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I think my vagina is falling out...

Far too many women I know, who are younger than me, have had a prolapse.

Knowing this made me realise how common it is, and I wanted to find out more.

I sent some questions through to Cheryl Ludwik, from the

Physiotherapy Centre Bendigo to answer.

Massive thanks to Cheryl for taking the time to answer these, and 

for rolling with my sense of humour...

Oh God, I think my vagina is falling out, what is it?!

It might be that the walls of the vagina have collapsed inwards or your uterus might have descended down into the vagina.  This is called prolapse, which means something dropping down.

HOWEVER, you need to make sure that it is not something else like a swollen gland or other problem that needs medical treatment.

 

What should I do???  Where do I get help?

Stop, breathe and don’t panic.

Dr Google does not have the skills to assess you properly, so make an appointment to see your doctor and ask them to have a look.  You might find this a bit embarrassing, but remember that doctors have seen loads of vaginas.

 

Is it going to be like this forever? (and can it actually ‘fall out’?!)

Be assured that you will never stand up and leave your uterus or bladder on the chair behind you.

Prolapse is a condition that can change over time. It can stay the same, get better or even get worse.

But, if you don’t’ do anything about it, it usually gets worse.  Prolapse is usually caused or worsened by something in particular.  It could be as a result of an activity or an accumulation of activity that strains, weakens or stretches the ligaments and tough tissues in the pelvis which hold the organs in place.  This can include pregnancy, giving birth, heavy lifting, constipation and straining, prolonged coughing, high impact exercise or fitness exercises that place excessive load on your abdominals and pelvis.

Can I fix it?

You can certainly do many things to improve a prolapse and prevent it from worsening.  The two key things are to improve the support from underneath and reduced the pressure from above.

The support underneath comes from the pelvic floor muscles. You also need to learn to use the pelvic floor muscles when doing things that cause some pressure on the prolapse (eg coughing, lifting, exercising).  You mustn’t hold your muscles on strongly all of the time or they can get tired and painful.  You may need to see a pelvic floor physiotherapist to help you learn how to use your muscles correctly.  Doing the exercises incorrectly may worsen the prolapse.

See the following websites to find an appropriately qualified physiotherapist - 

Continence Foundation of Australia (physiotherapists with post graduate qualifications in continence and pelvic floor physiotherapy) 

Australian Physiotherapy Association.  Find a Physio.  Select “continence and women’s health” in the treatment area box.  You can check the extra qualifications of each person on this website.

Women who have a large prolapse that protrudes a long way out of the vagina should see a gynaecologist for further help.  This may include use of a specially fitted support ring (pessary) that holds the prolapse up. Sometimes, where a prolapse does not respond to the above strategies, a surgical repair may be needed.  This is something to discuss with your doctor.

 

My husband wants to know if I can still have sex (I’m 100% fine if the answer is no)?

Sex is unlikely to make a prolapse worse.  Depending on what part of the vagina or uterus is dropping down, you may feel discomfort in some positions, so have some fun experimenting with different positions.  Sometimes a bit of extra lube will make things easier.

If your pelvic floor muscles are tired after sex, you might feel a bit heavier for a few hours or even the next day.   

If there is no discomfort, and you feel OK about it …go for it.

Some women feel uncomfortable about the change in their body which can affect sex drive. Understanding the prolapse and feeling like you are doing something about it can change how you feel about it.

 

Aside from my husband being horny, what other parts of my life will it impact?

To manage a prolapse, allow it to recover and/or prevent it from getting worse, it is important to modify some things in your life.

The enemies of prolapse are: 

·         high impact activities (running, jumping)

·         high increases of pressure in the abdomen (lifting, strong abdominal exercises, repetitive coughing)

·         the prolonged effect of gravity (for example if spending all day on your feet).

You will need to think about how you can do things differently to limit lifting and carrying.

You might need to look at alternative fitness exercise.  See this link for further information about protecting the pelvic floor with exercise. 

 

I’m pregnant, can I still have a natural birth?

Many women with pelvic organ prolapse are able to have a natural birth. As there are different types and severity of prolapse, it is important that you discuss this with your midwife or obstetrician during your pregnancy so the birth plan can be made with the prolapse in mind.

 

Just so I don’t feel super weird about it, please tell me it’s common?

You are in good company.  Many women have a mild prolapse (up to 40-50 percent of women) and many don’t even know it as they have no symptoms.

REMEMBER, you can do something about it.

For further information about prolapse see the following link.

 

Cheryl Ludwik is a APA Titled Continence and Women’s Health Physiotherapist.

 

The Physiotherapy Centre Bendigo is located at -

59 McIvor Rd, Bendigo East, Vic 3550

They can be contacted on (03) 5442 4044 or admin@physiotherapycentrebendigo.com.au

 

*Special thanks to Leah Ladson for taking pictures of me 'pretending' to have a prolapse.

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