Have you (or your partner) been told that you have a pelvic organ prolapse and are worried about what it means for the future of your relationship?
Many women feel awkward discussing the condition over lunch with their girlfriends or a romantic dinner with a new partner. They worry their new (or existing) partner will be “grossed out” and want to end the relationship. Or fear that if they disclose their prolapse, they’re the only one amongst their group of girlfriends with this condition.
Sadly, it’s a tricky subject because most women feel hesitant or ashamed about disclosing their pelvic organ prolapse. So it’s still a taboo subject that we keep to ourselves. But it shouldn’t be because you’re certainly not alone if you suffer from this condition. Pelvic organ prolapse affects millions of women across America.
At Nancy Branberg Physical Therapy, we help you feel good in your body without pain or shame. We provide a safe space for you to have honest conversations about how the condition affects you and your relationship, and we help you fix it.
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What Is a Pelvic Organ Prolapse?
Pelvic Organ Prolapse occurs when one or more of the organs in the pelvic area move out of their normal position and drop down. The affected organs include the urethra, vagina, small intestine, uterus, rectum, or bladder. In most cases, it happens because the pelvic floor’s connective tissues, ligaments, and muscles are weak and cannot hold the organs in their correct positions.
When it occurs, and the pelvic organs drop, they may protrude or encroach into another organ and, in some situations, fall so far down that they extend out of the vagina. As a result, you might experience urinary or fecal incontinence, and during sexual intercourse, the vagina might make sounds. Unfortunately, many women ignore the early signs because of these unusual symptoms. They don’t seek treatment until the prolapse becomes even more pronounced.
Pelvic organ prolapse is quite common among women. At least one in four women in their late 30s – 40s and one in their women in their mid-60s suffering from this condition. Towards their 80s and beyond, almost half of all women face this issue. The leading cause is childbirth and the body’s changes during pregnancy. These tend to weaken the pelvic floor muscles. However, some women who have never had a pregnancy can suffer from this condition. Other risk factors include:
- Being overweight
- Undergoing a hysterectomy
- Genetic anomalies or connective tissue conditions
- Growing older
- Hormonal changes brought on by menopause
- Any injury to the pelvic floor
Some of the other causes that may lead to pelvic organ prolapse are:
- Lifting heavy weights or HIIT exercises
- Excessive coughing due to lung diseases/ smoking
- Straining when evacuating the bowels due to severe constipation.
What Are The Symptoms Of Pelvic Organ Prolapse?
Pelvic organ prolapse has several symptoms. On occasion, pelvic organ prolapse can occur suddenly. e.g., You could be working out at the gym and feel the connective tissue of the pelvic floor give way and feel something bulging from your vagina.
But often, it develops more gradually. Some early symptoms of pelvic organ prolapse include the inability to empty the bladder entirely or urinary incontinence and leakage. In addition, there may be persistent pain in your lower back, and having sexual intercourse may become painful. You may also find it challenging to enjoy sex and achieve orgasm or feel like your vagina is “loose.”
In some cases, pelvic organ prolapse can cause new constipation issues or aggravate pre-existing chronic constipation. In pelvic organ prolapse cases where the rectum protrudes into the vagina, it can cause severe bowel issues. To help move things along, you can try increasing your daily water and fiber intake.
What Are The Treatment Options For Pelvic Organ Prolapse?
In mild cases of pelvic organ prolapse, losing weight can go a long way in reducing pressure on the organs in the pelvic area. You can also learn to do core strengthening exercises and specific exercises to help strengthen the all-important pelvic floor muscles.
In more severe cases, your doctor or physical therapist may suggest:
- Vaginal pessaries: One of the simplest ways to get relief is to begin the use of vaginal pessaries that are inserted within the vagina and provide support to the organs in the pelvis. Pessaries are beneficial in urinary incontinence and can help reduce the “bulging” sensation.
- Pelvic floor exercises: One of the most effective ways to build up strength in the pelvic floor area is through Kegel exercises. However, you must do them correctly, or they can worsen the condition. To learn how to do them, we recommend you seek the assistance of a pelvic floor therapist and women’s health specialist. They can use sensors to gauge muscle strength in the area and instructs you on how to perform the exercises correctly. Then, when you’ve mastered the technique, you’ll be able to do them at home without supervision.
- Surgery: In severe cases where your quality of life is severely affected, your doctor might recommend surgery. But surgery is a last resort. It is only recommended if you have severe bowel or urinary incontinence, cannot retain a pessary in the vagina, or have severe pain.
How To Prevent Pelvic Organ Prolapse From Affecting Your Relationship (And Your Sex Life)
If pelvic organ prolapse has already started affecting your relationship and sex life. Don’t panic. The good news is that a pelvic organ prolapse doesn’t mean your sex life is over. With professional treatment, many of the women we see at Nancy Branberg Physical Therapy salvage their relationships and report significant improvements in their sex lives and ability to orgasm.
Plus, you can do many things to improve things at home and in the bedroom in the meantime and prevent pelvic organ prolapse from affecting your relationship.
For example, your partner might be hesitant about engaging in physical intimacy with you because of fear of causing discomfort or pain. However, if you have a posterior bowel prolapse or anterior (front) vaginal wall prolapse, you are unlikely to exhibit any significant symptoms and not experience pain during intercourse, so you can put your partner’s mind at ease by explaining this.
Every case of pelvic organ prolapse is different. So regardless of the specific type of prolapse, we recommend you discuss what is comfortable and discuss your symptoms (or lack of) to allay your partner’s concerns.
Another common problem is that your partner may feel the “bulge” of your prolapse during intercourse. It can feel strange, but since the walls of the vagina are mobile and flexible, likely, you will not experience pain during intercourse.
So again, try it and see how you feel. But again, discuss it with your partner and reassure them that there is no pain or discomfort. Over time they will become more comfortable with these new sensations.
You can also reassure your partner that intercourse will not likely exacerbate a pelvic organ prolapse, so they don’t have to worry about that. This reassurance should reduce the stress around intimacy for you and your partner.
A fulfilling sex life is due in part to being open and sharing what improves the experience and sensation for both of you. This intimate exchange is vital for all couples, not just when you’re dealing with pelvic organ prolapse.
A few additional ways that you can make your sex life more comfortable and enjoyable with pelvic organ prolapse are:
- Plan the foreplay: When you plan sex, you should consider the needs and enjoyment of you and your partner. But to specifically make things more comfortable for you. We recommend that you spend ample time on foreplay to help you relax, build up the excitement, and move you closer to climax. Taking deep breaths at the start of your sex session can also help relax your pelvic floor muscles and make things more comfortable.
- Explore non-penetrative sexual options: In most pelvic organ prolapse patients, there is no bulging out of the vagina nor any change in sensitivity to the clitoris. If you and your partner find penetrative sex uncomfortable currently. Why not discuss and explore various forms of non-penetrative sex with your partner? Such as clitoral stimulation.
- Make sure to use lubrication: For women, lubrication during sex reduces discomfort or pain and heightens the sensations, including arousal, which can be helpful with pelvic organ prolapse. It can also promote enjoyment for your partner. Use a natural oil or water-based vaginal lubrication gel, preferably.
- Select the correct positions: For women with certain types of prolapse, such as uterine prolapse, certain sexual positions can cause discomfort, so discuss and choose the most comfortable position to make sex enjoyable for both of you.
Time To Get Help
If you’re concerned about pelvic organ prolapse or want more information, please don’t hesitate to contact us.
Don’t let pelvic organ prolapse stop you from doing what you love.
We’ve seen it all before and know that we can help you.
Nancy Branberg
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