This shouldn’t be the case: around a half of all women will have some degree of pelvic organ prolapse in their lifetime.
Six years on and, while I have a general diagnosis of “pelvic organ prolapse”, I do not know which prolapse I have, to what degree or whether or not I have multiple prolapses.
Here is everything I have learned, and everything I wish I had already known about living with pelvic organ prolapse, before I had to.
… and so will your period While prolapse shouldn’t affect your period, your period can affect your prolapse.
Another demographic affected by pelvic organ prolapse are those experiencing menopause – people who, like those who have just given birth, are subject to vast hormonal fluctuations and are therefore more vulnerable to poor mental health.
I didn’t realize how drastically my life would change when I developed pelvic organ prolapse in 2019 after giving birth to my daughter, and it seems that neither did my doctors. My inability to use tampons and my nearly constant bout of UTIs made every new “surprise” feel even worse because I hadn’t prepared myself mentally or practically.
This shouldn’t be the case because approximately 50% of women will experience pelvic organ prolapse to some extent during their lifetime. The four types—vaginal, uterine, bladder, and rectal—all entail the descent of one or more pelvic organs into the vagina. It frequently causes an internal bulge, but as it advances, it may also become visible from the outside. The fact that prolapse is so diverse and, importantly, understudied leads to a wide range of possible symptoms, most of which are, in my opinion, underemphasized in medical literature. Living with an organ that descends into your vagina is often referred to as “uncomfortable,” as if it were like wearing jeans that are too small. The NHS website defines stress urinary incontinence (SUI), which can be extremely crippling, as “problems [with] peeing.”. It appears that the scant information on prolapse is meant to reassure you that your symptoms are not serious, but for many of us, that is not the case.
Prolapse, which I experienced after giving birth, can also be brought on by injury, menopause, aging, or for no apparent reason at all, as far as medical research is concerned. On the other hand, you may have all of the symptoms but find it difficult to receive a diagnosis, or you may have none of the symptoms and not even be aware that you have it. After six years, I still don’t know which prolapse I have, how severe it is, or if I have more than one, even though I have been diagnosed with “pelvic organ prolapse.”. Despite my dissatisfaction with this startling ignorance of my condition, I must rely on what I do know in order to survive each day. Here are all the things I’ve discovered about living with pelvic organ prolapse, as well as the things I wish I had known before I had to.
It will be different with penetrative sex.
I did not consider the impact prolapse might have on my sexual life when I was initially diagnosed. However, as it happens, this is most likely the aspect of my life that has suffered the most. Yes, I suffer from stress urinary incontinence (SUI), but when is the worst time to lose control of your bladder? I also have vaginal pain, but when is the worst time to experience vaginal pain? At 29, I believed I would never be able to have penetrative sex again after a few painful attempts at intercourse.
But over time, I came to understand that placement was crucial. A significant difference was made when I had sex on my side to prevent the penis from penetrating so deeply. A friend suggests placing a cushion under your butt to raise your pelvis and cause your cervix to recede, but of course, this is not good if you start on deeper penetration. Lube is a huge help in encouraging the penis to “find the path of least resistance,” as we both agree. Regarding the SUI, I urinate before, even if I don’t believe I need to. Having sex in the bathtub or getting completely lubricated are two incredibly easy ways to cover up larger or smaller leaks for those who might be ashamed about losing control of their bladder.
… and your menstruation as well.
Although your menstrual cycle shouldn’t be impacted by prolapse, it can. My vagina definitely feels heavier now, and I’m especially hesitant to put myself through too much physical strain in the days leading up to my period. I have to apply heat pads to my vulva instead of my abdomen (over clothing, to prevent the risk of burns) because I now have more severe vaginal cramps, possibly as a result of my uterus descending. It’s nearly impossible for me to use tampons and mooncups because my prolapse just squeezes them out as soon as I put them in. It was discouraging for me to go back to pads after a ten-year hiatus, and I still haven’t found a period pants brand that I like. All of this led me to use the coil, which has at least lessened my physical discomfort. It’s not for everyone, though, and even though I didn’t have any pain during insertion, I would advise anyone who is worried about it to ask their doctor to apply a local anesthetic gel or spray (pain relief is not routinely offered for IUD fittings).
