Uterine Prolapse Questions

Dear Vitality,

The whole concept of prolapse being a result of a misshapen spine and pelvis is about as thoroughly explained on this site as it’s going to be for awhile. The posture and theory behind it are described much better here than in the first edition of STWW.

From this perspective, that you were active, working out at the gym, eating well, etc., doesn’t have a lot of bearing given the probability that your were doing all these things in postures unsupportive of your pelvic organ system.

Prolapse is a structural problem that has its genesis in the way intraabdominal pressure flows through the body when we are upright. No tincture, acupuncturist, or chiropractor can affect this reality.

If you are certain you wish to decline surgery, I suggest being fitted for a pessary or trying the sea sponge; giving the V2 supporter a try; and paying closer attention to both the standing and seated postures.

You may grow to appreciate your tummy once it is stretched out in the gentle bow-shape we are trying to achieve here. At 73 you deserve to have the softness that this age naturally brings.

Wishing you well,

Christine

Hi Vitality,

It was not my intent to discourage you but to help save you time and frustration by offering the few things that women here know to be truly helpful in lessening or making more comfortable the symptoms of prolapse.

So sorry about not explaining the sea sponges and supporter. It's easy to forget that a newcomer has no concept of these. I talk about both of them here in the FAQ section, but realize today that I don't have a link up for the V2. You can find it at www.birthjoy.com.

Vitality, there are many adjunct treatments that can be energizing, relaxing, and health-promoting. However, my whole point of being here is to help women understand the true cause of prolapse. The way we hold and use our musculoskeleton is what makes the difference whether these organs are pinned into place by the forces of internal pressures, or quite literally blown out of the body. Good food, wonderful herbal preparations, and great therapies are tremendously helpful toward bringing the body back to a more healthful state, but the underlying issue of how we hold the framework that gives support to the organs must be addressed if we are going to experience any change in our conditions.

Christine

Dear Vitality
I am having the same problems as you. I am 58 and in a years time I have gone from a willowy slender body to a sagging one with the protruding tummy. Very shocking to me because the only difference is I have stage 2 bladder prolapse ,oh and I fell causing my spine to curve 70 degrees. The combination has been stressful. I do the posture described under bodywork but I have to do the exercise in bed instead of against the wall. The sea sponges can be purchased at a health food store, however I was already fitted with a pessary before I found out about them. My pessary is causing me problems in that it won't stay in place, so I may try the sponge next. The sponge is discussed somewhere here, sorry I forgot where but you will find it if you look around enough. I would like to keep in touch with you since we are experiencing similiar problems. Peace Linda

My Healing Pages:
http://www.homestead.com/happytrails2u/hits.html
Dear Vitality, I want to know about the vaginal cones. I had my pessary size changed and reinserted only to have it move and cause bleeding again. Now I have to go in for an ultrasound and I just dread it-I actually don't want to know if something is wrong, Ijust have too many things wrong already. Plus a hysterectomy lays you up for 6 weeks and I won't be able to walk my faithful companion, my dog-Rosalee.I was using Tampons with success, I thought the pessary would be a choice I wouldn't have to deal with everyday. ARGH. Keep in touch and ask me anything, I left my page link on this note-it has alot of links for Scoliosis and Fibromyalgia and I am currenty working on a new page for Prolapse info. Peace, Linda

Arnold Kegel recognized that some women, when instructed to contract their pelvic floor, would also contract their gluteal muscles. Even with extensive instruction, some women upon his lithotomy table continued to squeeze their buns tightly together, which exasperated the old doctor who condescended, “These patients probably have a lesion of the CNS.”

For me, that image brings to mind a naked, terrified, humiliated woman in a compromised position. Nevertheless, one of the most enduring concepts (in fact the only concept) in all of conventional perspective on pelvic floor health is that of the “correct kegel.”

I copied this from biolifedynamics.com:

“Remember, you should try to separate from anal squeezing. If you are in doubt, go back and find your PC muscle while attempting to urinate.”

Now I ask you ladies….help me settle this issue once and for all. Who amongst you can squeeze your PC muscle or stop the flow of urine without “anal squeezing?” Anybody??

