A Quick Look into Pelvic Organ Prolapse (POP)

POP what? Don’t worry, it’s not as confusing and intimidating as it sounds. However, it is very common and there is more guidance the healthcare community should be providing to those who present with symptoms. It is estimated that about 50% of women have some degree of prolapse. If 50% of women had a particular shoulder or knee injury, don’t you think they would be given healthcare advice to manage that injury?

What is POP anyway? Pelvic organ prolapse occurs when a pelvic organ (bladder, uterus, rectum, and sometimes the intestines) begins to descend into the vaginal wall, and is often associated with pelvic floor injury or weakness. One of the most common risk factors for POP is pregnancy and childbirth due to the extreme load and stretch that the pelvic floor must manage during this time. Other risk factors include chronic constipation or straining; obesity; excessive activity and load (with under-training for said activity); and poor intra-abdominal pressure (IAP) management.

Some of the most common symptoms and complaints of those with prolapse include:

  • Heaviness or pressure in the vagina
  • Feeling of a tampon “falling out”
  • Sensation of or visible bulge in the vagina
  • Symptoms worsen with activity or at the end of day
  • Urinary leakage
  • Difficulty voiding
  • Constipation
  • Pain or discomfort during sex
  • Avoiding penetration
  • Avoiding exercise or difficulty with exercise

One of the most important pieces about POP is that it is treatable and it is manageable! Symptoms do not have to last forever and the diagnosis of POP should not become an identity. Some information out there labels “safe vs unsafe” exercises for those dealing with POP, when in reality, that list does not exist! Each individual has different contextual factors, subjective history, and activity preferences that makes their healing process unique. Pelvic organ prolapse does not limit the activities and life you are able to have; it takes finding the right ways to do those things you want. And by no means does that mean it is “easy,” but it can be done. Why limit your quality of life?

Despite what some might tell you, there are plenty of treatment options available to those who want to address POP. A few great places to start include:

  • Pelvic Floor Physical Therapy
    • Consult with a specialist who can give you a recovery roadmap tailored to your situation.
    • All exercises are safe, and a PFPT can help you find the way each exercise works for you.
    • Learn all about your pelvic floor, pressure management, posture, and whole-body connections.
    • Get recommendations for other providers to make up your pelvic health team.
  • Pessaries
    • Think of a tampon, except used 24/7 or during specific activity instead of during your period.
    • Fit by a gynecologist, urogynecologist, midwife, PT (in some countries).
    • Trial-and-error to find the right fit – don’t give up after one fitting!
    • Perfect adjunct while going through PT to give more support to the pelvic floor and organs.
  • Take advantage of gravity
    • Gravity tends to make things worse, so go AGAINST gravity to make it better.
    • Lie on your back, elevate your pelvis and legs using pillows or yoga blocks.
    • Take more breaks during the day, if possible, to lie down and give your pelvic floor a break.
  • Control IAP
    • Intra-abdominal pressure (IAP) is a HUGE factor in POP.
    • Learn breath strategies to minimize pressure. A common one is to exhale before and during exertion (think exhale while lifting, squatting, sitting up, etc).
    • Stack your ribcage and pelvis to optimize muscle activity and reduce pressure.
    • TRAIN! Don’t just jump right into high-intensity or impact, build the foundations first.

The biggest takeaway here: pelvic organ prolapse is a common, treatable condition that does not have to limit your quality of life or chosen activities. Find the right providers who can help you. Contact us today to learn how our pelvic floor physical therapists can set you up with a treatment plan to better your pelvic health and move beyond POP! If you are local to New Haven, CT we can even bring PT to you via our concierge home visits. Not up for in-person, no problem! We have virtual services too. Set up your first appointment today!

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