“Pelvic organ prolapse is seldom life threatening but it is always life altering.” – Sherrie Palm
After the birth of my daughters, I was diagnosed with a health condition that I had never heard of before called pelvic organ prolapse. As a first time mother it was easy to dismiss the physical sensations I was experiencing, including pressure and pelvic pain within the standard six week healing period. I eventually began to realize something was physically wrong when these symptoms continued beyond that time frame. My symptoms included vaginal pain and pressure, however, I now know that there is a range of symptoms and some can be as unique as the women experiencing them. The more common symptoms also include urine leakage or retention, constipation or difficulty emptying the bowels, painful intercourse or lack of sensation. Many visits to the doctor about these symptoms lead to a feeling of shock as I listened to the details of my condition. My doctor speculated that I had pelvic organ prolapse and specifically, cystocele. He explained that my bladder had most likely herniated into the vaginal canal. I questioned why I had never heard of this condition that can be brought on by the birthing process.
After researching further, I learned that one of the main causes of prolapse is in fact, childbirth. It is estimated that 50% of all woman who have had children will experience prolapse later in life. My symptoms of having cystocele improved by the time I became pregnant with my second child yet I started to ask more questions. I was concerned about the prognosis of having pelvic organ prolapse and how having another baby would impact an already weak and damaged pelvic floor. At that time no definitive answers were provided and unfortunately in my case, after the birth of my second child, my prolapse became much worse. I also developed a rectocele when the rectum herniates into the rear of the vaginal wall. Cystocele and rectocele are two of the five types of pelvic organ prolapse or POP. Other types of POP include a uterine prolapse when the uterus herniates into the vaginal canal, an enterocele when the small intestine sitting behind the uterus prolapses and a vaginal vault prolapse when the vaginal canal herniates into itself. Once a woman experiences one type of prolapse another type often presents itself.
My experience living with pelvic organ prolapse was one of constant pain and discomfort. The little things that I once took for granted including exercising, excreting, and intimacy with my husband became barriers for me. Eventually the emotional impact began to manifest. My priority was being a good mother to my two little girls yet my energy was dwindling and I felt that I was “acting” for them. I pretended to smile while inside I cringed at the pain and the reality of what was happening to my body and my life. One of my most defining moments was when the Urogynecological Specialist I had waited a year to see told me that she believed that surgery was not the best option for me due to my younger age and the fact that surgery for POP had risks. I felt lost, alone, and fearful not knowing how I would ever feel better without medical intervention.
Since this time I have discovered many new pathways to reclaim wellness once diagnosed with pelvic organ prolapse. I have learned that awareness and prevention are critical. If I knew then what I know now I would have accessed care and programs that would have optimized my pelvic floor health through knowledge and strengthening. After asking for a referral to a Urogynecological Specialist I believe that the first step is to make an appointment with a pelvic floor physiotherapist for an assessment which will provide a woman with vital information helping her to move forward with pelvic floor strengthening and knowledge. Even if you don’t have POP I still encourage all women to visit a pelvic floor physiotherapist for an assessment. After learning as much as you can about your pelvic floor with the pelvic floor physiotherapist you can begin an exercise program such as Pfilates™ to strengthen your pelvic muscles and this should become a lifelong practice. Much more than doing kegel exercises this program targets larger muscles in conjunction with a kegel to promote optimum strengthening of the pelvic floor. My hope is that all women are aware of the condition of pelvic organ prolapse and start doing what they can now to prevent POP altogether or stave off its onset.
While we still have a long way to go, the good news is that in the six years since I have been diagnosed and have lived with pelvic organ prolapse, there is increasing awareness and progress has been made. There are many more options for women living with POP. As we continue to share our stories and awareness grows, my hope is that the interventions that are needed such as surgery are perfected. Until then I have found that both emotional and physical support are integral for women living with prolapse. Multiple pathways towards wellness for women provide us with choices to optimize our health. Founder of APOPS (Association for Pelvic Organ Prolapse Support), Sherrie Palm refers to POP as the silent epidemic of women, yet through dialogue and advocacy future generations of women will have hopefully have a very different experience. After reading this article, my hope is that you will not be in the dark as I was and that makes sharing my story extremely worth while!