Not I, and believe me I should know these past few weeks!!!!! :)

Does anybody else think this issue is important? Is my perspective skewed? I think truth-seeking around some of these deeply ingrained belief systems is vital if we are going to change the way prolapse is treated universally.

You can't do a kegel without anal squeezing! Not in my opinion, anyway. My daughter and I were talking about this, and she wondered if she was doing the kegels incorrectly becaause she inadvertently was squeezing her anus at the same time; I told her I thought all the muscles were sort of connected? Is that right? I don't know, but it sure feels that way.

In fact I asked a friend who is a PT this same question (because of this board of course :-)). She said she sees it all the time (she specializes in womans PT) and she has to tell the woman to stop squeezing, relax, and then start again. She said it's a very small muscle and we try to overdo it by overcompensating with anus too. I catch myself doing it when I am doing my kegels. When I go see my PT next week I will ask. I relax and start again, this time, not trying to squeeze so hard but smaller if that makes sense. It's very counterintuitive so I think it takes as much focus on thinking about it as actually doing it. So far I can only achieve the smaller muscle squeeze (if I am in fact doing it correctly but I can tell the difference) by laying down when I do my kegels. I will update about this again next week.

Oh, my friend lives in another state or else I would go to her. The PT I am going to is her old boss though. I have told them both about this website so wouldn't it be great if they visited us too?

My friend has been saying for years that it wouldn't matter if we had had C-sections but now she is reversing that and thinking when the time comes for her she is going to investigate an elective C-section. I told her about what this board and other says about the C-section debate, but she says when forceps, etc are involved, there is too much damage. And I raised the question of those C-sections that had PF damage after, how many of them tried to first deliver vaginally? Do they separate those women from the other C-sections? She also said that heredity does play a part, both her mom and her sister are dealing with UI or bladder prolapse. My mom and sis are too.

Likewise she told me to avoid surgery at all costs - a lot of her patients are post operative patients. But she did point out that she never sees the ones that come out surgery ok. My own PT says we won't know how much the PT will affect my situation but a stronger PF going into surgery is better then a weak one. Of course we agree that the surgery is an absolute last resort, 34 is too young for hysterectomy.

It's going to be a long journey but with support we can do it!

Kathy

That certainly is the "party line", but is it the truth? Anyone else??

I have found you can differentiate between the muscles by doing a few faster clenches before you do a longer one.

But also to say - That if you overdo these you will make prolapse worse (i did)

I find it helps to do it to music - I also think that quality is vbetter than quantity as i was doing 300+ a day and it got so much worse - now i do about25-50 a day and its ten times better :)

I agree with superdeja...sometimes less is more. I believe that I helped my rectocele develop with my kegels (I was trying to make the cystocele go away, I was kegeling maybe 100 times a day). now, another question, why is it so terrible to squeeze the anus along with the pc? and why is it that we believe that stronger muscles are the key here? muscles rarely work in isolation. I wonder, if you strengthen a muscle in isolation aren't you messing with the balance in the body? as far as strengthening a muscle group before surgically slicing into it, well, again, I'm not sure how that's going to help a post surgical woman regain a natural vagina. It is time PT's started thinking more critically about this. I see WW hosting professional seminars for PT's in the future......

I thoguht it was all one muscle but the Physio told me that when Kegeling using the anus and vagina it brings in muscles that take over - like a ring of muscle around the anus or something.

She said to differentiate between anal squeezing and just Kegels

Something like that - lol (Bad memory hits)

I guess we all hafta find our own road and I will travel any and all roads that keep me away from surgery! lol

Thanks for the responses - I guess I find the silence more amazing than the confusion of answers!

This issue has got to be addressed because it constitutes nothing less than fraud.

If you place your finger just slightly inside your anus and try every which way from Sunday to isolate out and contract ONLY those muscles your PT has told you about however subtle, however high, however obscure, however whatever, you will find it ABSOLUTELY IMPOSSIBLE not to also contract your anal sphincter.

