20 Feb Pelvic Organ Prolapse—What Can Be Done?
It is really common for women to have some descent in their bladder, uterus or bowel, and it is not just women who have had babies—this condition can be an issue for women who have never had kids as well. Research supports physiotherapy as a first-line treatment for pelvic organ prolapse (POP). A 2016 Cochrane review of the physiotherapy studies for POP found that pelvic floor muscle training significantly decreased symptoms and improved the stage of prolapse when compared to control groups (Dumoulin et al., 2016).
Many women diagnosed with POP had no idea it was even possible for prolapse of the pelvic structures to occur, had no idea where to seek treatment (or that treatment even existed!), and were scared to discuss their concerns with their friends or healthcare providers. Additionally, many people’s concerns are written off as a “normal” part of aging by their practitioners; this leads to people living with potentially modifiable symptoms because they simply don’t know where to go or who to see.
Sometimes the advice given to a woman to help a prolapse is not very practical. For example, a young mother being told not to lift anything heavier than 5 or 10 pounds and to stop all exercise beyond swimming and those performed in lying down positions. While this might be important in the early stages of healing, the exercises and movements would have to progress to the point that this woman could comfortable lift and carry her baby, and get back to the activities that she finds meaningful and fulfilling. No two pelvic floors are the same and everyone experiencing POP has different goals and abilities.
Research has supported that different people manage intra-abdominal pressure during activity differently, and each woman needs to understand how their own body will respond to the exercises and activities that they are interested in returning to. Some women who are looking to resolve or manage their symptoms tend to do well with the help of physiotherapy and lifestyle modification/education. A physiotherapist who works in this area will have advanced training to help pelvic floor issues, and will likely do an internal assessment to gauge the strength, endurance and control of the pelvic floor, and address the pelvic floor engagement with proper breathing to manage pressure changes.
If you’re noticing pressure or heaviness in the vaginal area, or you can feel a bulge in your vagina in the shower, get checked by your doctor or a pelvic health physiotherapist—there is much that you can do to help this problem!