I got my diagnosis and still confused!

Hi Tintagel,

Not to worry, most women have a hard time deciphering which part is at or near the vaginal opening. Yes, it’s always the vaginal walls or cervix that prolapse - the organs are behind the walls. You are in good company, as the most common presentation of prolapse is cystocele/rectocele with the uterus above. We call this “nature’s pessary” because the bulgy front and back walls help prevent the cervix from descending further.

Who knows why your symptoms have worsened. The important thing is knowing you can adjust your diet, bowel health, posture and exercise to slowly improve how you’re feeling. Take it very easy - gentle rocking motions on hands and knees. Drop down onto forearms to make it even easier for your bladder to fall into place behind your lower belly.

I’m not a fan of treating prolapse with estrogen. That’s one of the few “tools” in the gynecologic tool kit, but from my perspective exogenous estrogen has nothing to do with reversing prolapse and is not worth the risk-reward ratio. That’s for every woman to work out for herself, however.

Wishing you well,

Christine

Hi Tintagel

Sometimes POP can feel like your pelvis has been invaded by aliens. One day there is a bulge in one place, then the next the bulge is somewhere completely different. It can be confusing. This commonly happens to women who start doing WW work. Suddenly they have a different sort of POP and think it is getting worse.

I think what happens is that the body starts to rearrange its pelvic organs and produces different symptoms for a while. Eventually it settles in one configuration, and as long as you keep your posture correct, keep your bowels moving along, dress sympathetically (as opposed to pathetically ;-)), use your body correctly, etc, it will eventually keep that new configuration, which might be good enough to be workable for the rest of your life.

First I noticed pelvic pressure, particularly postpartum after second baby, then became pregnant with third baby. After that periods were heavier, and more uncomfortable, but shorter. Went about five years before getting a pessary, because my cervix was descending, then that eventually didn't work any more and became more trouble than it was worth and it kept falling out or getting out of position. so I managed with nothing.

About ten years after that I went through a heap of marital stress, and became very constipated. Rectocele appeared and made it worse, because I couldn't empty my bowels properly. Doctor diagnosed cystocele. Another doctor then commented on rectocele as well as cystocele. Eventually I could feel my cervix peeping. Then I found Wholewoman and I think I went through all the different manifestations again, in a different order. After 6 1/2 years of WW I can sometimes feel cystocele, eg while washing my vulva under the shower , occasionally (like four times a year) I get constipated or dehydrated and the rectocele messes up my bowel emptying until I get the fluids right again, but my previously retroverted uterus is now high and I can hardly reach my cervix. It has been like this for about three years. Now 2 years post menopause.

It changes all the time. The doctor was probably right, at the time she examined you. I don't know that doctors even know that pelvic organs can move around, but I certainly do! Don't let it get you down. It is quite normal. Your different way of using your body has simply de-stabilised the abnormal positions. Your body will eventually get the message, hopefully.

Try and understand what is happening in your body. If you can visualise it by looking at diagrams, having a feel, and doing a drawing, or whatever, of what you can feel, you will eventually understand. The DVD will be helpful, but the book is the best aid to understanding how WW posture works. The DVD is more of a 'how to do it' aid. I think being able to understand our 3 dimensional pelvic anatomy is essential, because you can then interpret what is happening in your pelvis, no matter what activity you are undertaking, and avert symptoms before they even happen. WW posture becomes knowledge rather than a data, a successful cake rather than a recipe and a set of ingredients.

Louise

Hi Tintagel

It is hard to say which is the causative factor. POP is caused by many different factors, so it takes many different factors to manage it.

Our skin sags as we get older. Everyone knows that. And it is blamed on loss of collagen. As a friend of mine once said, "As you grow older your upper arms turn into wings." This means that there is some stretching or breakdown of connective tissue, I guess.

It is hard to wade through all the Beauty Porn sites (lies and salesmanship dressed up as fact) when you google collagen, but I found this Wikipedia article quite helpful for understanding it. http://en.wikipedia.org/wiki/Collagen#Types_and_associated_disorders . It is the main component of fascia, if you can believe Mr Wikipedia. 35% of the body's protein is one sort of collagen or another. Muscle is only 1-6%, so there is an awful lot of collagen elsewhere! In this case, Wikipedia is about the most credible source I could find with a quick google. The references that support this assertion look to be good references. This being the case, it would provide an additional reason why POP is popularly regarded as an older woman's condition.

Cystocele and related 'celes happen when the fascia between the vagina and the bladder weakens for some reason, and a bladder which was held forward by the front vaginal wall, presses back and makes a bulge in the front vaginal wall. If you press in a jiggly way for long enough on a fibrous mesh (which is what fascia is), like eg, the layer of roots that forms around the outside of the potting mix in a pot when a plant grows too big for it, or a piece of loose knitting made with giant needles, it will eventually give way in one spot and that starts breakdown outwards from the initial pressure point, until your finger breaks through. We are talking spiral-shaped protein here, not synthetic knitting yarn. Wool, which has a crimp, would probably give way like collagen, especially if it is not very tightly twisted yarn.

