A pelvic pain condition I haven't discussed yet is Pelvic Organ Prolapse. Now this can range from mild to severe, so you don't always know you have when you have it, but I don't think many people are aware that it exists or what to look for symptoms wise. Therefore, I am writing a tell all blog to define and describe the details of this condition to keep you better informed.
What is POP? This situation occurs when the pelvic floor muscles and tissues have weakened to the point that the pelvic organs have slipped downward out of place. The most common organ for this to occur with is the bladder. A side by side image comparison shows what this looks like so that you can see the difference, but what does it feel like? Well, it apparently feels different from person to person, which may be why it's not always easy to diagnose. It comes on slowly over time so doctors won't automatically go to this condition if early symptoms are present. Since this isn't an issue I personally suffer from, but one I've come across many a time, I've had to do my research to learn the ins and outs of POP. I always think it sounds really painful and with all of the pelvic issues I've had to deal with thus far, I'm glad this one hasn't crossed my path yet. It doesn't sound fun.
What are the symptoms of POP? It can show up as urinary incontinence, like leaking, or retention, sexual difficulty, like Dyspareunia, tampons pushing out, or a bulging of the tissue or organs that slip into or past the vaginal opening. It really depends what organ is slipping, how far it has slipped, and what it is pressing on. The diagram above shows 3 types of POP, including the Cystocele (which involves the bladder), the Uterine, and the Rectocele. There is also Enterocele, where the small intestine falls, and the most severe type, vaginal vault, where the top of the vagina falls. You can see how each of these would cause a different end result. Some women feel heaviness or pressure in the pelvis, an urgency to go to the bathroom, or like a golf ball is in the vagina.
What causes POP? It could be a number of things. Childbirth is an obvious one, but this can happen due to age, frequent constipation, obesity, connective tissue disorder, squatting when lifting, and even genetics. Basically, anything that can stretch or tear the pelvic floor could allow for Pelvic Organ Prolapse to occur so you should be as careful as you can to ensure its integrity throughout your life. Below is what it would look like if you held a mirror below the vaginal opening to see an organ bulging through at the latest stage of POP. Stages 1 and 2 are considered mild to moderate, while stages 3 and 4 are severe.
How do you treat POP? The first and simpler option is of course to go to pelvic floor physical therapy for a personalized pelvic floor exercise regime. A therapist can teach you exactly how to move your muscles appropriately and do Kegels the correct way to ensure the PC muscle is strengthened and can support your organs to hold them in the right places. If that doesn't work a more complicated option is putting in a pessary to support the organs. If you choose to go this route remember that you can't fit a menstrual cup up by the cervix where the pessary lies, though you may still be able to wear a tampon beneath one. Last but not least, if these still aren't enough, a more severe case of POP could require surgery. This can be performed through the vagina or abdomen, with stiches and possibly surgical mesh. Depending on the severity of the pain, whether you want kids in the future, and what your sexual outlook appears like, the vagina can be sealed shut, the position can be restored, or the tissue around it can be repaired. These are of course all important decisions to be discussed with a urogynecologist who specializes in remedying these types of problems.
Where do I go for support? Despite how extremely common this condition is (up to 68% of women will experience it in their lifetime), Pelvic Organ Prolapse is still shrouded in shame and not talked about enough for women to be aware it could happen to them. This website offers a support system with informative articles, a list of doctors to see for a diagnosis and treatment, and an online forum to discuss the trials of POP with other women out there struggling. You can also follow the hashtag #pelvicorganprolapse on Instagram for helpful advice from pelvic floor therapists, other doctors, and everyday women like yourself who are navigating these waters. Remember, no matter how much it feels like it at times, you are not alone in your pain and there is a whole online community waiting for you.