Not such a dirty word.
by Carrie Seow, women's health physiotherapist
The idea of having a pelvic organ prolapse (POP) can be very daunting and upsetting to most women when they first hear that they may have one. They may feel abnormal, ashamed or the odd one out. But POP is more common than you think, with approximately 50% of adult women having some degree of it. POP means that the pelvic organs (bladder, uterus or rectum) start to descend or fall downward into the vagina from their usual position higher in the pelvis.
Symptoms of POP can include:
- Vaginal heaviness or bulging sensation in vagina
- Dragging in the lower back pain
- Painful intercourse
- Reduced control of bladder or bowels
- Urinary or defecation difficulties
However, it is good to remember, that POP can also be asymptomatic. Yes, the organs may be sitting lower, but there are no symptoms to be felt with this. The degree to which a prolapse bothers a woman (if at all) will be highly based on individual factors.
POP can be caused by pregnancy and childbirth, aging and menopause, obesity, chronic coughing, chronic constipation and heavy lifting. When you think about all the different life stages women go through, it is not surprising that a degree of vaginal laxity is common and quite normal after giving birth, pregnancy or after going through menopause. After-all, the rest of the soft tissues start to sag a little too with gravity, such as our skin, or our breasts! The same is happening within our bodies also.
Treatment may involve a spectrum of approaches including:
- doing nothing (some POP is asymptomatic and is unlikely to get any worse depending on lifestyle factors)
- conservative treatments such as lifestyle modifications, pelvic floor exercises, vaginal pessaries, and oestrogen cream
- surgical treatment.
It’s always a good idea to get assessed by a women’s health physiotherapist if you suspect that you have a pelvic organ prolapse.