Pelvic Organ Prolapse: Are My Organs Falling Out?
Pregnancy and birth come with significant changes to your body. Prolapse is a change that can happen - and it can seem scary if you don’t have all the information. We love to educate people in pregnancy about risk factors of prolapse, common symptoms, and how we treat it, so that if you find yourself with symptoms, you know it will be okay. If you’re reading this after finding out you have prolapse, or suspecting you might, please know that you can heal. Your symptoms CAN go away, and you CAN do all of the things you want to be able to do.
Are My Organs Falling Out?
Your organs are NOT falling out of your body. The bulge or tissue you may see in your vagina is the wall of your vagina. A prolapse happens when your uterus, bladder or rectum shift slightly out of place, and they push into the vaginal wall. If you feel something pushing from the front, it’s likely your bladder or uterus. If you feel it from the back, it’s your rectum. These organs sit snugly in your pelvis, surrounded by muscles and connective tissue, and it’s incredibly common for one or more of the organs to shift.
What Is Pelvic Organ Prolapse?
Pelvic organ prolapse occurs when one of your pelvic organs (bladder, uterus, or rectum) shifts out of place in your pelvis. This can happen for many different reasons, but it’s important to note that it’s your body’s response to a change. You did nothing wrong. You are not broken. You are not gross. Your body is incredible, and can do incredible things. Your body has adaptive methods to protect itself, and a prolapse can be a result of your body just doing its job. It can result from a change in connective tissue, scar tissue, muscles that are too tight and tense or too long and lax, and/or from a cumulative increase in pressure to your pelvic floor.
Vaginal birth is a risk factor for developing prolapse. This is important to know because it CAN happen. If you learn about abdominal and pelvic pressure management (and how to PUSH efficiently in a way that protects your pelvic floor), it’s possible that you can lessen your chances of developing pelvic organ prolapse. There are also genetic components, and there’s no proven way to prevent prolapse. But there are things you can do in pregnancy and during your birth to support your pelvic health.
Symptoms of Pelvic Organ Prolapse (POP)
Prolapse symptoms can include
A bulge or heaviness in the vagina
Urinary frequency
Urinary incontinence
Feeling like you can’t fully empty your bladder
Constipation
Needing to move tissue to fully empty your bowels
Difficulty fully emptying your bowels
Feeling like a tampon is falling out
Symptoms are so directly correlated to anxiety and stress levels that we always talk about mental health and stress management with pelvic health clients. In fact, once our clients with overly tight and stressed out pelvic floors learn how to relax (i.e. STOP doing kegels), their symptoms nearly always disappear. These symptoms aren’t fun, and they can make you feel like you’ll never be able to do all the things you need and want to do. But we promise there is hope. We have watched clients transform from feeling depressed, not exercising, and being scared to lift their baby, into being full of hope, confidence, and exercising the way they want to.
What Is The Treatment For Pelvic Organ Prolapse?
Treatment looks different based on your symptoms and needs. For some people, learning how to relax and lengthen their pelvic floor muscles allows more space for the organs to shift back into their place. Learning how to soften and manage scar tissue can also play a huge role in healing. For others, more strength and connection with the pelvic floor and deep core may help resolve symptoms. And for almost everyone, learning how to control abdominal pressure when lifting, pooping, and completing all your normal daily activities, relieves symptoms.
There is also an incredible device - called a pessary - that can be inserted into your vagina to provide support for the vaginal wall. Using a pessary does not mean you’ll never get better without it. It’s not a crutch. It’s a tool to use to relieve symptoms while you work on improving your pelvic floor coordination and surrounding strength.
When Should I Check For POP?
We encourage everyone to see a pelvic floor therapist by 6 weeks postpartum, no matter if you had a vaginal or cesarean birth. Some OBGYNs and midwives will check for a prolapse at your 6 week appointment. We love and respect our OBs and midwives, but not all of them know how to explain prolapse and give you treatment options. It is an area of education that is severely lacking in our women’s healthcare system.
If your provider tells you off the bat to do kegels, to limit your lifting/exercise, and/or that you need surgery, PLEASE seek the opinion and treatment of a pelvic floor therapist. Kegels are most likely not the answer, and they may make your symptoms worse! You should be able to lift and exercise how you want, but under the care and guidance of a movement expert (a pelvic floor OT or PT). And please, please, please seek conservative treatment before seeking surgery. There is an incredibly high fail rate of these surgeries, and there is always pre-hab and re-hab to be done if surgery is the best choice for you. If you see or feel a bulge down there, don’t panic! And don’t Google… Dr. Google is not our friend when it comes to prolapse.
Pelvic Floor Therapy At OWN Your Pelvic Health
If you’re worried about prolapse, we’re here for you! We are pelvic health OTs and have specialized training to treat this condition. Because we only see pregnant and postpartum clients, we work with more people with prolapse than any other generalist pelvic floor therapist. That means we have endless approaches to understand what may work best for YOU when it comes to pelvic floor therapy. The same treatment that worked for our last client may not work for you.
If you’re interested in hearing more about this, book a free discovery call with us.
Written by: Dr. Courtney Trocinski