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Pelvic Organ Prolapse - The Hidden Medical Epidemic

September 2nd 2021 | Written by Rhea Kumar (She/Her)

Some women call it “the bulge” (no, not that bulge), to describe the discomfort of living with pelvic organ prolapse. Pelvic organ prolapse (POP) occurs when the tissue and muscles of the pelvic floor no longer support the pelvic organs resulting in the drop (prolapse) of the pelvic organs from their normal position

The vagina is composed of three compartments of support: the front (anterior), top (apical) and back (posterior).

Normally, the pelvic organs, such as the bladder, uterus, vagina and rectum are all held together by the tissues and muscles of the pelvic floor. However, when someone suffers with pelvic organ prolapse (POP), the vaginal wall protrudes through or toward the vaginal opening. 

According to the Columbia Department of Urology, in some cases, POP can range from a small, asymptomatic bulge to a bulge outside the opening of the vagina.

What Are Some Common Symptoms of POP? 

  • Heaviness or pressure in the pelvis
  • Pain in the lower back or abdomen
  • Frequent bladder infections
  • Constipation
  • Urination problems
  • Increased discharge from vagina 
  • The feeling of “sitting on a ball”

Some symptoms can worsen when you stand or walk for long periods of time. Why? Because gravity adds pressure on the pelvic muscles. 

Who Does POP Affect?

Individuals of all ages can be affected by POP. However, it is more common in older individuals who have given birth or with individuals who have had surgery done - both factors can result in a weakening of the pelvic organ muscles. Difficult childbirths and giving birth to multiple babies may also increase one’s chance of developing POP. 

However, as stated, younger individuals can also develop POP. You can be at risk if you have had chronic lung disease (chronic coughing), connective tissue issues such as lupus or rheumatoid arthritis, are overweight or have been obese from a young age and persistent constipation that has caused you to strain to pass a bowel movement. 

What can you do if you think you have POP? 

Doctors treat POP with four basic approaches:

  1. Observation:
    Vaginal prolapse is rarely life-threatening, so observation in women without obvious  symptoms is touted as a good option. Because the condition does gradually worsen, doctors recommend periodic follow-up exams.

  2. Nonsurgical management:
    Pelvic floor muscle training (Kegel exercises) can tighten the muscles of the pelvic floor, and can be helpful for women with mild prolapse. *Please note: Never attempt nonsurgical management without the consultation of a medical professional.

  3. A Pessary: 
    An internal support device that women can insert to hold the organs in place.

  4. Surgery: 
    Using the patient’s own tissue or a mesh to lift and repair the fallen organs (⅔ of pelvic for surgeries performed in the U.S. are for treatment of POP) .

For less serious cases, physical therapy can also help reduce symptoms.

Though POP has yet to crack the surface of mainstream attention like other reproductive issues such as PCOS or endometriosis, it’s slowly getting the popular recognition that it undoubtedly deserves.