Prolapse: 5 ways pelvic PT can help.
POP, or pelvic organ prolapse, is a common diagnosis…. especially in postpartum women and women who are entering into menopause.
What is it? Essentially, prolapse is when organs start to fall into the vaginal wall (usually the bladder, uterus, or rectum). Sounds scary, but usually progress can be made! Risk factors include: being pregnant, being in menopause, longer push phase of labor, doing activities that including breath holding (think: lifting heavy weights, bearing down during bowel movements, lifting children, etc). A OB/Gynecologist will grade the prolapse when they do an assessment. Grades are listed from 1-4 with 1 being minimal and 4 being all the way outside of the vaginal opening. On a side note, most postpartum and menopausal women are grades 2-3, rarely do we see a grade 4. Grade 4s are the best surgical candidates.
How can pelvic PT help?
Pelvic PT can provide an assessment to determine your risk and a general idea if you may have prolapse. Technically they can’t diagnose, but they can give you a good idea.
Exercise: sometimes kegels are the answer, and sometimes they are not. Your pelvic PT will teach you what you need to know based on their assessment. If you lift heavy things and you are holding your breath, they will teach you how to safely lift (complete exercises and lift your kids!) so that your abdominal pressure is managed and not contributing to your prolapse (now or in the future). Pelvic PTs are important for helping you to determine proper graded return to exercise: both strengthening and conditioning.
Pessary or other support options: pelvic PTs are now able to help fit pessaries (think orthotics for your vagina) but OBs can as well. Pessaries can be a way to help to support the organ so that you can build strength and maintain function. When I’m working with postpartum runners, I often suggest compression shorts. This gives some perineal support and helps the mom be active for her mental and physical health. Another support device that we love is the Squatty Potty! Best $20 I ever spent.
Do you need a vaginal estrogen cream? Pelvic PTs can often be a part of helping you decide if vaginal estrogen cream would be helpful and where you can go to get some prescribed. The vagina loves estrogen, and estrogen is an important component to muscles. Sometimes low estrogen states (like postpartum and menopause) would benefit from an estrogen cream in order to decrease POP and improve your symptoms.
Help you to manage your prolapse symptoms: often times the feeling the prolapse is not the first symptom. Difficulty voiding urine or bowel, dripping after urination, urinary incontinence, constipation, feeling heavy in the vagina, uncomfortable or painful intercourse, back pain…. these are all possible symptoms of prolapse. Pelvic PTs can help you manage and improve these symptoms. In fact, a lot of women make great gains in their symptoms even if the grade of prolapse doesn’t change that much.
Prolapse sounds scary, but it doesn’t need to be. Your body is not broken. There is hope and Pelvic PT can be an important aspect to your recovery and symptom management.
