Help! I think I have a prolapse!

Have you recently been told by your GP that you have a prolapse? Maybe you have recently noticed a bulge down below when wiping?


A number of my patients have come to see me in a fluster because either their GP has told them they have a prolapse after a pap smear or because they have noticed a vaginal lump and are concerned they may have cancer.

It is not unusual for your GP to notice a prolapse on routine pap smear. After all, 50% of women over 50 years old will have a prolapse of some sort and mild and moderate prolapses (ones that are contained within the vagina) are often asymptomatic!

If I don’t have any symptoms, should I be concerned?

Studies report variable risks of progression and regression of prolapse depending on the type of prolapse you have and its severity. Generally speaking, minor prolapses are more likely to regress and not progress.

One longitudinal study showed that there is 10% risk of progression and 10% chance of regression of any type of prolapse after 1 year. After 5 years, there is 30% chance of it worsening and 17% chance of regression(1).

Despite there being variable data out there about progression and regression rates, the best thing you can do if you know you have a prolapse of any kind is to get it checked by an appropriate health professional. This can either be a gynaecologist or a pelvic floor physio.

Not only can a pelvic floor health specialist help to determine your risks of progressing prolapse, they may be able to help you reduce the prolapse as well.

What sort of things in my lifestyle could make my prolapse worse?

Risk factors that may worsen prolapse include:

  • Ongoing constipation
  • Chronic coughing or sneezing
  • Age
  • Repetitive heavy lifting
  • High impact exercise
  • Increased BMI
  • Childbirth
  • Distended, stretched and weakened pelvic floor muscles


What are my options for treatment?

Depending on the severity of your prolapse, treatment options may include:

  • Lifestyle changes
  • Pelvic floor exercises
  • Pessary (a removable device placed inside the vagina to support the prolapse)
  • Surgery

How can physio help?

A pelvic floor physio can assess the severity of your prolapse and can address other risk factors for ongoing prolapse. This often requires an internal examination as well as specific questioning.

The physio then will develop a program of exercises according to what your body needs. You will then require regular follow up to help progress your exercise program as there is good evidence to show that supervised pelvic floor muscle training over 6 months can symptomatically and anatomically improve prolapse(2).

So if you have concerns about prolapse – book an appointment with our pelvic floor physio now to get the help you need!

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1. Abstract – published in ICS. “Prevalence, incidence, progression and regression of pelvic organ prolapse in a community cohort: results of a 5 year longitudinal study.”

2. Hagen S, Stark D. Conservative prevention and management of pelvic organ prolapse in women. Cochrane Database of Systematic Reviews 2011, Issue 12. Art. No.: CD003882. DOI: 10.1002/14651858.CD003882.pub4


Autoimmune Diseases & Gut Function

There’s been a lot of emerging evidence in the last 10 years or so to show that there may be a connection between gut function, autoimmune disease and even mental health problems.

If you have read the GAPS (Gut and Psychology Syndrome) diet book by Dr Natasha Campbell-McBride, you will have read that a poor gut microbiome can cause and exacerbate symptoms of autism, dyslexia, ADHD, schizophrenia, anxiety and depression.

To learn more about GAPS, please visit:

But what I’d like to explore further today is the connection between gut function and autoimmune disease.

So what is autoimmune disease?

Autoimmune disease is an umbrella term for a group of conditions where the body’s antibodies attack the body’s tissues.

Autoimmune conditions can include the following:

• Rheumatoid Arthritis
• Lupus
• Polymyalgia Rheumatica
• Asthma
• Endometriosis
• Fibromyalgia
• Chronic Fatigue Syndrome
• Sjogren’s syndrome
• Multiple Sclerosis
• Fibromyalgia
• Crohn’s disease
• Hives
• Raynaud’s syndrome
• Type 1 diabetes

How do you contract an autoimmune disease?

