Pelvic Organ Prolapse - How to Avoid It and How to Deal With It
Physical Therapist and award-winning author, Marianne Ryan explains how doing too much, too soon after childbirth can cause pelvic organ prolapse. Ryan offers advice for avoiding pelvic organ prolapse and how to deal with it. One of the complications that can develop as a result of childbirth is pelvic organ prolapse, POP for short. This is a condition where organs such as the uterus or bowels slip down from their normal position inside the pelvis leading to pelvic pain, back pain, incontinence (urine and fecal) and sexual dysfunction. The degree of slippage varies from person to person and can be made worse by certain activities, especially those that increase the pressure inside your abdomen, such as heavy lifting, sit-up exercises, and straining when you pass a bowel movement. Pelvic Organ Prolapse can develop as an immediate result of childbirth or it can take years or even decades to appear. The aim of this blog article is not to scare you but to make you aware of Pelvic Organ Prolapse because there are times it can be prevented and, even if you can’t prevent it, it is treatable with the right physical therapy program1. You will also learn some other tips on how to deal with it.It can take a long time for a woman’s body to fully recover from the rigors of pregnancy and childbirth. More often than not, women do not realize this and return to activities or exercise that are too challenging, far too soon.
To illustrate this, I would like to share a story about a lovely patient of mine who tried to return to her pre-pregnancy exercise routine too early.The Dangers of Doing Too Much, Too Soon − A Case Story: Megan was referred to me after her doctor diagnosed her with pelvic organ prolapse, which she developed after her six-week postpartum checkup. Before she got pregnant, Megan was very active. She loved “boot camp-style” exercise programs and ran half-marathons. After she got pregnant, severe nausea during her first trimester slowed her down some but after her nausea went away at around 14 weeks pregnant she started using the elliptical machine for cardio and doing lower-impact exercises such as yoga to keep in shape. Fortunately for her, she had an easy vaginal delivery and sailed right through her first six postpartum weeks, breastfeeding came naturally and she felt pretty good since her baby was sleeping 5 to 6 hours a night.
At her six-week postpartum checkup her doctor gave her a “thumbs up” and told her she could return to her normal activities. Megan was overjoyed and decided to start working out the next day. Megan started with what she thought was an easy routine: running a couple of miles on the treadmill, working out with some weights, and doing lots of sit-ups. Right after her first workout, she felt something odd, as if she had a “golf ball” in her vagina, but she ignored it and kept up her daily workouts. Two weeks after she started working out, she went straight from the gym to the grocer and carried two heavy grocery bags up three flights of stairs to her apartment. When she got to the top of the stairs, she lost control of her bladder and wet herself. Worse yet, she felt a distinct bulge coming out of her vagina. When she checked herself with a mirror, Megan said she saw “part of her insides poking out of her vagina.”
She got in to see the doctor immediately and he told her she had pelvic organ prolapse; her bladder was falling into her vaginal canal and protruding out of it. Yikes! To treat her, the doctor put her on estrogen cream to improve the tone of the pelvic floor muscles as, since she was nursing her baby, her body was producing less estrogen. He also referred her to me for pelvic physical therapy.Fortunately, Megan’s story had a happy ending. I initially saw her for two and a half months. I taught her the correct way to do a pelvic floor contraction and the exercises in the Baby Bod®Program. I also suggested she use a Pelvic Floor Support Belt during the day to support the bottom of her pelvis (you can find one I recommend by clicking here) and talked to her about protecting her body from injury until it had fully recovered from childbirth. Megan eventually made a full recovery, her prolapse got better and she was eventually able to safely return to all her regular sports.
How to Avoid Pelvic Organ Prolapse:
Don’t Do Too Much Too Soon!
The point I am trying to make here is that Megan returned to activities and exercises that were too challenging, and too soon after giving birth. Most moms are not aware that it takes much longer than 6 weeks to fully recover from the stress placed on the body as a result of the changes that occur during pregnancy and from the rigors of delivering a baby.
The amount of time it takes depends on how much damage occurred during delivery and how long it takes for the hormones in your body to revert back to their pre-pregnancy levels. The hormones that are produced during pregnancy cause the joints and supportive tissues in your body to become looser and your muscles to become weaker. Since it can take several months for these hormones to reach a new balance after you give birth (longer if you are a nursing mother) this means your body is less stable for quite some time after childbirth. During this time it is important to try to prevent injuries.
