Prolapse and Menopause?

Good question, Sue, and I surely don't have the answer because we do not yet have a cohort of women who have gone from pre to post-menopause with prolapse.

I believe, however, that a lot depends on the woman, her state of health, activity, whether or not she is practicing the posture :-) etc. The uterus definitely shrinks with estrogen withdrawal as do the vagina and surrounding structures. Would this cause an increasing or decreasing of prolapse symptoms?

My feeling is that there is probably some kind of inverse ratio at work i.e., an increase in natural shrinkage with corresponding decrease in tissue strength and elasticity due to the aging process. Is artificial estrogen plumping up our aging tissues the answer? I don

I am "perimenopause", or I guess, in the few years before. My prolapse is at the introitus, or was, last month. My doctor tells me that with menopause prolapse gets worse as the tissues weaken, and he said nothing about the uterus shrinking. I have read the same thing in doing online research. But Christine makes a good point; is there a good study group from which they draw this conclusion? I have seen no actual research. And I now strongly suspect that this is anecdotal, mythical, and an assumption. Doctors also used to always tell us that we needed our tonsils removed and we know now that was not true. There are innumerable things they tell us that turns out wrong. Oh, I am sure the DOCTOR believes it! But if he tells all women this, and then operates on them, how does HE know it is true? I am a little resentful that my doctor neglected to mention the drawing up effect of uterine shrinkage.

I have discovered a curious effect of wearing the pessary this past month. I had to remove it this week for my period, and my organs have stayed partially up. I am MUCH less prolapsed, and remain more comfortable, than I was before I ever wore the pessary. Now, you must understand that immediately upon removing it I began to wear super plus size tampons. I believe the tampon is acting to block the re-descent of the uterus. I am also practicing a little posture change, but not a whole lot. I still slouch quite a bit. But I have changed my clothing completely; bought a bunch of overalls and never wear anything constricting my waist anymore, and am paying much better attention to not straining at stool. All of this stuff seems to have effected a change in preventing the uncomfortable bulge at the opening, and the tampon has been absorbing much better, as now it is actually under the cervix, whereas before I seemed to be sliding the tampon in ALONGSIDE the uterus instead of under it. Bottom line... putting everything back up in place with the pessary seems to have made it all WANT to stay up there. Now, I suffer NO illusion that it will all stay up permanently; I've no doubt it would all slip back down given a short amount of time, if I leave everything out of there. But I DO think it means there is a possibility I can arrest further worsening of the condition. If I physically prevent things from stretching farther lower, I think perhaps I can prevent the uterus from ever exiting the vagina. That is my hope anyway. :-)

Anneh

Hi
I have gone from pre to meno with a sag and never had a period with my "os" outside my body.
It came out with the arrival of meonpause (last period).
I am hoping this is a stage and as shrinkage occurs it will help.
Cathy

Hi Anne,

Just like so many other really helpful and useful studies that COULD be conducted on prolapse, I know of none that look at the positive effects of estrogen decline on the prolapsed uterus. Instead, looking through the lists of recent studies in the library makes me want to tear my hair out:

I am wondering if it might be possible to approach universities with a strong interest in women's health, particularly physiotherapy area and suggest it as a research project. They will know what funding is available for treatments that
1. keep women out of expensive hospital beds and
2. away from the health problems that anaesthetics, surgery and hospitals can cause
3. reduce the insurance risk for doctors because of surgery they do not perform
4 challenge the existing mythology

Assume nothing. Maybe nobody has ever suggested challenging the 'reality' that the cervix will drop after menopause.

Cheers

Update: I visited my gynecologist today to check the pessary, and he was very pleased that I am having such a positive experience with it. And... after my complaining on this board about him not mentioning that the uterus can shrink up, he actually mentioned that sometimes the uterus shrinks back up a bit when you are very old. (I hope it isn't because he's been reading this board and figured out who I am!!) He mentioned a lady in her 80s who had worn a pessary for years, but because of recent shrinkage no longer needed to. Then he hastened to tell me that I should not expect anything like that to occur to me any time soon. But he is happy to let me go with the pessary as long as I want. I agree... I am not expecting the uterus to shrink back up, and I won't be surprised if it continues to descend, but right now the pessary has me comfortable, and even when it isn't in, things seem more "inside" than they have been in a long time.

In the meantime, I'm still going to keep up with the latest surgical solutions... and probably continue to be horrified by them. I rather doubt I will EVER allow myself to go under the knife. I hate to disappoint my poor gyno... but I'm just too chicken. Reading the post-operative regrets and complications on other boards has me way too freaked out. Nerve destruction so you have to self-cath to urinate for the rest of your life, erosion of mesh through the vaginal wall, pain, pain, pain, busted stitches, bleeding, vaginal vault eversion etc. etc.... why in the world would I buy into that route when I can just keep stuff pushed back up there with this doughnut??????

Anneh