Have you been told you have a prolapse? Do you feel a heaviness in vagina by the end of the day, pain in your pelvis or during sex? Or are you suffering with incontinence?

At Complete Physio we have clients who have these complaints all the time and believe that education as well as the right treatment and diagnosis is key.

By the end of this blog, we hope that you understand a little more about what a pelvic organ prolapse is and how you can treat it.

What is a pelvic organ prolapse?

Pelvic organ prolapse is the downward movement of one or more of the pelvic organs from their normal position into the vagina. This can include the rectum, bladder, bowel or uterus.

Your pelvic organs are supported by the pelvic floor and surrounding structures. When the pelvic floor and these structures become weakened and stretched, it causes the vaginal walls to sink down leading to a prolapse.

The good news is a pelvic organ prolapse is treatable and not life threatening. It can however sometimes cause discomfort, pain and affect your day to day activities so it’s important to seek help!

How common is a pelvic organ prolapse?

It is hard to know exactly how many people suffer from pelvic organ prolapse as many people do not speak to their doctors, physios or friends about it.

Some people may have a pelvic organ prolapse but not experience any symptoms. One in three women suffer from a prolapse if they have had children with around half women over the age of 50 having some symptoms of pelvic organ prolapse.

This shows just how common it is but remember, not everyone will experience symptoms.

What are the symptoms of a pelvic organ prolapse?

There are a few common symptoms which you can look out for.

Pelvic organ prolapse can cause the feeling of something ‘dragging’ or ‘hanging down’ into the vagina. It can also cause a heaviness around the lower tummy and genitals. Sometimes you may be able to feel or see a physical bulge coming out of your vagina. It may also cause you to have symptoms relating to your bladder, bowel or sexual function.

You may also find it hard to pass urine or you feel that the bladder is not fully emptying properly. People also experience signs of incontinence and can leak urine when you cough or sneeze.

If your bowel is affected, you may experience incomplete emptying or constipation. If is also not uncommon for sex to be uncomfortable, and you may feel a reduction in sensation during intercourse.

These symptoms can vary throughout the day and often are more noticeable at the end of the day. However, they can also vary from day to day as well as person to person. This makes it important to ask if you are experiencing any of these.

What causes pelvic organ prolapse?

There are a number of factors that can cause a pelvic organ prolapse. The most common cause is pregnancy and childbirth, especially if you have had a prolonged second stage of labour, a difficult delivery, a large baby or multiple pregnancies.

Other things that can also contribute to a prolapse include obesity and heavy lifting (due to the increased downward pressure on the pelvic organs), smoking, constipation, age and menopause (due to hormonal changes), chronic cough and previous pelvic surgery.

What can you do to help manage and improve symptoms of a pelvic organ prolapse and when should you seek help?

Your pelvic organ prolapse can change and improve with rehabilitation. There are also some simple changes that you can easily make to your lifestyle that can improve your symptoms and prevent them from worsening.

Some simple things that you can do include:

  • Seeing a pelvic health physiotherapist for a specialist assessment and guidance with rehabilitation if you are experiencing any of the symptoms described. They will complete a full body assessment, including a vaginal examination with consent. This will enable them to ensure that the treatment is individualised to you and your symptoms and help you set and achieve your own personal goals.
  • Consider how you are lifting things. If something is heavy it will cause you to strain which can cause increased pressure on your pelvic floor. Ask for help if you do feel yourself straining to lift.
  • Aim to ensure you are drinking around 1.5 – 2L of fluid a day and incorporate fibre into your diet to help you avoid constipation. Try not to strain when you go to the toilet and aim to have your knees higher than your hips, feet relaxed on a steady surface and a straight back with a forward leaning posture.
  • You can continue with or start low level impact exercises such as Pilates, yoga, cycling or swimming before working on gradually adding impact with the support of a specialist pelvic health physiotherapist. This will help strengthen your pelvic floor and prevent symptoms as you increase your activity.
  • If you are overweight, try to adjust your diet to help you lose weight which will in turn reduce the load going down through the pelvic area.
  • Ensure that you use natural plant-based lubricants for sexual intercourse and try different positions to see what you find most comfortable.
  • Be aware that sometimes your symptoms may feel worse whilst you are on your period, after standing for a long time or at the end of a busy day, especially when you have spent a lot of time on your feet.

If you have tried these simple tips but are still experiencing symptoms or you notice your symptoms getting worse, it is important to speak to your GP or get in touch and we can help.

What treatment is available for pelvic organ prolapse?

If you suffer from symptoms of a pelvic organ prolapse, the good news is the first line of treatment is physiotherapy.

At Complete Physio we advise that you book in to see a specialist pelvic health physio who can complete a full and thorough assessment. They will look at your body as a whole, how you are moving and breathing, as well as completing a vaginal examination with consent.

Your physiotherapist will also be able to provide you with advice, education and support, with the aim of guiding you back to your normal activities and exercise without symptoms. They will also ensure you are activating your pelvic floor muscles in the right way and help you to improve the strength and coordination. By helping you to make small changes to your lifestyle, you will also be able to manage your symptoms independently in the future.

If you find that your symptoms have not improved enough, we will be able to help you with adjuncts such as pessaries or a referral to a surgeon in infrequent cases. Your physiotherapist can support you with this, as well as with decisions around alternative treatment and how to access them. It is important to know that surgery is usually completed to help manage the symptoms of a prolapse rather than the severity of a prolapse.

It is really important to remember that everybody is different, so it is important to be guided by your symptoms and seek help from a specialist if you are unsure on what to do.

If you have any questions about pelvic organ prolapse then simply get in touch or book an appointment with a member of our women’s health team.

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