1/2 of all women who’ve had a child have some level or prolapse.
It’s a widely cited statistic, and unfortunately it’s pretty bang on (1, 2). So it’s pretty clear we need to talk about pelvic floor health, and why it should be a priority for all women.
After a pretty intense birth with my wee one, I was horrified to be in this camp. Alllll the pushing led me to have a catheter for a few days and I had to put a lot of work in to get that urinary incontinence sorted. And it’s definitely taken time! Studies suggest that postpartum incontinence plus pelvic organ prolapse are common conditions among new mums, and apart from the birthing process, that there are several other risk factors that can contribute to its development.
Additionally, studies indicate that pelvic organ prolapse can cause a range of symptoms - such as discomfort, pain, and urinary or bowel dysfunction, which of course then can have a pretty negative impact on women's quality of life. (Those days of jumping on trampolines may feel like they’re long gone for so many!)
But what can be done? See below for some common go-to’s:
See a Women’s Health Physio
Now if you’ve any issues after birth, this one should be your first port of call, honestly. Call one up. It's really important to speak with a professional to determine the best course of treatment for you - and nowadays they’ll often do an ultrasound where you can see if your pelvic floor is engaging (too much or too little) and what it looks like in there.
The pelvic floor is a complex structure made of muscles, fascia and nerves that essentially connect your abdominals, diaphragm, pelvic girdle, bladder, bowel, uterus and your hip bones together. A women’s physio worth their salt will do a thorough assessment to pinpoint which part of your pelvic anatomy is letting you down, they’ll help assess the severity of your prolapse, and recommend the most appropriate treatment options.
Sydney-siders, I can’t recommend Women in Focus physiotherapy enough! Usually, they’ll guide you to the following…
Pelvic floor muscle exercises
Known as Kegels, these exercises can help strengthen the muscles that support the pelvic organs and may improve symptoms of prolapse. Many women start these during pregnancy and it’s really not a bad idea! (3, 4)
However, while this is a good start, it’s really important to know that there is more to pelvic health care than simply doing ‘kegels’!
Lifestyle modifications
Making changes to your diet, exercise routine, and other lifestyle factors may help reduce symptoms. This may include losing weight, quitting smoking, or avoiding activities that place stress on the pelvic floor.
Acupuncture
Yes! Some research suggests that acupuncture may be helpful here (5, 6). Studies have shown that acupuncture can help:
Strengthen the pelvic floor muscles, which can reduce incontinence and other pelvic floor problems. The stimulation of acupuncture points can help to increase blood flow to the pelvic area, which can improve muscle function and reduce pain.
Relieve chronic pain, including pelvic pain. Research suggests that acupuncture can activate the release of endorphins (aka the body's natural painkillers), and stimulate the release of neurotransmitters (such as serotonin and dopamine), which can help to reduce pain and promote relaxation (7).
Reduce Inflammation, which could otherwise contribute to pelvic floor dysfunction. Acupuncture may help modulating the immune system and reducing the release of pro-inflammatory cytokines -> thus helping alleviate pelvic pain and other symptoms associated with pelvic floor dysfunction.
Surgery
Now of course we’re not going to jump to surgery right away - but in more severe cases of prolapse, surgery may be recommended to repair the pelvic floor and provide support to the organs.
Pelvic floor health really is critical for women's wellness, and while - let’s be honest - most of us may not really want to shout it from the rooftops that we’re peeing our pants a lot of the time, there IS help. Please don’t let anything stand in the way of you receiving help, as in most cases these issues won’t resolve on their own. As Women in Focus say, “A woman’s wellbeing starts from within” - so what are you waiting for?
Sources:
1. American College of Obstetricians and Gynecologists. (2018). Practice Bulletin No. 185: Pelvic Organ Prolapse. Obstetrics and Gynecology, 131(6), e168-e186.
2. Wu, J. M., Vaughan, C. P., Goode, P. S., Redden, D. T., Burgio, K. L., & Richter, H. E. (2014). Prevalence and trends of symptomatic pelvic floor disorders in U.S. women. Obstetrics and Gynecology, 123(1), 141-148.
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3733901/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4061703/
5. Li H, Huai B, Li D, Wang Y, Zhang Y, He M, Liang F. (2017) Acupuncture for the treatment of pelvic organ prolapse: a systematic review and meta-analysis. BMC Complementary and Alternative Medicine.
6. Chen Y, Khor M, Mainwaring F, Lam H, Ng E. (2019) The efficacy of acupuncture in the treatment of women with pelvic organ prolapse: a feasibility study. Journal of Acupuncture and Meridian Studies.
7. Lee SH, Lim S, Kim SC, Chung JY. (2015) Acupuncture for chronic pelvic pain: A systematic review and meta-analysis. Evidence-based Complementary and Alternative Medicine.
- Jelovsek, J. E., & Barber, M. D. (2006). Women seeking treatment for advanced pelvic organ prolapse have decreased body image and quality of life. American Journal of Obstetrics and Gynecology, 194(5), 1455-1461.
- Tegerstedt, G., Maehle-Schmidt, M., Nyrén, O., & Hammarström, M. (2006). Prevalence of symptomatic pelvic organ prolapse in a Swedish population. International Urogynecology Journal, 17(5), 497-503.
- https://www.womeninfocusphysio.com.au/