How do I know if I am doing too much too soon?
My book, Baby Bod – Turn Flab to Fab in 12 Weeks Flat makes it easy to figure out whether your body has fully recovered from childbirth, even if it has been years or even decades since delivering your baby.In chapter 5 there are two tests you can use to measure how well your core muscles, including the pelvic floor muscles, are able to support the pelvic organs and your spine. After completing the tests, you can follow the step-by-step program I have developed to help women to fully recover from childbirth, including dealing with Pelvic Organ Prolapse.How to Deal With Pelvic Organ Prolapse:Physical TherapyThe good news is studies have shown that physical therapy treatment can reduce or resolve POP for some women (1, 2, 3). This means that the right physical therapy program can PREVENT SURGERY, so you owe it to yourself to consider going to a physical therapist who specializes in women’s health and has advanced training in pelvic physical therapy.To make an appointment with one of the physical therapist at Marianne Ryan Physical Therapy in Midtown Manhattan please call 212-661-2933 or email us at: info@MRPTny.com.Estrogen Cream and PessarySome women may need to use estrogen cream to help improve the muscle tone in the pelvic floor muscles. This can help increase the support of the pelvic organs. To get a prescription, you will need to see your gynecologist or a health care provider who can evaluate your condition and prescribe medication.Your health care provider can also evaluate your current condition and decide if you are a good candidate for an internal support device called a pessary.
External Support
There are many different kinds of external support belts and girdles on the market. The one that I found to be most comfortable and offers the right amount of support is the Pelvic Organ Support Belt. To find it, Click Here. Baby Bod Program
To help women reclaim their bodies after childbirth I developed the first DIY program you can do at your own pace and in your own home.The program is safe and proven to work by medical science! Learn how to reduce or cure pelvic organ prolapse by following this simple exercise and self-care program.There are several different levels to the Baby Bod Program, here is a breakdown:Baby Bod Book: The Book: Baby Bod – Turn Flab to Fab in 12 Weeks Flat is available on Amazon. It is a step by step guide to help you recover from childbirth and strengthen your body from inside out. The exercises are gentle and take minutes to do per day.Exercise Tracker for Your Phone: The Baby Bod Exercise Tracker App was created to help busy moms keep track of their exercise program. Sometimes you will need to break the program into “bits and pieces” so you can easily fit them into your day. It is available itunes and google plus.Baby Bod Coaching Program: Do you feel like you would like extra support in learning the program? Then maybe you would do well with the Baby Bod Coaching Program. (Click here for more details)Just imagine, you can have your own personal Baby Bod Coach walk you through the program while you are pregnant or after childbirth, no matter how long you have been a mom.We offer a package of coaching sessions via Skype. You can start while you are pregnant, as early as the day after you deliver your baby or years later.
Click Here for more information on the Baby Bod Coaching Program. Physical Therapy Treatment: Do you feel like you would prefer private one-on-one coaching sessions and manual physical therapy in our Midtown Manhattan office?The physical therapists at Marianne Ryan Physical Therapy are trained to provide you with safe and effective exercises and can offer hands-on treatment for pelvic organ prolapse. To make an appointment please call 212-661-2933 or email us at: info@MRPTny.com.
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You can also get a sneak preview of my book, by downloading a FREE section called “Why You Should NOT Do Sit Ups to Flatten Your Tummy” by CLICKING HERE.I love to read your stories, thoughts and questions so please share them in the comments box below. And, if you’d like to receive future posts direct to your inbox then you can subscribe by using the subscription box on this page.
Marianne Ryan PT, OCS References1 Hagen S, Stark D. Conservative prevention and management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2011 Dec 7; (12):CD003882. doi: 10.1002/14651858.CD003882.pub4.2 Hagen S, Stark D, Glazener C, et al. Individualised pelvic floor muscle training in women with organ prolapse (Poppy): a multicenter randomized controlled trial. The Lancet. 1 March 2014; 383(9919):796-806. doi:10.1016/S0140-6736(13)61977-7.3 Hagen S, Stark D. Conservative prevention and management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2011 Dec 7; (12):CD003882. doi: 10.1002/14651858.CD003882.pub4.