Maybe you experience heaviness, dragging or bulging sensations. It may be expected a few days after birth but if it is weeks if not months or years down the track- these symptoms may indicate something is going on down there that CAN be helped – particularly postnatally.
Don’t ignore it – please come and get checked – knowledge is power and postnatally things change a lot and we can harness those bodily changes for the better.
Heaviness, dragging and bulging are common symptoms of prolapse.
What is a prolapse?
Prolapse in terms of a female vagina is referring to one of the vaginal walls ‘falling down’. The walls we refer to are:
- the front (anterior) vaginal wall (involving the bladder)
- the back or posterior wall (involving the bowel)
- the uterus or vaginal vault if you have had a hysterectomy. (The roof of the vagina)
For many there is a normal amount of movement but when it becomes symptomatic it can become an issue. Sometimes it can come to the vaginal entrance or even protrude out.
What causes this?
The commonly known cause can be childbirth with a long labour but there are many other contributors:
- heavy lifting
- repetitive and or chronic coughing
- straining to do a poo / chronic constipation
- genetics
Pelvic floor strength can be involved but it is essential to realise that the fascia or connective tissue the surrounds our organs and helps hold them up can get damaged. Sometimes in a single event and sometimes over time they can drag and loose their elasticity.
How can we help this?
Pelvic floor physiotherapy can assess this and work out what has or is contributing to your prolapse or if in fact you have one that we need to worry about.
For some it is just ‘watch and wait’.
For everyone behavioural change is also something that can affect our pelvic floor function that we can address. Simple yet frequent activities like doing a poop with a toilet stool under our feet can be a game changer. Maybe you might need a little bit of perineal support with some toilet paper under your hand.
Postnatally things like being fatigued or sleep deprivation, baby carrying potentially with a carrier that is ill fitting or put on in a rush can mean we may place extra load on our pelvic floor and organs.
Forcing yourself to push the pram for an extra walk when really your body cries out for legs up- maybe there is another choice of activity or is there something else we can change to enable you to get that walk in.
For those in all generations: getting a personalized assessment of your pelvic floor measurements which includes looking at the vagina and the organs, can be the best way to know which activities may be suitable and what is contributing (or not contributing) to your symptoms! Knowledge is empowering- it certainly can take an element of fear away.
Pessaries are a conservative (non-surgical option). Pessaries are silicone devices used to insert inside the vagina essentially to offer support or scaffolding to the vaginal walls. There are both risks and benefits of pessaries to be discussed. They can be tricky for some to fit, but worth a go as it is a simple self management technique and can allow someone who couldn’t exercise to get back into it with no heaviness or leaking!
For those after pregnancy – The collagen formed during pregnancy converts back to less elastic type of collagen (type 1) thus is is a good time to fit a pessary and hope that some positive change can be made.
I am trained in fitting pessaries and have a limited stock in the clinic.
Pelvic floor muscle training has evidence of helping certain types of prolapses. IT is important to be realistic about the effect pelvic floor muscle training may have.
Finally, some people may need to chat to their GP about using topical oestrogen – it can plump up the tissue and make everything a bit more comfortable.
What do I do?
Please reach out today and make an appointment to get your assessment to see what is contributing to your symptoms and then we can make a plan moving forward.
Sometimes there is a lack of awareness down there, sometimes it is matter of being a bit more honest with ourselves and offer the self-care that we would prescribe to others.
For those in their postnatal era and applicable reminder for those beyond this era
Please remember that postnatal changes – it is a season in your life where change is the only certain thing.
Learning to surrender to the moment was a gamechanger to me. Consider sometimes letting go of what we want in the moment and leaning to accept where we are at.
But also know that there is a physio on your local corner with an empathetic ear and a plethora of evidence based knowledge that may help whatever is making life difficult.
Knowledge AND awareness are power.