Prolapse - Let’s talk about it!
Prolapse… when we first learnt what it was we were like “Omg this sounds terrible!”…. then we’ve had five kids and let’s just say we now know just how common prolapse is! We’ve navigated post-birth injuries ourselves and we are here to tell you it’s not all doom and gloom!
Prolapse is very common with up to 50% of women who have had a vaginal delivery having some form of prolapse.
Prolapse is something that many, many women live with in silence because well… it’s just not really the kinda topic ya bring up over coffee with your girl friends is it? It’s very private and loads of women find the whole topic embarrassing which we completely understand!
It’s is a topic where many women want answers to questions but they are too shy to ask.. so we are here for you girls!
In this blog you’ll find everything you might need to know about pelvic organ prolapse, what it is, symptoms, navigating exercise, risk factors, treatment options and more!
What is a prolapse?
Pelvic organ prolapse is a condition where the organs in your pelvis (uterus, bladder and bowel) slip down from their usual position into your vagina.
Imagine your pelvic organs are pinned up inside your pelvis with strong tight ropes (your fascia and ligaments) when we have increase abdominal load on your core and pelvic floor (cue pregnancy!!!!!!) it causes these ropes to stretch and strain.
These ropes will not always just go back to normal after birth and can become slack. With the ropes feeling slack and looser naturally the pelvic organs shift and can drop down to sit lower. - Cue prolapse!
Causes of a prolapse
There are a number of different ways the core can be put under increased load causing those ropes to become slack these include:
Pregnancy - So much load bearing down on those ropes! Plus when we are pregnant our body produces a hormone called relaxin, this literally relaxes all our tendons and ligaments to make way for the baby, this can add to and amplify prolapse symptoms.
Constipation - Again the bearing down that comes with constipation can cause, add to and amplify prolapse symptoms.
Heavy lifting with poor breath control
Vaginal birth
Weight gain
Symptoms of a prolapse - what does it feel like?
There are a number of different symptoms that come with a prolapse, some people feel one symptom others my feel multiple symptoms. These include:
Fullness
Like you are sitting on a tennis ball
Sexual pain
Struggling to orgasm
Like something is in the way
Heaviness
Dragging
Bulging
Stages of prolapse
There are varying stages of a prolapse stage 1 through to stage 4, the grade of prolapse has to be taken into account with the amount of symptoms the person experiences.
The most common is stage 1 - 2. With stage 1 it is in some ways just ‘normal’ post a vaginal delivery, your tissue has been softened, stretched, your body has changed and moved a little - your vaginal walls will not be that same as they were pre birth because you pushed a baby out. There is a load of negative thinking about prolapse, but grade 1 is pretty normal.
Grade 3-4 is more serious where you can see and feel the organs protrude outside the vagina.
What should I do if I think I have a prolapse?
If you feel like you might might have a prolapse it’s important you speak to a medical professional because continuing without treatment could see the symptoms worsen over time.
Prolapse can be diagnosed by your GP, OBGYN or Women’s Health Physiotherapist they will do an internal examination of your pelvic floor.
We know.... it’s not that fun to have people up in ya grill but honestly if you’ve had a baby this is nothing! It generally wont hurt (may feel a little uncomfortable) and it’s over really fast!
During the exam they will generally get you to bear down and feel for descent of the pelvic organs and with this will be able to give you an understanding of if there is a prolpase as well as treatment options.
Risk factors for a prolapse
Pregnancy
Vaginal birth - forceps delivery
The more pregnancy’s and births the higher the risk
Constipation during pregnancy
High impact sports
Long pushing phase during birth
Breath holding during exercise and day to day movements
Weight lifting with poor technique and lack of breath control
Getting back into exercise too soon after childbirth
Doing the wrong exercises in the postpartum rehabilitation phase
The role of the pelvic floor in prolapse
Think of your pelvic floor as a support hammock for your pelvic organs.
When your organs are dropping down and your pelvic floor is functioning really well it gives support to those pelvic organs. Your pelvic floor is really important in supporting your prolapse - you want this magic muscle group functioning super well!
A daily pelvic floor programme is important (don’t worry, fitting in ya pelvic floor exercises won’t take long and you can do them pretty much any where, any time!)
Now… just doing your pelvic floor (kegels) is not enough as your pelvic floor does not work in isolation… you need your whole body to be functioning strong around your pelvic floor. Why? Because if your glutes are super weak, posture is bad and your core is not strong then chances are you will still feel your prolapse symptoms.
Our She Restores - Pelvic Floor and Core Restore Classes are perfect for anyone wanting to work on connecting to their core, strengthening their pelvic floor, develop better posture and alignment as well as basic functional strength. These classes are part of our $13 per month membership - find out more here
Prolapse and exercise
You need to move! In fact not moving can make your prolapse worse as your supporting muscles (glutes, legs, arms, core) get weaker when they are not in use. Prolapse is not a reason not to do exercise!
However, choosing the right workouts and exercises for you is important to improve and prevent symptoms. What the right exercises are for you will be different for someone else as it totally depends on severity of the prolapse.
A good general rule of thumb is if an activity is causing symptoms (i.e. a feeling of heaviness) then you shouldn’t be doing it at that stage. This is not to say never do this activity again but you will need to improve strategies/strength before you can perform it symptom free.
Generally speaking low impact exercises are more tolerated by prolapse patients as they minimise stress on the pelvic floor.
She Moves workout recommendations: She Tones - low Impact, She Starts - Beginner, She Restores - pelvic floor and core restore and She Flows - Stretch.
Higher impact exercises such as running, jumping and heavy lifting place more strain on your core and pelvic floor so are less tolerated – BUT can be worked towards if this type of exercise is important to you!
Treatment for prolapse
There really is so much help you can get to manage your prolapse, our advice would be if you try one things and it dosen’t work then don’t just give up or think oh well this is it for me! Try the next thing or the next professional, sick with it and you’ll find what works for you in time.
Regular pelvic floor exercises (3 sets per day)
Ensure your exercise programme or class is delivered by a qualified personal trainer! Your trainer needs to be able to cue correct pelvic floor and core activation as well as prescribe prolapse friendly exercises. Check your trainers qualifications!
General strength and conditioning for optimal full body functioning
Seeing a women’s health / pelvic floor physio
A women’s health physio is a fantastic investment for someone with a prolapse (sometimes sessions can be funded if you speak to your GP) they specalise in supporting women through this sort of thing, you can read more about women’s health physios here.
Try a few physios if you need to. We have experienced a range of different physios now and there is a huge difference. Make sure you take the time to find someone that you feel comfortable with and someone who has a treatment plan that is going to work for you.
Toilet habits are important!
Avoid constipation (You want your bowel to be functioning well so there is no straining and no extra downward pressure - Bit gross but ya poo should be like a slippery sausage k!)
Put ya feet on a foot stool to create a straight pathway. (It put’s your rectum in a much better position to pass a motion and reduces strain)
Don’t let yourself get dehydrated!
Vaginal support pessary
These are inserted by a women’s health physio and sit inside the vagina to support the bulging wall
Some women’s wear these all the time others wear these just for exercise
Surgery
Surgery is often discussed for those with stage 3-4 prolapse.
Surgery should be the last resort once all other options have been tried and exhausted.
Wow, that was a long one!!! We hope that this has helped you, if you have learnt one thing then we are happy!
Our biggest message would be If you are diagnosed with a prolapse please know that you are not broken, you did not do something wrong, your organs are not just going to ‘fall out’ and there are so many things that can be doe to help you manage!
If you would like support from us please just email and we will help you out: renee@she-moves.co.nz
You can also check out our postpartum packages here - we would love to work with you!
