Understanding Pelvic Organ Prolapse

Before the birth of my daughter in 2017, I had never heard the term ‘pelvic organ prolapse’. I did not know there were physical therapists that specialize in pelvic floor physical therapy and I definitely did not know that as many as 1 in 3 women will develop this condition in their lifetime. I was 1 in 3.

Pelvic organ prolapse occurs when the pelvic floor muscles and connective tissue weaken or tear, causing one or more of the organs inside the pelvis to slip from their normal positions and bulge into the vagina. The pelvic organs consist of the uterus, vagina, bowel, and bladder.

I believe that education on this topic is key – if I had known about it earlier, I maybe wouldn’t have felt so broken and alone.

Usually, the muscles and connective tissues in the pelvis support these organs and hold them in place. There are several factors that may cause damage to the pelvic floor, the most common being pregnancy and childbirth. Pregnancy and vaginal delivery can damage the pelvic muscles and nerves, allowing pelvic organs to descend. This can occur more commonly in women who have delivered a large baby, have required forceps during delivery, or have had many babies. Symptoms of prolapse resulting from this damage to the pelvic tissues can occur shortly after pregnancy but often take many years to develop.

I was four weeks postpartum from a vaginal delivery of my 9lb 8oz daughter when I realized something was wrong. For me, the first symptom was a bulge-like feeling in my vagina; similar to when a tampon is not inserted correctly. What followed was a long journey of research, doctor’s visits, pelvic floor physical therapy, grieving the loss of what I thought early motherhood would be like, and ultimately, surgery two years later.

There are four main types of prolapse:

• Anterior vaginal wall prolapse (cystocele): The front wall of the vagina sags downward or outward, which allows the bladder to drop from its normal position and bulge into the vagina or past the vaginal opening.
• Posterior vaginal wall prolapse (rectocele): The weakened vaginal wall and perineum allow the rectum to bulge into the vagina or past the vaginal opening.
• Uterine Prolapse: Weakening of the supports of the uterus and upper vagina allows the uterus to slide down into the vaginal canal or past the vaginal opening.
• Vaginal Vault Prolapse: Weakening of the upper support of the vagina in a woman who has previously undergone a hysterectomy. This allows the top, or “roof,” of the vagina to descend into the vaginal canal or past the vaginal opening.

In my case, I had a combo of cystocele and uterine prolapse. This condition affected my mental health, relationships, and my ability to be the mom I had always envisioned. I felt robbed of early motherhood as I was constantly in pain and/or thinking about my vagina. I am now passionate about educating others and hopefully getting past some of the stigma around this condition. Because it involves talking about our vaginas, incontinence, painful intercourse, bowel issues and pelvic pain, a lot of women are uncomfortable talking about it; even with their doctors. Many women believe that passing a little urine when they run, jump or sneeze is normal – it’s not! It’s common, but it’s not normal and there is help and relief out there. There are both non-surgical and surgical options available for treatment. These include:

• Pelvic Floor Physical Therapy

Pelvic floor physical therapy helps rehabilitate the muscles of the core, which include the pelvic floor muscles, the abdominal muscles, the back muscles, and the diaphragm, and to optimize their function.

• Pessary Therapy

A pessary is a small device that is inserted into the vagina to mechanically support the pelvic organs above the pelvic floor muscles, eliminating the protrusion of tissue from the vagina. Pessaries carry minimal risk, as long as they are removed and cleaned regularly.

• Surgery for Pelvic Organ Prolapse

Women desiring definitive treatment of pelvic organ prolapse may opt for a minimally invasive surgical repair. There are a few different surgical options, and a woman may benefit from one type of surgery more than another based on her age, prior surgical history, the severity of prolapse, overall health, and personal treatment goals. Your surgeon will help you determine which surgery is best for you.

I believe that education on this topic is key – if I had known about it earlier I maybe wouldn’t have felt so broken and alone. If you are experiencing incontinence, bowel issues, feeling a bulge or protrusion of tissue in your vagina and/or pelvic pain, please talk to your doctor!

I am now just a little over two years out from my surgery and I feel like I got my life back. I can now walk long distances again, chase my daughter on her scooter, and not think about the pain in my vagina every waking hour. My mental health has vastly improved and I am finally the active mom I always wanted to be.

Why I’m a Therapist:

It takes bravery, vulnerability and trust to ask for help and support. My goal is to provide a warm, authentic, compassionate and non-judgmental space where we can work together on your healing and personal growth. I am a therapist largely due to my own experiences with infertility, birth injury/trauma and maternal mental health and feel that my personal journey coupled with my education and training, provide a unique perspective when supporting you through yours. Whether you are struggling to conceive, mourning the loss of a pregnancy, recovering from a traumatic birth, or finding your footing as a new parent, I am here to help.

Education & Training:

I received a Master of Education in Counseling from DePaul University in 2013. I have also completed specialized training with Postpartum Support International and have a certificate in Perinatal Mood and Anxiety Disorders.

Areas of Specialization:

I believe in an individualized approach to therapy and seek to integrate multiple evidence-based approaches (including cognitive behavioral, relational, and mindfulness) into individual treatment. Specialties include infertility, birth trauma and/or injury, grief and loss, and perinatal mood and anxiety disorders. I am LGBTQ+ affirming and inclusive.