Exercise and you will have a different relationship.
My mobility was not affected by my prolapse during the first year or two, but now it usually only happens in the days before or after a particularly strenuous activity. On the worst days, it felt like an enormous effort to just stand up; I would have to contract my pelvic floor muscles as hard as I could to fight the feeling that my cervix would fall out of me. Physiotherapists advised me not to pick up my infant, which is practically impractical advice for a new parent. This made me doubt every hug. Friends who enjoy running were especially upset to learn of their prolapses. After she was able to overcome the stigma, incontinence pads were a game-changer for someone who couldn’t run 10 meters without losing complete control over her bladder. A pessary, which is a tiny ring placed inside the vagina to support the organs above it, is an additional choice.
Gynecological infections might be more common in you.
However, using pessary increases the risk of vaginal infections. This is because prolapse in general is likely to increase infections, but the pessary may introduce bacteria into the vagina. Urinary tract infections (UTIs) are the most prevalent because the descended organs can either stop the bladder from emptying completely or cause minor leaks and urine pooling, which provides an environment for bacteria to grow. In addition to providing an environment that is conducive to infection, leftover semen from penetrative sex may become trapped in the prolapse’s pockets. Tougher cleaning practices and harsher products may seem like the solution to these issues, but they may actually harm the vaginal ecosystem. I have not yet found a better option than routinely buying over-the-counter vaginal self-testing kits and asking my doctor for specific medication, if necessary. This is costly and time-consuming, so I hope that in the future, general practitioners will think about providing free self-testing kits for gynecological infections that occur frequently.
It might impact your options for future conception.
According to several medical experts, I should avoid getting pregnant again if I don’t want my prolapse to worsen. Having a caesarean section instead of giving birth vaginally wouldn’t help me in this situation because carrying another baby could put a lot of strain on my pelvis, which could significantly worsen my symptoms and outlook for the future. I won’t be offered surgical repair until I’ve made the decision not to become pregnant once more.
It’s vital to remember that not all prolapse sufferers are advised against getting pregnant; this is determined on an individual basis. If you are ready for your prolapse to possibly worsen, you can proceed regardless of the advice you receive. However, calculating that risk can be challenging for many people. To give women with advanced prolapse as much reproductive choice as possible, more research into this and other interventions is desperately needed. However, there is growing evidence that pessary use during pregnancy can result in the best post-birth outcomes.
Although it may seem unachievable, the mental toll isn’t.
When I was initially told that I had prolapse, I was unwilling to get out of bed. This was partly due to my constant feeling that my health and physical condition were getting worse with each action I took. But primarily, it was due to the psychological toll that my prolapse had taken on me. The doctors covered my condition with euphemisms and seemed to hardly comprehend it. Having no idea what the rest of my life would hold, I felt completely cut off from both my body and the child I was told not to pick up after giving birth. It goes without saying that this is a breeding ground for postpartum depression.
Menopausal women are another group impacted by pelvic organ prolapse; similar to those who have recently given birth, they are prone to significant hormonal changes and are therefore more susceptible to mental health issues. In order to comprehend the psychological effects of gynecological conditions, one must first recognize a fundamental aspect of medical misogyny: the near universal underdiagnosis, undertreatment, and understudy of women’s health conditions. More pain is experienced by women, and they are less likely to receive a diagnosis and treatment.
It can be discouraging to feel as though the system is working against us. However, it’s critical to recognize the sheer number of people who share this experience, advocate for improved treatment options, and collaborate to de-stigmatize under-discussed conditions. I was able to get over my initial feelings of shame at my body’s betrayal after sharing my prolapse story with others and then hearing from so many others about their experiences. Talking about how to control my period or have better sex gave me a toolkit to use going forward. Although significant institutional change is still required, for the time being I am thankful that I am not too embarrassed to use an incontinence pad if necessary. Nor ought you to be.
On May 29th, Emma Szewczak and Dr. Andrzej Harris’ book The Stitch-Up: How Medical Misogyny Harms Us All will be released by Vintage for £22. Get your copy at guardianbookshop.com to show your support for the Guardian. There might be delivery fees.
