Beth Davies Coaching

The new definition of pelvic organ prolapse

You may have been given a prolapse diagnosis even if you weren’t/aren’t experiencing any symptoms. This often leads to feeling floored or blindsided because you had absolutely no idea there had been any change to the position of your organs. 

A more recent clinical definition by the ICS (International Continence Society) uses the following 2 parts: 

“anatomical prolapse with the descent of at least one of the vaginal walls to or beyond the vaginal hymenal ring with maximum Valsalva effort” 

AND 

The presence of bothersome characteristic symptoms, most commonly the sensation of a vaginal bulge, or functional or medical compromise (such as urinary retention, obstructive renal failure or severe vaginal wounds) due to prolapse in women without bother (Collins et al, 2021) 

So, lets break this down for each 

What does this mean if you have descent or change to the position of your organs and no symptoms?

It depends!! This may depend on the stage or grade you have been given. In that a Grade 1 or 2 is now considered to be a normal range of movement of the pelvic organs especially when you take parity and aging into account. 

The issue is that your diagnosis hasn’t been given the context it requires. And you may have been made to feel like your anatomy is abnormal, or you’re just a cough away from losing your organs. THIS IS NOT TRUE! 

So, what would be helpful if you have a prolapse diagnosis and a grade 1 or 2? My recommendation would be to see a women’s health physio who can help assess your prolapse and pelvic floor and help with a plan of action to either build support eg more strength in the pelvic floor muscles. If you have a strong pelvic floor but laxity of the pelvic ligaments (which essentially ‘hold things up’), then a pessary may be appropriate for either long term or tactical use. Education about exercise, pressure management, movement, and lifestyle strategies would also be useful. 

What does this mean if you have symptoms alongside descent of the pelvic organs?

So, when there is both objective (a change in position of your organs) and subjective (the feelings of bulgey-ness/heaviness etc), it’s useful to take a 2 part approach 

Part 1 – understanding what the pelvic floor needs? Is it more strength, more coordination, less tension, more range of movement? Might a pessary be useful for support for exercise/everyday life? And then how can the pelvic floor muscles be incorporated into movement or exercise because they don’t just work in isolation. But in COMBINATION with other muscles. 

Part 2 – Identifying and understanding what might be driving your symptoms? Is it exercise? or is it lack of sleep? Rubbish diet? Constipation? Reading everything you can about prolapse and still feeling no better informed? Symptoms aren’t always a reflection of the degree of change in the position of the organs…! 

Read this blog about dialing up and dialing down prolapse symptoms 

There is a TON of nuance when it comes to pelvic organ prolapse. So, if you have been told to ‘just do your kegels’ or told that you must avoid exercise if you have prolapse and no symptoms, please know that there are approaches that support both short term and long term goals, pelvic  floor function and your active life. 

Beth Davies is a highly experienced personal trainer and coach specialising in female pelvic health, pelvic organ prolapse and exercise. Her programmes educate, empower and support women back to training or their active life, eliminating symptoms and building strength and confidence. She has been featured in women’s lifestyle magazines and websites, including  StylistMetroWoman & Home and Marie Claire UK 

 

 

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