The history of corsetry shows that human tissue will change shape over a period of months as the abdomen is trained by 24/7 lacing into a particular shape, and permanent or semi-permanent changes will happen to the positions of organs and tissues. This has to involve changes to the fascia web that keeps our organs in their functional position in the body.

So I guess it is a combination of both. The fascia behind the vaginal wall becoming less elastic and more prone to going out of shape once we near menopause, and the bladder pressing backwards.

The cause of the bladder pressing backwards can be:-

* Poor or inappropriate posture, or
* surgical alteration, or
* tight clothing around the lower abdomen, or
* heavy lifting or exertion putting extra pressure on the body's structures, eg pelvic floor, abdominal muscles, fascia that holds everything in its place,
* intraabdominal forces going in the wrong direction or increasing greatly, eg lots of coughing.

This forces the bladder backwards, so it is over the top of the vulva and prone to going down the plughole, rather than resting against the lower abdominal wall, out of the way, and able to absorb intraabdominal pressure by the lower abdominal wall distending under its pushing.

The other thing that happens with aging is that we tend to lose muscle strength, so we stoop more, probably exacerbated by lifelong slouching. Slouched or stooped posture lowers the chest, which in turn tilts the pelvis backwards and unwinds the pelvic muscles, and the pelvic floor will become horizontal, which removes the stabilising effect of the 'back wall', which will become floppy if not stretched tight by the nutation of the pelvis, and allows the bladder to fall/roll backwards.

Well, that was a simple question with a very inexact answer that is probably within a bull's roar of being right. But it makes sense to me.

Would anyone else like to comment?

Louise

The response of course, is to

Yes, the saggy elastic bits just have to be accepted as normal, particularly as you have lost a lot of weight. I think you will firm up a bit over the next 12 months or so, just like after pregnancy, but maybe not to the same extent.

Well done, losing all that weight. I think you can rightly claim your saggy bits to be trophies from that process; a remainder of what you have achieved, and how much your body will be appreciating it.

Women's bodies go through so many changes during our lives, whether it is the monthly changes from different parts of our menstrual cycle, or weight gain and weight loss during and after pregnancy, or simple weight gain or loss from changes of lifestyle etc. I try to look at POP, and the demands it makes on me as just another body adjustment. I have not consciously brought this upon myself. Out with them!!

Life is full of situations where we make decisions based on what we believe to be true at the time. If we beat up on ourselves for every time we made a decision that turned out to be wrong we would all be cot cases. You just have to accept that you listened to the wrong information for the right reasons, and not take it personally and judge yourself for not being perfect. Then move on and deal with it.

I know what you mean about trousers. I have pairs in the far reaches of my wardrobe that I actually felt comfortable enough in 7 years ago, that I just cannot wear for five minutes these days. They are just all wrong and I can't wait to get them off again. I cannot believe that I used to suck my tummy in as much as I did, and was proud of it!! Some of it is a change in bust, waist, hips measurements, but it is mostly postural change.

Louise

I cannot find where you mentioned how much weight you have lost - I do - However - KNow that losing weight affects POP alot - But in time it levels out and yoru POP seems OK again. I have lost 131lbs, and have had good times and bad times with my POP and it is like it has to 'gain it's composure' again after weight loss. Especially if you have lost it fast.

I know how it feels to feel panicky And even after I had been here for a long time and I did somethign stupid (or was it the weight loss?) and I felt'different' down there - I fell apart for a while but then my POP sorted herself out again and life became normal - POP stopped peeking and went back inside - So now - After 5 or so years here - I have come to the conclusion that the 'ups and downs' in the life of POP are just there maybe to remind us to never get complacent and think that all will always be well...... :-)

You WILL be ok - You WILL learn how to live - And live WELL - With your POP

Hi Tintagel

I wouldn't feel silly about mistaking a cystocele for a prolapsed uterus. I was told I had 'a minor prolapse' after my second child, spent a long time thinking it was my uterus and turned out ( eight years later) it was my urethra. Nobody told me what it was originally - I self diagnosed from Christine's book and then my doctor agreed with me.

I notice you say you're worried to walk from your car to your office. All I can say about my experience of living well with a front wall prolapse is that walking NEVER makes it worse and generally makes it a lot better. Standing around for a long time is what gives me symptoms of heaviness, but it's always at its very highest after walking in posture, and this seems to be the experience of so many women here. Why not decide to enjoy your holiday - it sounds great. If you keep your backpack a reasonable weight, carrying it on your back should be no problem. Perhaps you could always give yourself the choice to opt out if you do feel your symptoms worsening, maybe with the excuse of back trouble if you're shy. It's a shame to let this minor health thing spoil your enjoyment of life and I'm pretty confident that you will find that your walking hobby is actually very helpful to your symptoms.

Doubtful

MeMyselfandI, how long after the weight loss do you think it took before your POPs were stable-ish again?

A good question Tintagel. What is it that some women are able to do and others are not.

I think it is to do with posture, but the posture is only the container. I think the top of your vagina has moved forward, which makes it easier for your bladder and uterus to end up at the top of it.

This is where encouraging your bladder, uterus and rectum to come up out of your pelvic cavity, and get them into the correct configuration, then locking them forward by bringing the top or your sacrum forwards inside you, comes in.

