About one-third of women suffer from pelvic organ prolapse at some point in their lifetime. But even though the issue is extremely common, many women are hesitant to talk about it.
What is pelvic organ prolapse?
Pelvic organ prolapse refers to a bulging or herniation of one or more of the pelvic organs: the uterus, vagina, bowel, or bladder. When women start to experience symptoms of prolapse, they will often feel a bulge or heaviness in the vaginal region, or they will feel a pressure of pushing down. Other symptoms include urinary and bowel symptoms and pain with intercourse.
But as Marc Ashby, MD, and urogynecologist, says, “There is a common belief that these issues are a part of getting older and you have to live with it, but that’s not the case.”
What treatments are available?
Dr. Ashby notes that treatment of pelvic organ prolapse does not always include surgery, and he always discusses non-surgical options with patients. “We work with patients to find a solution that fits best for them and their lifestyle and treatment preferences.”
One non-surgical option involves placing a device into the vagina that will help support tissues. When surgery is the best option, it can be done in the most minimally invasive approach possible. Most commonly the doctor will go through the vagina, sometimes using a laparoscope or occasional abdominal incision.
Your doctor may also refer you to pelvic physical therapy. According to Nicole Cornett, DPT, pelvic physical therapy consists of helping with strengthening pelvic floor muscles, bladder retraining, diet modification and lifestyle changes, learning better posture and ergonomics, and becoming educated on proper lifting techniques and how to protect the body from certain straining or overuse. These treatments are designed to improve pelvic alignment and stability.
Pelvic physical therapy can a beneficial treatment option for patients electing surgery as well. When surgery is necessary, Nicole says, “Research indicates that pelvic physical therapy prior to and after surgical procedures can improve the patient’s outcome.”
Who is at risk?
The condition is most common in post-menopausal women. Childbirth and having multiple children puts women at a higher risk for pelvic organ prolapse, but is not the only factor. Genetics, hypermobility, and anything that causes excessive pressure on the pelvic floor, such as obesity, chronic coughing or constipation, or heavy lifting and straining, are all risk factors as well.
“The most important thing for women to know is that there are options for treatment,” says Dr. Ashby. "There are ways to improve your quality of life. If this is something that is bothering you—ask about it.”