cytocele and using tampons and Pilates

I've used an olive oil lubed tampon for two years with wonderful success. I feel normal most of the time. You must use it lying down and you must aim it towards the rear.

The best help is doing core work constantly. We can never put back the tissues, but we can strengthen the muscles in our "gut" to accomodate the sagging. When you tighten the core of the body, everything works better.

By developing core strength, Christine's posture is a no brainer.

Judy

Hi theteach,

The “natural history” of prolapse is not fully understood, but there are some definite truths that have been identified by practitioners for over a century. One is that - generally speaking - the worse a woman’s cystocele becomes, the less she is bothered by stress urinary incontinence. This is simply because the bladder is bending backward, and in doing so clamps off the urethra. Consequently, she has to learn to wee leaning forward in order to open her urethra and completely empty her bladder. In a younger woman (you don’t give your age, but I mean in a woman with normal anatomy), the pubococcygeous muscle acts as that same clamping device to keep urine inside the bladder until you want it to go out. With a slight cystocele the muscles are held open and therefore do not clamp as effectively. Our work is to find a good balance with either the normal muscular clamp (which you strengthened with PT), or the flopped over clamp. Once the perfect muscle clamp is compromised, it is life-long work to maintain a good alternative balance. That alternative is slightly bulgy front and back vaginal walls that support the urethra and bladder in a somewhat natural configuration, preventing both incontinence and urinary retention.

Each woman needs to experiment with what reduces symptoms and what exacerbates prolapse. Judy has just given her take on what she finds most helpful. However, I take issue with “doing core work constantly”, because it is an unnatural response to a more-or-less natural condition. I have no doubt that PTs and yoga teachers really do get results with some percentage of their prolapsed clientele who are willing to suck it all up with tremendous time and effort. I believe the other option that WW has identified: some movement (great amount of individual variation) of the organs forward, no tampons, and acceptance of prolapse as an inevitable part of birthing and aging in Western society, is available to a far greater number of women. We should be able to “fix” prolapse by doing something easy and natural, like sticking our stomachs Out rather than sucking them In...and the Whole Woman work has proven that we can do just that. We will be talking a lot more about the core in the coming days and weeks.

Yes, there is a definite sucking in sensation with the firebreathing - but results take time as we are remodeling pelvic fascia - a very slow and imperfect process.

Christine

...and I must clarify that we are not flopping our lower bellies out, but allowing our chest to expand naturally, which inflates the upper abdomen. You can see this on any young child - as it is the natural human form.

These exercises are fine. Just make sure you are doing them in natural female posture so that they are helping to move the organs toward their normal positions. We try to avoid a lot of heavy navel-to-spine work.

These exercises are a little more creative, but do you see how they reflect a paradigm that the organs need to be pulled up to sit above a horizontal pelvic floor? Without the framework that the organs actually need to be moved forward and away from a vertical pelvic wall, the exercises are simply fancy kegels.

Ah, the cystocele, with its accompanying bouts of urinary incontinence. Mine gave me the experience of arising from seated posture to find I had "leaked" slightly, with no warning sensation. I believe my bladder eventually fell further just enough that I no longer experience the incontinence.

Sports tampons helped me for quite a while. I used Bliss Balm as a lubricant. I'm using a silicone ring-with-support pessary now, which I take out at night. I have also begun using the "Roll for Control" exercises developed by PT Janet Hulme. One thing I like is that they are done on a wedge which puts hips up and works against gravity. It's too soon to say whether they help. However, my PT used some of those exercises to help me with the incontinence issues. (Some involved elastic bands.) Who knows what helped the most?

Walking seems to be all around beneficial. That motion helps to keep the vertebral disks supple. I think we were made to walk, and most of us sit too much. Also, walking puts our spines in the extension position, which helps to counter the flexion position of sitting, slouching, etc. Keep walking and finding out which other exercises help. It sounds like you have a good PT.

Best wishes,
Saddleup

Hi theteach,

Two points.

Remember that the function of the vagina is to let things out, babies, menses, foreign bodies, penises, etc. It is not an organ which is inherently meant to hold things in, eg tampons. The cervix holds babies in, and the pelvic cradles the uterus while it grows the baby. The squishiness and the ease with which the vagina accommodates foreign objects is one of its characteristics, but we are still expecting a lot of it when there is a bladder, uterus or rectum impinging on it, and changing its shape. I do hope you find a way to trick it into holding the tampon. You could also try a sea sponge or a medical pessary.

We have discussed this before, but I wish there was a little, soft, squishy, flat, perhaps saline-filled sac, a bit like a small breast implant, that women could try as a pessary; something about the same density as human tissue. I think you can get little things like this for slipping inside a bra, kind of like an external breast enhancer. Chicken fillets?

Anyone ever tried one in the vagina? A bit weird, I know, but POP is a pretty weird thing to have anyway! ;-)

Christine's comment about the exercises with a Theraband being just fancy Kegals is probably true, but is there any harm in that? One of the challenges of anyone designing exercises is that people get bored very easily. That's why there is always a new exercise program happening down at the local gym.

Go for it. Hope you get some benefit.

Louise

Sorry...but I couldn't resist.

Saddleup, I am sorry you have not been able to keep riding without it worsening your symptoms. I continue to hold out hope that you will prevail.

Stay tuned.

Christine

Christine:

For some reason, I just found your reply today. If you think doing the Hulme exercises will harm me with respect to POPs, please tell me your perspective. I like the anti-gravity aspect of doing exercises on the wedge. I've no idea whether or not they will actually help. Thank you.

Saddleup

Hello theteach,

No question that older women see less reversal for all the reasons you mention. But if our tissues are well nourished, I think we see just as much stabilization - over time.

The “falling” is quite the puzzle, isn’t it? From my perspective, the organs are pushed into the vagina by internal pressures raised each time we take a breath. In normal anatomy, the organs are pushed out in front of the pubic bones, but because of structural changes due to the ways we sit and stand, they begin to be pushed toward the back. Fascia and vaginal wall tissue have no real strength and lose the battle fairly early on. However, when we change the direction of the flow of intraabdominal pressure, our pelvic interior begins to move toward a more normal anatomy. Some younger women experience positive change almost immediately and this is how we know we are on the right track.

Once the bladder is all the way back to the vaginal opening, it is difficult to mend the stretched fascia. However, I think you can hear a chorus of women saying “keep trying”. It may take years to see results.

To tampon or not to tampon, that is the question. I think we have to use all our resouces and the tampon/pessary/sponge is one of them. I am far better off without any, but would certainly try to wear one if I had severe cystocele/rectocele. But I would wear it as I continued to consciously pull my organs forward with all of my movement throughout the day. It is a special and beautiful kind of dance.

I hope we hear from our dear member Flora, soon. She is one of our elders and an inspiration to all of us struggling on the other side of menopause.

Wishing you well,

Christine

P.S. I am so curious whether your bladder fell further back as a result of kegels and the reason why your urinary incontinence has improved!

Saddleup...I wrote my last blog just for you! Did you see it in the Village Post?

I am so trying to get women to experience natural pelvic organ support for themselves. It is a steep hill - lol.

((((hugs))))

Christine