Do you feel a heaviness or a dragging sensation in the vagina, or do you feel that something is dropping down or falling out? Is it worse after exercise or at the end of the day? If so, do not be afraid. This is not an uncommon problem among women, but it is something that women don’t like to talk about. It called prolapse, and there are things that you can do to help.

The boat in the marina…

The prolapse could be your bladder, your rectum, and/or your uterus (Still do not be afraid! It is not dangerous!) Your pelvic organs are supported much like a boat in a marina. Your ligaments are like the lines of a boat that holds things in place, and your pelvic floor muscles are like the water that supports the boat from underneath. If the water drains out of the marina, what happens to the lines? They stretch and finally break. If the lines break, the boat will not stay in place.

Why does this happen?

There are a number of reasons why prolapse occurs. A forceful straining and pushing down that occurs during childbirth, or a continual straining that may occur throughout our lives including with chronic constipation, chronic coughing, bending, lifting, and being on our feet, and gaining weight, to name a few.

Can anything be done about it?

Yes. Several things. Let’s start with the most conservative interventions and go from there:

• Try to stop bearing down (called valsalva or increasing intra-abdominal pressure like when having a bowel movement) as much as possible. Much can be done to avoid chronic constipation, which is a great place to start. Also, learning how to perform exercise and activities of daily living (like getting out of bed or lifting heavy objects) without bearing down are also very doable.
• Pelvic floor muscle exercises: While pelvic floor strengthening exercises may not fully correct prolapse, it is proven to help and may be enough to control or eliminate the symptoms of prolapse.
• A pessary: A pessary is a device that is inserted into the vagina and holds your organs up. Newer pessaries are much easier for people to insert and remove and women often only use them as needed, like during high impact activities.
• Surgery: Yes surgery can be done, but I think of it as a last resort. Prolapse surgery sometimes don’t last for a long time, particularly when women continue doing the things mentioned above.

Where should I start?

It is recommended that you get your Dr. to check things out first to make sure that there is not something more serious going on. If there isn’t, ask them to send you to a physical therapist who specializes in pelvic disorders, and they can educate and guide you on your way to recovery.

Talk about it because help is available!

Written by Sandra Trevillian PT, who speaks of this from our Scottsdale office.