend you see a consult with one; if you have any difficulties locating one let me know and I can help guide you. It is so unfortunate that this occurs at all. The inflammation in your bladder is a flag that s/b addressed, it is unlikely that it will go away on its own.

Good luck, please keep me in the loop.
Sher
Helpful - 0
Avatar universal
I need help since having the transoburator sling and McCall vaginal vault suspension, all I have had is constant uti's been on antibiotics almost constantly since surgery in June 2010, also have sharp pain when urinating not the usual with uti and now on the inside of my bladder I have a spot that is red & inflammed, have had biopsy so we know its not cancer.  Would like to know if you have heard from other women with problems after surgery and what solutions they have found.

Shsully662
Helpful - 0
1128665 tn?1269273471
It's truly my privilege to share what I've learned with women in every country! As each of us passes the info on to others we shift recognition for pelvic organ prolapse-I'm so grateful to all the women I've had the privilege of guiding; we all work toward the same goal-establishing POP awareness so women recognize symptoms when they occur.

Sher
Helpful - 0
Avatar universal
Thank you sou much for sharing this information. I feel much better now that I know what my problem is.
Pinky,
South Africa
Helpful - 0
1128665 tn?1269273471
I sure appreciate the positive feedback but the most important thing here is you found info you  needed to help you through the process and get your questions answered. If every woman who learns she has POP finds the answers she needs and then pays it forward by telling other women, soon the grassroots movement will snowball and women around the world will become aware of pelvic organ prolapse-a health condition that has been on medical record since Egyptian times yet sadly still remains in the closet because the media won't touch a subject with such "yikes" symptoms. It's women like you that spread the word that help me help other women and for that I'll always be greatful. We are a huge club,women helping women.

:)
Sher
Helpful - 0
Avatar universal
Ladies//Gentlelmen, if you don't have a copy of  Sherrie J. Palms book, "Pelvic Organ Prolapse, The Silent Epidemic," please get it.  I ordered mine from Amazon.com.  You will be amazed at the knowledge she has compiled and the "hands on" advice she gives is superb for the "before and after" surgery questions/care because she has lived through it.  Reading her book was like having one of Oprah's "AHA MOMENTS."  I've marked, highlighted, and made comments in the margins of most of the pages as it related to me.  It was like I was walking in her footsteps.  

I am 60 and had a stage III Pelvic Organ Prolapse (POP).  I had my surgery (cystocele, rectocele and mid-urethral sling) on Jan 21, 2011.  I'd been diagnosed back in June 2010 by my gynecologist and referred to a urogynecologist at the Washington Hospital Center.  After a few visits and some urology tests, I was diagnosed with Stage III POP in July 2010.  Never heard of it!  Come to find out it was almost as common and "apple pie."  Women just did not want to talk about it because it was so embarrassing.  WELL I WANT TO SHOUT ABOUT IT!  I am 10 a year breast cancer survivor and I feel I'm a POP survivor too!

I was "flapping in the wind" trying to find as much information as I could about POP.  I was all over the internet trying to find information about it.  It was sheer luck that I stumbled upon Sherrie's first internet video.  She was asking the same questions I needed answers to regarding POP.  Some questions, I didn't even know I should be asking. She was starting a grassroots advocacy for women suffering with pelvic floor health issues. I followed every search engine leading to anything she had posted on the web.  I found a web page www.sherriepalm.com and found her book.  

Although I was extremely anxious to get the surgery done, I held off until because I had a pre-paid planned trip in late August 2010.  And I wanted to wait until after the holidays once I knew it was "life altering" and not a "life threatening" condition and the recovery period would be 6-8 weeks.  Although it sure felt like it was "life threatening" when I first heard the diagnosis. I wrote to Dr Oz and asked if he would do a segment on POP in late November 2010.  I gave him my surgery date in hopes that something would be aired before them.  The second week of Jan 2011 he did a segment on POP and it was titled "women suffering in silence."  I almost cried.  That's it in a nutshell so to speak.  I'm in my 5th week of recovery after surgery and doing fine thanks to my urogynecologist and Sherrie J. Palm's book (or should I say POP Bible).
Helpful - 0
1128665 tn?1269273471
And just so you know I hear the same kind of feedback about how physicians address POP as insignificant on a regular basis but there are some wonderful urogynecologists out there who are compassionate women's health advocates (this is the specialist for this disorder); when the time comes that you do have insurance coverage, this is the kind of dr you want to see. Hang in there, we're working hard to change the mindset of the medical community about this health issue; millions of women around the world are suffering in silence.
:)
Sher
Helpful - 0
1128665 tn?1269273471
DUH, just reread post and realized it was a comment to the 2nd article I suggested you read-sorry about that, too much worky, not enough playtime!
Sher
Helpful - 0
1128665 tn?1269273471
Here's my input for whatever it helps. There is no way I would ever give up doing the things I love, especially exercise related activities. Staying fit impacts all  aspects of general health, it just makes no sense to me to give it up. What you can do is continue down a path to help prevent your POP getting worse and ideally help it improve. I do speak with women on a regular basis in the same scenario as you, no health insurance, so there has to be a path to self-treat that creates some benefit.

You should be wearing some kind of internal support when you are playing soccer, even if it is only a tampon, at least you are creating some support structure to the area. Once you have some spare money, you can bump that support up a notch by seeing a physician and getting fitted for a pessary or PM (private message) me and I can give you the name of a product you can get online without dr visit for internal support as well as give you the site info so you can explore it ahead of time. Either of these paths will help trememdously when you are in a very active state as far as creating internal support and preventing urine leakage. A pad is not a very user friendly path for anyone but at least it allows you to continue to do what you love to do.

http://www.medhelp.org/health_pages/Womens-Health/KEGELS-AND-KEGEL-BREATHING/show/1133?cid=591

Yes, absolutely keep doing the Kegels, are you sure you are doing them properly? Kegels are no different than any other exercise program, it is only of benefit if it is done properly. Here is a link to an article I posted on Kegels/Kegel Breathing. Even if they don't create a lot of improvement, they should help prevent progression of POP. Also might want to take a look at the 2nd post on forum, it has a lot of basics about POP that may help you recognize if there is more than one POP issue.

If you have any other questions, give me a shout!
Sher
Helpful - 0
Avatar universal
it is of no use....doctors won't listen. They tell me to stop playing soccer, working out, and keep doing my kegals, wear a pad. I am so frustrated and because I do not have health insurance; I am basically screwed.
Helpful - 0
1128665 tn?1269273471
So glad you were able to find the info you were looking for Halo!
Sher
Helpful - 0
1401690 tn?1281956554
this has been more helpful then the internet has shown me ive been looking info up for days and found this site and joined and love this site u and everyone are so helpful i have all those symptoms thank you for the post
Helpful - 0
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