sea sponges, exercise, vaginal walls

Submitted by Judith on September 13, 2009 - 7:24am
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The question of using sea sponges or other pessaries during exercise has come up before but I was wondering whether any one could answer a more specific question. If there is a rectocele and/or cystocele, do you think there is any risk that using a sea sponge, both for exercising and generally, may make uterine prolapse more likely because the vaginal walls are more open? I can see how that would be the case with a sphere. Thanks. Judith

louiseds

September 13, 2009 - 8:42am

Hi Judith

I guess it could make POP more likely, but I think you might have meant "could make worsening of POP more likely"??

Yes, the vagina is designed to be flat and relaxed, not open and stretched sideways. I would rather not use either.However, we don't really know what a sponge does when it is inside the vagina. How open is it?

L

Judith

September 13, 2009 - 10:34am

Hi Louise, thanks for replying. What I meant was: if there is already rectocele and/or cystocele, but no uterine prolapse, would using a sponge make it more possible for uterine prolapse to develop also, because of keeping the vaginal walls open. I don't know how much difference there is in practice between a sphere and the sponge. The sponge is obviously soft and squidgy and seems to mould itself around what's there, but it nevertheless must act similarly to a tampon in holding the vaginal walls apart, although less than a sphere would.

I'm not actually needing to use the sponge now but I have been recommending it to other women because I found it quite psychologically comforting and I was just wondering whether the recommendation should come with a warning as well. Someone did ask specifically about using it during exercise. Thanks Judith

louiseds

September 13, 2009 - 10:18pm

Hi Judith

I don't really think there is enough understanding out there in gyn land about the mode of action of pessaries and other pessary-like devices. That's why there are so many different types. A bit like repair surgeries; if one doesn't work they invent another that they think will be the definitive answer. All I have ever seen is an acknowledgement that the vagina is normally pressed flat. I have never seen a comment that it is OK to distend it with a pessary, though that is what they do. Many 'two dimensional' pessaries will flip through 90 degrees so they are flat in the same plane as the vagina. This is followed by a statment that the woman has positioned it incorrectly, not that the pessary has assumed its 'best fit' orientation all by itself. This is the main reason I stopped using one. As soon as it flipped it would make its way towards the vaginal entrance. Not much use in that!

As for the sea sponge, I think I had better leave commenting on that to women who have used it.

My suspicion is that, where there is cystocele and rectocele, it is likely that the uterus will also prolapse eventually (Christine has said this numerous times), the cervix pulled down by the anterior vaginal wall with the body of the uterus following, which is what happened to me. Nature's pessary had arrived! When it happened, life quite quickly became more comfortable, even if it was a bit unnerving. There were now three organs, instead of only two, blocking the plughole. I really have found uterine prolapse to be the least alarming of all of them. Of course, by the time my uterus prolapsed, I was used to the cystocele and rectocele sitting there, and I knew they were not coming any further, so I was relatively confident that the descent of my uterus was not a big deal. It had been slowly descending anyway. I certainly wouldn't have gone back to using a pessary of any sort to try and hold it back. I was not confident that it would make any positive difference at all after the unsatisfactory pessary experience I had 15 years ago when my POP's were considerably less, and I stopped using the pessary because I became more worried about the pessary falling out than I was about my organs falling out!

Actually, by the time my uterus descended it was shrinking in perimenopause anyway, and it is probably about the size of a colpexin sphere now, but positioned optimally, probably hanging off the end of my vagina like a little, forward-leaning counterweight, not positioned halfway down the inside of my vagina with nothing holding it there but the tone of my menopausal vaginal walls.

I would really like to see a vertical MRI of my menopausal pelvic region in Wholewoman posture. It certainly would help to visualise how and why my organs are held away from my vaginal entrance without the help of any pessaries or tape or mesh.

Cheers

Louise

Judith

September 14, 2009 - 1:54am

Thank you Louise for that detailed reply and for sharing your own experience so clearly, it's really interesting and helpful. It actually answered a question that I had from one of Christine's old posts about the shrinking uterus, whether she was saying that it's a good or bad thing. It's certainly very reassuring to have a positive spin on it all, thank you. I hope especially that it gives hope to the younger women on here that it isn't downhill all the way, so to speak.

When women do end up with organs outside the body, is that quite rare, is it due to incorrect posture etc? I remember another old post, may even have been one of yours, not sure, referring to an elderly woman who probably did have what I presume is 4th stage.

Re the sponge as opposed to other pessaries, it is the one that seems to have the most popular support on here, although some women find it drying and irritating. When I was using it I didn't do so during exercise so I don't know what effect it has then. Certainly I found it very comforting when going out for the day, just to overcome the irrational fear that everything might drop out on the pavement. I would be very interested to hear about other people's experiences. Thanks again, Judith

louiseds

September 15, 2009 - 1:47am

Hi Judith

Yes, I did post about the elderly woman. I think it is quite rare, but from reading the stories about the women in Nepal I can see how it could just as easily happen in first world countries.

Just because you and I are affluent enough to have electricity, a computer and literacy skills doesn't mean that there are no women outside, even in our street, who have poor postnatal care, incorrect information and the little or no physical help when they get home from hospital with a new baby and are left to run a household, maybe a business, maybe do heavy work in manual labour. We all know that there are many factors that conspire to produce POP. If you draw the short straw in enough of these factors in the absence of good health care, for long enough, I can see how it could happen. Next time you are in a shopping centre (mall) on pension day cast your eyes around at the women around you and imagine what some of them have to deal with on a day to day basis.

Any woman who is downtrodden, whether by poverty, domestic violence, mental health problems, doormat mentality, self-abuse, lack of a caring community or sheer exhaustion, will eventually wear that state in her posture. You know the posture I am talking about, the posture of defeat. Head forward and down, shoulders hunched, maybe to protect her children, maybe from needless shame; butt tucked under for self-protection.

I don't think poor posture by itself can be said to cause POP. IMO it is a major contributor where there are other contributing factors like constipation and poor postnatal care, but Wholewoman posture certainly has the opposite effect on POP symptoms in many, many women.

It will be interesting to hear from women who do have serious POP.

Louise

Judith

September 15, 2009 - 3:44am

Thanks for the reply, thought provoking and so true - poverty, deprivation and general oppression are responsible for so much misery and ill health. We are indeed the lucky ones to be able to take some control of our own lives. Judith