The figure eight-shaped bulbocavernosus muscle wraps around both vagina and anus, and is fused to the pelvic diaphragm. The whole action of the pelvic floor, or levator ani ("elevate anus" in Latin), is to squeeze this area closed like a pair of elevator doors.

I don't for a minute believe either that those vaginal cones are "ancient Chinese therapy" because the Chinese are too smart for that. What needs to happen is to tip these organs back over the pubic bone where they belong. Why in the world would we want to add MORE weight to an already overburdened back side??? What is the gain? Strong muscles are all well and good, but the pelvic floor muscle is a thin, sinewy structure that can only get so fit! PT's throughout the land know how often a prolapsed women presents with very strong pf muscles.

Rather, I think the cones are a result of a buffed out, weight-trained culture that simply can't get beyond concepts that are just anatomically wrong!! I'm feeling pretty angry about this and am going to retreat for a couple of days (I'm having out-of-town company this week, too) to write an article about this, which then needs to be sent to the AMA and the American Physical Therapy Association.

Christine

I'm trying to get a handle on how it is that several women on this board have mentioned that they've DEVELOPED rectocele from improperly engaging during Kegels. How does this happen, anatomically? And, more importantly, how can we prevent this?

Christine, you are right that this issue needs to be addressed by the greater medical establishment.

Also, I find the issue of inadequate postpartum resources for new mommies as a huge disservice to women. This culture is very pro-prenatal everything but then as a newly postpartum women, we're kind of 'dropped'. Meanwhile, fundamentally, I feel that this time can be an amazingly healing, transformative and strengthening period in a woman's life if it's honored for being that. There is the Ayurvedic principle of "42 days for 42 years"...meaning that a new mom should focus on herself and bonding with baby and not much else for the first 6 weeks postpartum in order to maintain good health of the following 42 years. Family is expected to help and of course there are the healing and nourishing herbs, spices and food that are given to assist. We as a culture are SO demanding on postpartum moms, expecting us to bounce back immediately to return to work, activity etc. Seeing models like Heidi Klum get back into shape in order to pose at the Victoria's Secret fashion show 8 weeks after giving birth...what kind of ideal is that to hold up for women to try to emulate?

Again I want to reiterate as a PT that we received VERY little information about the pelvic floor and it's relation to structure and function in school. There was a weekend 'elective' that we could take in women's health, that was about it. Since I didn't take it, however, I don't even know if the information that was given was even accurate. What a shame. In general, PT is not a very holistic field (thus my frustration with it at times). In my journey through prolapse I have learned so much about my body and how posture, movement as well as overall health through diet are absolute necessities, but there aren't many people around who embrace this notion. Hmmm...perhaps it is part of my life path to explore this further.

Michele (mermaidsd)

I honestly cannot speak from a scientific veiwpoint. I can only say what feels to be the case for me. once I started doing kegels religiously I could feel a pulling on the posterior wall of my vagina. a few days later, lo and behold, a bulge right where I felt that sensation. I have no idea if this is sound, anatomically.
as far as PT's go....I'm a PT too. we had one inservice re: pelvic floor. the therapist who spoke to us spent at least half of his time telling us how lucrative pelvic floor PT is. the rest of the lecture was all about cones and weights and biofeedback. I don't remember any discussion of posture, I'm sure there wasn't any.

I think it may be coincidental to some degree, but I do believe the pessary-rectocele connection is more concrete.

Yet again...we are the only mammal with a flexed (curved under) tailbone. All other tailed mammals have bones that are either straight or turned up. I actually have an article by an anthropologist about this stating that it is because we lay on our back.

Try kegels laying on your back. There is a definite pulling sensation at the back vaginal wall. Flip over or stand up and that sensation disappears. I suppose if you did 300 of these a day in this position there could be some negative stretching.

The brilliant book by Naomi Wolf, "Misconceptions", (recommended on Christine's reading list), is great in describing the many disservices to women pre, during and post- natally. She writes a great deal about the nurturing that takes place within other cultures post partum. I have to agree Michele that we are dropped post partum and left to struggle alone during a huge physical and emotional upheaval. Thank god for those of us with supportive partners/ families, and god help the rest!