Informal Survey

Body: 

Well, I just met up with some friends from my high school days. All of us are in our mid-fifties. An extended conversation with three of them produced the following data. Of the four of us, three had undergone hysterectomies. One was for uterine cancer, one was for a severe case of fibroids, and one was because of prolapse. Of these three ladies, two of them later had bladder suspensions (TVT slings, from what I gathered) due to severe urinary incontinence. At two years post-op, they were both extremely pleased with their bladder suspensions, as they no longer suffer from incontinence.

So then there's me....prolapsed, but still in possession of my organs. It's amazing how common this problem is, and how virtually no one talks about it. If one took a real survey of a group of women in their mid-fifties, I wonder what percentage of them would say that they either currently experience prolapse or have had pelvic organs removed or altered because of it. My guess is that it's 50% or greater. What do you think?

Saddleup

...and there is no doubt...we are infinitely better off without extirpating surgery. It is true these continence procedures cure you Forever! But...at what cost?

My Grandmother is in her 90s- she had 4 boys when she was in her late 20s and early 30s. About 5 years ago when she was in her late 80s she had her uterus removed. She was having big problems with bleeding, low iron, and major discomfort. Her recovery was beautiful and she has had no problems.

Now think about it.....this woman, my grandmother did not wake up one morning with prolapse. It doesn't work that way. And she certainly didn't develop it in her later years while she was home (no job, no children, no heavy lifting), with hired help for everything from grocery shopping to trash removal.
No, I'm sure her prolapse developed slowly over the years, starting about the time she first became pregnant with her first son.
I guarantee that every woman has some from of vaginal laxity, it's a given- we all have wrinkles, we all sag, it's just the way it presents in each persons body that makes the difference. Well, that and the individual tolerance levels of each person.
I have a friend who pees herself all the time. She thinks it's funny. It really does not bother her- and she is totally open about it- saying things like 'don't make me laugh so hard, I'm gonna pee myself' and telling stories about being out somewhere and trying very hard not to sneeze. She takes care of small children and when they pee their pants she just tells them 'oh it's ok, let's clean you up, I have accidents sometimes too'
If I had her symptoms, I would be miserable. I don't have a tolerance for it and I don't have her sunny disposition either.
The same is true for pain. Sometimes prolapse causes people to feel pain. How much pain one person can endure peacefully is totally individual.
Some women are very aware of their body and some women are not. I have asked my mom to do the self exam, she tried but admitted that she has no idea what is what, she just can't wrap her brain around it. She doesn't think she has prolapse but has had symptoms in the past. I remember as a kid when she had her period she would not want to be on her feet in the kitchen. She said I would understand someday, but that for now, she just needed to get in bed because it made her ache to be on her feet.
So, ya, long story short, every single mom I have talked to in my group of friends has symptoms of prolapse. Many have openly discussed their bulges with me. But we are talking 100%.
What we are left with is what to do about it, how to minimize symptoms and how to continue living as we like. At some point for some women this becomes too hard, it gets worse, symptoms increase (for my mom- right before she stopped having periods all together- she started getting frequent infections and started leaking urine- she took detrol for a bit, then weaned off it and had no more problems) and they go looking for a cure.
A cure for a condition that unknown to them, had been developing for decades.
This is where wholewoman comes in. I feel so blessed to be practicing these techniques now. My symptoms are pretty much not there. If I was not an aware woman I wouldn't know I had prolapse (and no one has ever said one word to me during a vaginal exam). Now I can practice ww techniques for the rest of my life and avoid the shock that many women deal with later in life.
You are not alone, but it's something like belonging to a secret club, in order to be a member you must admit you have the qualifications and most people simply don't want to admit it.

Given how common POP is among adult women, you'd think that health care practitioners might want to educate their patients about the issue and teach them ways of preventing or minimizing the damage. To state the oft-repeated observation, the medical profession seems not to be all that invested in prevention.

