Why have my prolapse symptoms got worse?
Pelvic organ prolapse (POP) is a common condition affecting many women, particularly those who are active, have given birth, or are experiencing menopause. It can be incredibly frustrating when, despite your best efforts to stay healthy and active, your prolapse symptoms seem to worsen. Understanding the reasons behind these changes is crucial for managing your condition and maintaining your quality of life.
What is pelvic organ prolapse?
Pelvic organ prolapse occurs when the muscles and tissues supporting the pelvic organs (such as the bladder, uterus, and rectum) weaken or stretch, allowing one or more of these organs to bulge into the vaginal canal. Symptoms can include a feeling of pressure or fullness in the pelvis, urinary incontinence, difficulty with bowel movements, and a visible bulge in the vaginal area. The research shows that severity of prolapse may not correlate with severity of symptoms. Which means your prolapse may not have got worse, but your symptoms have ramped up.
Why Are My Prolapse Symptoms Getting Worse?
If you’re noticing a worsening of your prolapse symptoms, there could be several contributing factors. Let’s explore some of the most common reasons.
1. Physical Activity outside your current capacity
While staying active is beneficial for your health, certain types of exercise may exacerbate prolapse symptoms if your core/pelvic floor struggles to manage the pressure they create. If your pelvic floor or core is already fatigued or weakened, you may notice that high-impact activities such as running, jumping, or heavy lifting can increase pressure on the pelvic floor. This isn’t to say you can’t do them, but that your body may need help in helping to manage pressure and/or strengthen the core and pelvic floor system. Or that you may need to work up to them.
What to Do: Work on managing pressure better by looking at how you are doing certain activities, working on breathing strategies and by building a strong foundation that can manage load, impact and fatigue. My online programmes LIFTED! rehab programme and LIMITLESS! for a combination of pelvic health and strength training are a great place to start.
2. Hormonal Changes
Hormonal fluctuations, especially during menopause, can feel like they significantly impact pelvic organ prolapse. The decline in estrogen levels that occurs during menopause can lead to a change in quality of the pelvic tissues, or more/less sensitivity, exacerbating prolapse symptoms. This may also happen during postpartum and when breastfeeding when hormonal levels are adjusting after childbirth and estrogen is low.
What to Do: Speak with your healthcare provider about managing hormonal changes. Hormone replacement therapy (HRT) or topical estrogen creams may be options to help maintain the health of your pelvic tissues. Additionally, staying hydrated and maintaining a balanced diet rich in vitamins and minerals can support tissue health.
3. Chronic Constipation or Straining
Straining during bowel movements is a common factor that can aggravate prolapse symptoms. Chronic constipation, which leads to frequent straining, can weaken the pelvic floor muscles over time, potentially worsening the prolapse or prolapse symptoms.
What to Do: To alleviate constipation, ensure you’re consuming plenty of fibre-rich foods, staying hydrated, and possibly incorporating a gentle laxative or stool softener as recommended by your doctor. Learning proper techniques for bowel movements, such as using a footstool to elevate your feet while sitting on the toilet, can also reduce strain on your pelvic floor.
4. Poor Posture and Body Mechanics
The way you sit, stand, and move might impact the pressure placed on your pelvic floor. Poor posture, particularly during exercise or daily activities, may contribute to symptoms feeling worse, or always feeling heaviness in the pelvis.
What to Do: Work on improving your posture, especially when sitting or lifting. Strengthening your core (and rest of your body) through a balanced strength training programme for prolapse can help. Plus, being aware of HOW you do things is important and a change in strategy can mean a positive change to symptoms.
5. Inadequate Pelvic Floor Support
Sometimes, despite your best efforts, your pelvic floor muscles may not provide adequate support due to factors like previous surgeries, childbirth trauma, or a naturally weaker pelvic floor. This may lead to a gradual worsening of prolapse over time.
What to Do: If conservative management isn’t enough, there are other options to explore. Pessaries which are inserted into the vagina to support the pelvic organs, can provide significant relief. In some cases, surgical options may be considered, depending on the severity of the prolapse and your overall health.
Check out these blogs on Will a pessary help my prolapse and How to recover from Prolapse surgery
6. Stress Management and the Nervous System
Stress can have a profound impact on prolapse symptoms. Prolapse symptoms can be complex and nor always a sign of anatomical change! Stress can crank up the nervous system which means that you may be more sensitive to sensations within the body. Even if your prolapse doesn’t look any different, it can feel worse.
What to do: Understand that stress can play a role in your symptoms. We can’t always eliminate stress but having ways to manage stress can be really useful. Plenty of sleep, exercise and journaling can really help.
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When to seek help
If you’re noticing a significant increase in your prolapse symptoms or if they’re interfering with your daily life, please consult with a healthcare professional. A pelvic health physiotherapist can assess your condition and recommend appropriate treatments or interventions to help manage your symptoms.
Beth Davies is a highly experienced personal trainer and coach with over 10 years experience in coaching pregnant, post-natal, or female pelvic health clients. 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 Stylist, Metro, Woman & Home and Marie Claire UK
Beth’s trains and coaches women with pelvic organ prolapse or who are pregnant or post-natal, and provides 1:1 and face-to-face personal training in Leamington Spa, Warwickshire, and online across the UK and Europe.