The premise of what causes autoimmune diseases to develop include the confluence of 3 factors:

1. Genetic predisposition
2. Exposure to a trigger (eg specific antigen or protein)
3. Intestinal permeability

The majority of orthodox treatment for autoimmune disease involves immune-suppressant drugs and symptomatic management. Unfortunately this does not address any of the causal, driving factors of the autoimmune issue and therefore never fully resolves it.

So how can fixing my gut help with my autoimmune problem?

Considering that intestinal permeability is likely to be one of the driving factors for autoimmune problems, fixing this may help resolve a lot of your symptoms.

Leaky Gut Syndrome is the official term for intestinal permeability problems. It is a disorder where the cells of the intestine become permeable and leak substances into the blood stream that are toxic. LGS seems to be a common denominator for a number of diseases, not just autoimmune problems and is diagnosed with special urine tests and microscopic examination of the gut lining.

How can you develop LGS and what are its symptoms?

LGS can be triggered and caused by GIT infections (fungal overgrowth, parasitic infections), certain drugs, Crohn’s disease, Celiac, Ulcerative Colitis, excess alcohol consumption, strenuous exercise and food allergies.

The symptoms of LGS can include:
• Bloating
• Candida overgrowth
• Constipation
• Ongoing diarrhoea
• Gas

So if I do have LGS, how do I get it treated?

Treatment for LGS includes dietary control, elimination of anti-inflammatories and alcohol, supplementation and probiotic treatment.

If you think you may have LGS symptoms or you are suffering from an autoimmune disease, it is worthwhile seeing a Naturopath who can aid in your diagnosis and treatment.

Visceral Manipulation

What is it?

Our organs are often neglected as a source of problem when having treatment for pain or dysfunction in our bodies.

But it is far too often that they can be a source or contributor to our issues.

Our organs are so tightly packed inside us (particularly in our gut). They interact with one another and are dependent on sliding well across one another to work properly and without pain.

All organs in our body move according to two factors: mobility and motility.

Mobility is the movement of an organ in response to the body’s voluntary movement or to movement of the diaphragm during breathing.

Motility is the inherent motion of the organ itself (how it moves along its own axes).

If there is any fixation that restricts mobility or motility in an organ, this results in functional impairment of that organ and can also impact on how well the rest of our body’s systems work.

For example, if the liver is not moving properly it can effect right shoulder movement and cause pain. If the small intestine is restricted, it can cause lower back pain.

Mobility and motility can be disturbed when the organs have been exposed to surgery, infection or inflammation. It can also be disturbed when herniations are present (e.g. prolapse, hiatus hernia).

Through mobilisation, these organs can be restored to their proper function and can be helped to move according to their proper mobility and motility.

What conditions can visceral manipulation help?

Depending on how experienced your therapist is will depend on what conditions they treat.

Visceral manipulation can generally help with:

• Abdominal bloating, IBS, Crohn’s disease, SIBO, other gut disorders
• Pelvic pain disorders, endometriosis, pelvic congestion syndrome
• Prolapse, incontinence
• Hiatus hernia, stomach ptosis (sunken stomach), GORD
• Some lung and heart conditions

What should I feel during and after the treatment?

A therapist trained in visceral manipulation will assess you for where your visceral restrictions lie. 

During assessment, the therapist will do a general listen of the body by placing their hand on your head, which will guide them as to where your biggest issue is. They will then do a local listening placing their hand on the effected part of the body.

Once they find the implicated organ they need to work on, they will work at reducing the restriction and improving the movement of that organ by performing gentle and precise movements with their hands.

Occasionally the therapist will use your body movements to help improve the stretching and movement of the organs as well.

What should I expect from treatment?

Occasionally after the first session, there is a hyperreaction to the treatment as the body is having difficulty adapting to the new stimulus.

However, most times depending on what organ is treated, it can reduce pain and bloating, improve gut mobility, reduce reflux symptoms and create a feeling of general wellbeing.

How many treatments do I need?

Depending on the severity of your issue and response to treatment, sometimes it may take 1 or 2 treatments to see changes, sometimes several.

If you think you would benefit from visceral manipulation, book in with Rachel here:

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