It is really revealing, Alemama, that ALL the women in your circle have POP symptoms! And, as for my friends with the bladder suspensions, they know that they may need them re-done in several years, and they are content with that. Their incontinence got so bad that they could soak their clothes while just walking down the street. Our tissues don't get more elastic with age, though, and that's all there is to work with for repeated interventions.

Yes, it is quite the sisterhood. Slowly, the topic is coming out into the open, but a little preventative education could go a long way.

Alemama, the story about your mom when you were a kid resonates with me. I can remember when my kids were little there were a few times when I had to do the retiring to bed thing on day two of a period, after I had been on my feet for a long time (retroverted uterus, concrete floor, being a woman and all that). There weren't any grownups around to help so I just had to tough it out, or have dinner on the table later than normal. I was pretty adept at letting housework slide too. A day or two wouldn't matter. I just figured it was normal, but now I can see that it was normal but it was a sign of organs being out of place.

Then it became normal again, possibly after all the little kids lifting and carrying stage was over. Then it got worse again in perimenopause, with other symptoms, until my periods started lightening and coming less often. Menopause put a full stop to the story about painfully heavy periods and that dragging feeling.

I had no idea what went on in my vagina until I started doing Natural Family Planning when my final baby was born, but even then I was very cervix focussed. I didn't even get to know my clitoris well until my late forties. I had no idea what my anterior or posterior vaginal walls felt like. I had not explored my vulva at all, in spite of having two natural (hospital) births.

I just don't even think having a feel around is on most women's radar. They have no desire to get to know their genitals because they don't see any advantage in it. It is like 'down there' is all blurry, with folds and holes and places where liquid comes out. The doctor and my husband are the only people who take a peek down there, and probably with their eyes closed. It is an icky place associated with pain and mess, and leaking and some carnal pleasure if you get lucky. It is dirty, with harmful germs. It has a smell. It is the forbidden place. It is not a friendly place. It is associated with shame. Pudenda means 'shameful place'.

There is a whole branch of consumer industry devoted to denying the pudendum having a life of its own. We collect and discard its discharges in throw-away pads and hidden tampons. We use throw-away pads in our knickers to pretend that we don't leak urine and normal vaginal discharges, and so we don't have to touch these discharges, depsite thae fact that we happilyl share them with our sexual partners. There are all sorts of products to 'protect' us from menstruation, and to ensure that the pudenda's smell is covered up and denied. Hygiene is the word. It is not very helpful for women to nurture their reproductive and sexual centre.

Why would women challenge those perceptions? I think most would prefer blissful ignorance. So most women probably have a degree of prolapse but just think of it as what happens when you get older, not as a medical condition, like wrinkles. No, many women reach for the scalpel in response to wrinkles. Perhaps I should rephrase that. More like not obessively following Top 40 music any more.

Accepting vaginal sagging is only reasonable unless you know that there are many things you can do to ease the pain and discomfort and restore bladder continence., ie Wholewoman stuff.

If some degree of prolapse is really so normal in our society, then the levels of shame and denial must be really high.

My mother is 82 and had six children the natural way. I was the last and a breech forceps birth.. We all have big, anglo saxon heads ( as do my two beautiful children - ouch!). My mother is a slight, ladylike woman who doesn't do gynaecological talk. ( Her 'explanation' of menstruation to me as a child was so vague as to be funny.) When I was in the first throws of distress after discovering my pop, I confided in her. Big mistake. She claimed never to have had any problems at all like that, never to have even needed stitches ( and we are not talking gentle 'natural' vaginal births in 1950s and 1960s Britain, believe me, although it's true that some of us were born at home ) .

However, something about her claims rings hollow. She was the equivalent of a modern yummie mummy I suppose: not working, help at home, back in her tiny little Jackie O types dresses a few weeks after each birth. She is proud that she had her twenty foour inch waist back straight away each time. I really think 'having no problems of a messy, female type' was part of the deal, along with looking good and keeping the house and family running smoothly for my dad.

I asked her if she knew anyone who'd had a hysterectomy, and she says only one friend, a GPs wife, but they'd never discussed it.

