Menopause & Pelvic Organ Prolapse
Menopause often brings changes in a woman’s pelvic floor function.
The pelvic floor muscles can be weak, overstretched, slow to work, too tight or torn just like the other muscles of your body.
When the pelvic floor weakens it can lead to pelvic organ prolapse, where one or more organs of the pelvic area drop out of place. (bladder, uterus, urethra, vagina, small bowel, or rectum)
Causes of menopausal pelvic organ prolapse
While there are many causes of pelvic organ prolapse (heavy lifting, vaginal birth, hysterectomy), the lack of estrogen during menopause thins the supporting structures holding pelvic organs in place, causing them to fall.
Initially, prolapse can happen with stress from vaginal childbirth and later in life with menopause there can be further thinning of the tissues. When the tissues supporting the pelvic organs are thin or damaged, the organs they support may drop down and press against the wall of the vagina. This causes a bulge in the vagina that will sometimes protrude through the vagina opening.
What Does Pelvic Organ Prolapse Look Like?
The lack of vaginal moisture associated with menopause can also cause problems with sexual function. The vaginal tissue becomes frail and less supple and stretching from intercourse can be very irritating or even painful at times.
Symptoms of menopausal pelvic organ prolapse
Symptoms can range from minor pain and difficulty urinating to emotional distress. Unlike other symptoms of menopause, such as hot flashes, pelvic organ prolapse symptoms can increase with age. Other Symptoms of pelvic organ prolapse include:
• Pain or a feeling of pressure in the pelvis or vagina
• Feeling that something is coming out of your vagina
• Tissue protruding from the vagina (bleeding or tenderness)
• Difficulty urinating or a feeling that the bladder will not empty
• Bowel movement difficulty
• Lower back pain
• Urinary incontinence (urine leakage during sneezing, coughing or exertion)
• Frequent bladder infections
• Painful sexual intercourse (dyspareunia)
Treatments for menopausal pelvic organ prolapse
Since the reduction in estrogen is the main cause of menopausal pelvic organ prolapse, hormone therapy (HT) can help restore the vagina to premenopausal condition and may help to strengthen the vaginal structures supporting the pelvic floor. If your prolapse conditions are advanced, your doctor may prescribe a pessary. A pessary is a device that, when placed into the vagina, holds varying organs in place. There are many different sizes and shapes, and it may take a few tries to find the right one, but once you do, it can allow the muscles to function better and provide relief from the discomfort of prolapse.
In severe cases, surgery may be necessary. If you are considering surgery as an option, you may find my Pelvic Surgery Success Program beneficial. You will learn from me as well as Doctors, Pelvic Health Physical Therapists and Nurse Continence Advisors. You will also learn from others who have had surgery and what they wish they had known, done differently and what advice they want to share.
The Buff Muff App will teach you how to activate your pelvic floor appropriately and then add it to movement. There is a ton of free content available to anyone who downloads the app including a 7-day pelvic floor fitness challenge to introduce you to the concept of a whole-body fitness approach to pelvic health.