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 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 physiotherapy. 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 sorts of things in my lifestyle could make my prolapse worse?
Risk factors that may worsen prolapse include:
- Ongoing constipation
- Chronic coughing or sneezing
- Repetitive heavy lifting
- High impact exercise
- Increased BMI
- 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)
How can physiotherapy 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