How to manage your pelvic organ prolapse – Top 5 considerations

By Karen Bang, PT

If you have been told that you have a pelvic organ prolapse, what should you do next? A pelvic floor physiotherapist would define a pelvic organ prolapse as a subjective disorder where one describes a heaviness, bulging sensation, or pelvic pressure around the perineum. This is often associated with an anatomical shift or lowering of tissues within the vaginal canal. If these symptoms resonate with you, here are five things to consider to help you manage your pelvic organ prolapse.

Changing Positions

Often times, symptoms of a pelvic organ prolapse are often increased or decreased depending on the position that you are in. For example, folks typically report that their symptoms are aggravated when they are standing or at the end of the day after being on their feet. A position that often relieves symptoms is lying down. A great position that offers relief of pelvic pressure is placing your legs up a wall. So the next time you feel heaviness in your pelvic floor, lie on the floor, place your legs up a wall, spend 5-10 minutes breathing, and see if you feel better!

Training Your Pelvic Floor Muscles

If there has been a shift or descent of a neighbouring organ, like your bladder or rectum, and it is taking up space in the vaginal canal, there is likely a presence of pelvic floor dysfunction. You could have a weak pelvic floor or a tight pelvic floor and understanding which one you have is an important first step in pelvic floor rehabilitation. If your pelvic physio assesses your muscles as weak, you might start a regimen of strengthening your muscles. If your pelvic floor is holding too much tension, then it might be best for you to learn how to release that tension. The right treatment plan is different for everyone and must be individualized to help improve pelvic health.  

Training Your Breath

Did you know that the way you breathe has an immense impact on your pelvic floor function? When we breathe optimally by way of allowing the diaphragm to move through its full range of motion, we are basically exercising the pelvic floor at the same time! Take a moment to analyze how you are breathing right now. Does your breath go towards your belly, your chest, or maybe to the ribs? When you are exercising, are you holding your breath as you lift a heavy weight or do you take shallow breaths when you jog? These are all great things to consider as they impact the symptoms of your pelvic organ prolapse. Try this simple breathing exercise. As you inhale, allow the muscles around your bum and vagina to soften and relax. As you exhale, notice those same muscles gently lifting upwards. Your breath is more important than you think!

Training Your Toileting Habits

That’s right! Thinking about how you use the bathroom has a significant role in managing your pelvic organ prolapse. When you have a bowel movement, your pelvic floor muscles need to relax in order for your stool to evacuate. However, if you are constipated, you are more likely to strain and place unfavourable pressure onto your pelvic floor. This also goes for those who tend to push their pee out! You can become constipated if you aren’t drinking enough water, consuming enough fibre, getting enough physical active, or if you are experiencing higher levels of stress. Learn more about the relationship between your bowel and bladder function and your prolapse with your therapist.

Considering Alternatives  

Your pelvic therapist may recommend you see a specialist like a gynecologist or urologist depending on the type and severity of prolapse that you have. Your specialist will be able to assess whether you are a candidate for surgery. These surgeries typically help to reposition the prolapsed organ in a more favourable alignment. Although the longevity of the benefits of these surgeries is inconsistent, prolapse repair operations can provide much needed relief for many folks.

Another tool that your therapist may discuss with you is something called a pessary. This is a small plastic or silicone device inserted into the vagina to treat prolapse by providing extra support in the pelvic cavity. A pessary can be prescribed by a pelvic floor physiotherapist with special training, a physician, or a midwife. Often times, people will use a pessary while they participate in pelvic health physiotherapy simultaneously.

If you are unsure as to how to start managing your pelvic organ prolapse, book a pelvic floor assessment at Proactive Pelvic Health Centre!

References

https://pubmed.ncbi.nlm.nih.gov/24290404/

Course Notes, Pelvic Health Solutions – Level 1: The Physical Therapy Approach to Female and Male Urinary Incontinence