Kegelmaster and Rectocele

Davi, I do sympathise with your discouragement and your efforts to work out WHY your bulges seem to be getting bigger. Yesterday for me things seemed to be going well, and today all day my rectocele is bulging more, regardless of whether I have just emptied my bowels. Of course I am casting about for explanations, but I'm beginning to think that maybe nothing I have done or not done has actually made the difference, and if this state continues or, heaven forbid, gets worse, maybe that was just going to happen due to time and age acting on my underlying weaknesses (genetic and acquired).

I'm not saying at all that posture and diet etc aren't vitally important. Just that our current actions do not control our health 100%. Personally, I can't see how ordinary unassisted kegels could possibly make pop worse. I am hoping soon to be referred to see a physio specialising in these conditions - it will be interesting to hear her suggestions. Meanwhile, I hope tomorrow will be a better day for us both!

Hi Davi,

I think you’ll be able to answer your own question with a few anatomy clues.

When you put a tube-shaped object in the vagina, it effectively holds back the vaginal walls. However, when you “kegel” against such a device you are still pulling pelvic fascial layers as you tighten the sphincters. Through all the years of kegeling there still is no evidence that prolapse has ever been improved by this means, which your own experience validates. Is the potential for the development of prolapse increased in this way? We really don’t know.

However, we have a great deal of our own evidence that the mature vagina settles out with a bulge in front, a bulge in back, and the cervix above. This makes sense because in normal standing anatomy the front vaginal wall presses against the back vaginal wall to form a closed, airless space. With rectocele or cystocele, the vagina is being held open slightly by the bulge so that it is no longer protected against the forces of intraabdominal pressure. The organ that gets pushed into that open space by internal pressure is the one that is behind the wall opposite of the existing prolapse. It is almost a foregone conclusion that women with rectocele eventually develop cystocele and vis-versa. I have a great quote in STWW by a famous pelvic surgeon who says he has never seen prolapse contained to any single “compartment”.

The good news is that many women with this very common presentation of prolapse go on to improve to the point that they are virtually asymptomatic. The most frequent sentiment we hear in the ‘improved’ category is “I still have prolapse, but my symptoms are so mild that I hardly think of it anymore.” I can only hope for you this same outcome. Prolapse develops slowly and it is an equally slow process to stabilization/reversal.

Wishing you well,

Christine

Hi Davi and Alix

Nobody ever said that WW techniques would manage prolapse 100%. Yes, I think our collective history is showing that there is a settling out and the result that all our prlvic organs will eventually lie close to the entrance to the vagina some of the time. Everything else in the body settles in time. For me, close to menopause, that's OK. For younger women, who have bodies that still defy gravity, I know that acceptance of this is a big hurdle.

What we can do with WW techniques is to create an optimum environment for our pelvic organs by leaving room for them out front in the lower abdomen; keep the bowel moving and its contents soft; feed our bodies well; allowing the pelvic organs to rest on the pubic bone, instead of suspending them over the void; emptying the bladder completely on a regular basis; clothing our bodies to allow the lower abdomen to expand and move unrestricted; learn to use our bodies in a way that does not exacerbate POP or strain fascia further; learn not to be superwoman; learn alternative ways to exercise that do not put strain on the pelvic floor, and strengthen the internal musculature so that we *can* use our whole bodies in everyday life, organise our physical environment and behaviour so that we allow the organs to stay in optimum positions as much as possible, etc.

We also need to do the head work and heart work that builds the trust in our bodies' ability to respond to this support. We make a deal with the body. "I will look after you as best I can, and you will respond by behaving yourself. I will forgive myself and my pelvic organs' occasional bad behaviour. I will accept that you will never be virginal again, and I accept that you will carry these organs closer to the precipice than when I was younger, but that you organs down there will never leave my body."

After that, it is just doing the work every day to enable that to happen. Attitude is everything if you want to stay Whole, and if you cannot maintain an attitude of healing and acceptance, then more head and heart work is necessary to reach that peace, and get on with your life.

Every mind, body and spirit is different. Comparing ourselves to each other can be very frustrating. Wanting 100% health is probably unrealistic, except fleetingly. Reaching a point where we can say, "This is 'good enough'. If it gets better than this I will be over the moon", is very satisfying.

The other alternative is to chuck in the towel and walk through that Surgery Door into irreversible uncertainty. We all face this choice every day, and will for the rest of our lives.

Pep talk over!

Louise

Yes, Jacqui, estrogen is lowest at day one (menstruation) of the menstrual cycle. Check out this link:

http://lichensclerosisanswers.com/download/lichen_sclerosis_new_hope.pdf

for a primer on the menstrual cycle, but also for a clue about what else may be causing the irritation. There is a continuum of vulva issues, from mild to severe, and it’s important that all women realize how common these conditions are. After hysterectomy women are much more prone to high levels of LH than problems with cyclical estrogen.

Thank you for your honesty of expression regarding youth and loss. I agree, 40+ was the best! Your heartfelt words about your dd struck a deep chord with me and I hope I can share something and have it be okay. My thoughts have absolutely nothing to do with you personally, but are merely reflections of my own knowledge and experience.

Our oldest fairy tales warn of the dangers of women not being willing or able to surrender the powers of beauty and youth. As you say, our culture does nothing to help women accept change, but rather fans the flames of jealously and narcissism that are so endemic in our time. Daughters need more than anything for their mothers to be friends. Not ‘girlfriends’, but mothers who are selfless enough to be able to stand outside themselves to really see and care about their daughters well-being.

Without this bond of trust and love, girls are at a huge disadvantage. Personal power equates with a healthy sense of self and the mother-daughter relationship is at the core of that process. It’s the greatest treachery to have a mother who, instead of celebrating her daughter’s beauty and exuberance, harbors jealousy and duplicity. Of course there is a huge spectrum of such feelings, a certain amount of which can probably be considered “normal”. The problem is, very little stands in the way between a wounded daughter and a patriarchal culture that is economically driven to “cure”, “protect”, “improve”, and “perfect” her.

I’m quite certain a line can be drawn between the wounded daughter > menstrual difficulties > hysterectomy. This is not the only path to hysterectomy, but the most tragic one, and the antidote is stronger bonds between females, especially mothers and daughters.

I dedicate this post to the beauty, grace and strength of our daughters. May they change the world!

Christine

Great to hear that your dd is walking tall too! Helping girls return to their native form is a great gift - good work, mum!

Hi Louise,
While looking through posts I found your pep talk from 2009. Really needed that today.

Thank You
Heavenly

:-)