Management of Pelvic Organ Prolapse (POP)
Have you ever been diagnosed with Pelvic Organ Prolapse (POP)? Did you know approximately 50% of women have anatomical POP but only 3-8.3% have symptomatic prolapse? This means it is very common (especially after having a baby) but most people don’t experience symptoms. Although this is common, it can be scary to receive this diagnosis. But no need to fear, we will be discussing what it is, how to prevent worsening, and action you can take today!
What is prolapse?
Prolapse is a laxity or a loss of support in the vaginal wall. There are different types of POP and are classified based on where that loss of support is. At Shift Physical Therapy we understand how POP can negatively influence physical activity, self-image, and quality of life.
What are the different types of prolapse?
Posterior Vaginal Wall: Rectocele or Enterocele
Anterior Vaginal Wall: Cystocele, Urethrocele, or Cystourethrocele
Apical Prolapse: Vaginal vault prolapse, Uterine/cervix prolapse, or Enterocele
Rectal Prolapse
Common Symptoms
Pelvic or vaginal heaviness especially when the pelvic floor fatigues
A feeling or bulging in the vaginal area
You need to splint to evacuate bowel or bladder
Pain with intercourse
Can be associated with incontinence
Risk Factors
Although POP is more common in older women, it can affect women of all ages. Research shows that its cause is multifactorial (i.e. the effects of aging, vaginal childbirth, decreased muscle strength, etc.). Risk factors include:
Vaginal birth especially if instrumentation required
Genetic factors eg lichens sclerosis, Marfans syndrome, joint hypermobility, and Ehlers Danlos syndrome
Chronic Cough
Constipation
Occupation Heavy Lifting
Age
Do worse symptoms mean your prolapse is worse?
The severity of POP and symptoms are not correlated. Women can have grade IV (the worst) and have no symptoms and on the flip side someone with grade I can have severe symptoms.
When is prolapse a problem?
Prolapse is a problem when you are experiencing symptoms that you do not want to be.
Will lifting weights and exercise make my prolapse worse?
NO! As long as you are maintaining good mechanics and not bearing down. Studies show women who are weaker have more symptoms. Your pelvic floor physical therapist can help assess prolapse during exercise and ensure you are using good mechanics.
Tips for Managing Prolapse
Hip strengthening: The pelvic floor doesn't work in isolation. By working on strengthening the hips you can offload the pelvic floor and reduce symptoms
Managing Constipation: straining to go the bathroom can create pressure and may worsen prolapse. (To learn more about managing constipation check out this blog post.)
Pelvic Floor Muscle Training: Fatigue impacts the descent of the pelvic organs. If the pelvic floor is too tight, it needs to relax. If the pelvic floor is too weak, you need to strengthen it
Positioning: Under fatigue, pelvic organs can descend lower. Recovery position with hips up can make gravity work to your advantage. Spending 3+ minutes in this position can help alleviate symptoms (see picture below).
Ready to schedule your appointment?
Our physical therapists in St. George, UT have advanced, specialized training in the management and treatment of symptoms and dysfunction associated with pelvic organ prolapse. We are devoted to providing one-to-one care with individualized treatment programs in a peaceful and supportive environment.
Call 435-767-1252
