How do you know if you have a prolapse? Some urogynocologists go as far as to say that every woman will experience some degree of prolapse in their lives. A prolapse? What exactly is it, what causes it, what can I do to prevent it or resolve it? I wanted to use this blog to talk about all of these questions surrounding prolapse because so many of us have or will experience the symptoms.
Let’s take it one question at a time. What does a prolapse feel like? For some it may feel like a soft, round bulge within your vaginal canal. This may be your bladder or bowel that have dropped out of its normal position and is pushing on the anterior or posterior vaginal wall respectively. For others, they may feel a firm structure within their vaginal canal or pressing out of their vaginal opening. This firm tissue is their cervix and is caused from their uterus dropping out of its normal position.
The most common sensation that women describe when they are experiencing a prolapse is a heaviness or, sometimes, an achinesss in their pelvis. Many women describe a feeling like “the bottom might fall out,” as if their pelvic organs are lacking support. The diagnosis becomes more difficult when the symptoms are mild. You may only feel pressure or heaviness with certain activities and not others. With a mild prolapse, the bulge that many feel may be higher up within their vaginal canal rather than at the opening, and is therefore not as easy to discover.
Another question is whether prolapse is associated with incontinence? The answer is that the symptoms of prolapse may or may not be associated with incontinence. They both have common causes which could be one or several of the following: decreased estrogen levels, the constant pull of gravity, decreased pelvic floor muscle strength, and tissue damage from pregnancy and/or childbirth. Because of the common causes, the symptoms of incontinence and prolapse are often seen together, but not always.
Many ask me if they can exercise with a prolapse or if they will make things worse. My answer is simple – you must exercise with a prolapse or your symptoms will most likely get worse. Now, the type of exercise may produce different results. For example, heavy lifting or any exercise that makes you increase your intra-abdominal pressure through a valsalva maneauver may increase your prolapse. For this reason, I don’t recommend crunches or sit-ups because quite often they are performed in a manner that increases your intra-abdominal pressure. I recommend setting a solid base strength with 4-6 weeks of focused exercise for your pelvic basket from the Hab It dvd before returning to cardiovascular activity. It is important to know that you can return to the activities you love! Your pelvic floor will respond by getting stronger as you slowly introduce more activity, giving your body and opportunity to adapt.
The next logical question is what can you do for prolapse symptoms? As a physical therapist, I always recommend exercise as a first line of defense. I don’t believe that there is any down side to exercise. The exercises on our Hab-It: Pelvic Floor DVD are designed to directly strengthen your pelvic floor and supporting musculature of the pelvis and abdomen. Whether your exercise guidance comes from our DVD or from a women’s health physical therapist in your area, the benefits are many. You will learn more about your muscles and muscle actions increasing your body awareness, you will learn about optimal posture, and you will be given exercises with a direct purpose. The key is being consistent with your exercise and making a life-long commitment. This commitment will be to a stronger pelvic floor, better posture, and a more toned midsection. What is the down-side to that?
I want to conclude this entry by directing you to an excellent discussion forum at www.prolapsehealth.com where all options for resolution of prolapse symptoms are discussed. They also provide a link to www.moondragon.com for more direct information about prolapse. I encourage you to explore all of these sites as well as my other entries here at www.hab-it.com to gather as much information as you can. The more you know, the more control you have!