Now what's going on here? I know she has never been incontinent-it seems most of us with POP aren't- but she must have pop. Does she really not know, or does she just accept discomfort as part of being a woman- the same way she never disturbed slepping children or neighbours giving birth or made a fuss about miscarriages? I supppose that when the only options seem to be to put up with something or have something scary and embarrassing done surgically, then such stoicism is completely logical, but why the denial?

Interestingly, when I spoke to my older sister who is seriously into natural medicine and has a very strenuous life, as well as four grown up children, she commented in a blase way: 'prolapse, oh we all have a bit of that - of course we do, after children-' but it doesn't seem to be a major issue in her life. Maybe this is where a mindful, but not obsessive focus on ww techniques can help us: can free us up to get on with our lives with this kind of attitude.

I think we all fear it is a sign we have failed somehow as women, just as the extreme natural childbirth lobby make us feel we have failed if we have a rough birth, or serious complications, or need a life saving caesarian. If we could only all admit that the whole business of reproduction is often gruelling and takes its toll physically, but that we can make a lot of difference to our lives and symptoms. We are all busy pretending that our bodies can be conquered: made to behave through sheer will power or what I read one urogynaecologist endearingly describe as 'good quality' vaginal walls!

Now I couldn't be further from being an earth mother. I don't want to discuss my pop with people who are not sharing theirs with me because frankly, I don't want to be remembered for it. My vagina is a very small part of my life and identity. However, if there could only be good sefl help education disseminated through GPs and PTs, what a transformation that would be to the lives of women of my little daughter's generation.

How to get mainstream medicine open minded to something different? I can see it's a huge problem Christine is wrestling with. There might perhaps be others working in a similar way in non- English speaking countries. There is definitely a 'natural' posture and movement school of thought operating in Britain. I don't know the name of the approach and it's not specifically aimed at women but there is a big focus on getting the natural curve of a woman's lumbar spine back. Might overtures to people working in a similar, if not identical way, be the way forward to spreading the message and helping more women?

All so true, Doubtful.

Our shame, denial and unwillingness to talk about pelvic problems must date from times of extreme cultural modesty, layered on top of religious shame for being a woman, and now a fairly long history of devastating “help” by reconstructive pelvic surgery. Nora Coffey (www.hersfoundation.org) has particularly keen insight into this very subject. She says, “It’s a very powerful thing to take another human being’s sex organs”....and such a terribly dis-empowering thing to have them taken.

I believe the world will not survive if women continue to be forever weakened and changed through hysterectomy. Others (Michel Odent!) have said the same about cesarean. There is a balance of power that keeps the world turning and that balance has been extremely disrupted for a very long time. I do believe in ancient oral histories and artworks that reveal a world where women - and nature - were revered as life-giving and eternal, and societies were egalitarian and peaceful.

Today, as women’s bodies are being controlled and desecrated, so is the earth. And it will not stop until women demand that it stop. Btw, (sorry to go off-topic - but it’s all so very interconnected!) have you Americans heard of the Food Safety Moderization Act up before Congress this week? You can read about it here It threatens the very existence of farmer’s markets and backyard vegetable gardens. Enough is enough!! Please take action.

We have so much work to do around the issue of shame. Guilt is about what we do. We all have some of that and everyone wishes they could have done some things better. However, shame has to do with who we are. It is deep and diffuse in Western women and affects so much about our lives. I think our younger women deal with much less shame than their mothers and grandmothers, thanks to the cultural movements of the sixties, but shame remains a major reason for so much personal and relational struggle. Add prolapse to the mix and ...Yeow!! How many times have we heard young women exclaim that their defective bodies have failed them?

I have a wonderful assistant now (some of you may have spoken with Dinah) and we have been honing our strategy for getting WW into the hands of all women and girls. By this time next year, we will have made great progress in our continuing efforts to change the world of women’s health. But don’t expect your MD or PT to be climbing aboard our cosmic wholeness train anytime soon. They’re stuck somewhere in the 19th century and probably won’t be able to lend a helping hand - at least to this generation.

It really is a spectacular (if perilous!) time for women.

Christine

Very funny louised, very poignant! lol

hi to all, hugs and best wishes