Many members have expressed the same despair as you have. It is an act of faith to keep hitching them up in the hope that they will eventually stay up and forward. This is why we say this can be slow work, until, as csf illustrated it with her puzzle analogy, they get into just the right place, like a set of foam building blocks, or peaches arranged in a tray for transport, or the segments of a piece of fruit. There is an 'easiest fit' combination, where I think they fit best together and move more or less as one. Once they are combined together correctly they become a 'stable super pessary' which just sits where we put it, supported by WW posture.

I think a retroverted uterus is a problem because it prevents the top of the vagina from moving backwards. Getting the top of the vagina back enables the uterus and bladder to pressi against its front, compressing the vagina shut, and the rectum is squashed flat against the tailbone, preventing it from filling until the contents of the colon force it to fill, about 20 minutes after eating.

A full rectum is also an impediment to getting the top of your vagina back. Constipation makes it almost impossible because it turns the large intestine into a bag of dryish, long, thin rocks which will not conform to the shape of its container. I am thinking that after a bowel motion would be a good time to reposition your organs with firebreathing.

Managing and preventing constipation will also be important for you, even if you don't think you are constipated. This is a time when the right sort of diet is critical for you to give your body the best chance possible to rearrange its contents.

I think this is the reason why my organs stay put quite well these days. Once I approached menopause my uterus became much smaller. It had always been retroverted, but flipped over to normal position after three years of WW posture. My POP management became much easier once I realised this had happened, ie my cervix suddenly came out of the front vaginal wall, rather than the back vaginal wall. I don not know whether if flipped and stayed there or if it moved backwards and forwards for a while before settling forwards.

Louise

As with the Ups and Downs of Pop - The first 'down' which was the worst one was about 4mths or so. After that when I finally got a hold of myself again and stop freaking out and took a deep breath and drags myself up by the bootstraps again I noticed that every time I lost over 7lbs in a fast way (within a month or so) I would feel weird. Things would feel lower. And I would always check myself and see if this was me or if it was POP or fluke...

So I would say most times within 6 weeks I would have stopped noticing the weird feelings - If you remember after the 'Checkeramafest' which I finally stopped - LOL - I decided this was just making me more stressed and probably not good for the area keep touching and whatever. So after I stopped checking - It was like my body took a deep breath and decided to behave again.

Though every womans body is unique and time is just the number on the clock so to speak.

But I have noticed that when I lost weight and it was in a rush - I would feel POP more - Then after a while it was like it stabilized itself and I forgot about it. Life went on - Till I next lost a cluster of weight etc. Now - My weight is normal and I do not plan to lose more, so I guess POP will still do the up and down thing - which is just 'life' just hopefully she will enjoy the UP alot more than the down. LOL

Hi Tintagel

If you feel chafing or irritation to the bladder, or to the urethra that is between the bladder and your front vaginal wall, it may be to do with your doing a lot of exercises with a low bladder. I really cannot guarantee anything. I wouldn't do too much in the way of workouts unless you can do it in a way that does not irritate your bladder and urethra. Not yet anyway.

There are some parts of the workouts that are easy to do in posture, while others are harder, and require you to have built up some lazy muscles so you can maintain the posture. I would stick to doing just the elementary exercises for now, and leave the advanced exercises until you have been doing the elementary ones for a while. If there is a choice between staying in posture and doing the exercise, don't do the exercise.

Walking should be OK as long as you don't feel too chafed. Don't hurry your walking, and maintain long strides, picking up your back foot at the last possible moment, and keeping your chest raised at all times, and your shoulders relaxed. Relax your belly. Wing flapping is helpful too, to strengthen your back, chest and shoulders. Up hill is easier because you can keep your torso more horizontal at lumbar level and keep your bladder and uterus forward. The leg action of walking is a form of jiggling your organs into place because the two halves of your pelvis move independently of each other and your pelvic organs are moving around continually. Coming down is harder because you have to keep your centre of gravity back, which often involves hunching over to see your footing, and tipping your pelvis back. You will be the best judge of what hurts you and what is OK. Stop and firebreathe every now and then to hitch your organs up. The more time they spend up, the sooner they will find their golden spots. A child cannot go to sleep if she is not in bed.

You can also help your own body by making sure that your knickers do not rub on your exposed vaginal walls, that your vulva and vagina are well lubricated before you do any exercise, that your pubic hair is long enough to provide a buffer between your vaginal walls and clothing, etc.

I don't work out at all, apart from doing a few exercises casually. The exercise workouts are not an absolutely necessary component of WW work, although your POPs will get benefit from them. It is not a case of paying with your own physical exertion to make your POP symptoms go away. It is not like the DVD's you see advertised on the Net or on tele that tell you to do the exercises or use the machine and guarantee to lose 10 inches of your waist measurement in 3 months.

It is about making your body stronger and more flexible and more able to retun to a primitive female posture, and use that posture to do your daily tasks and activities. It is about feeding, clothing, sheltering and working your body in new ways that support, rather than destroy, your natural god-given physical structure. The exercises are not an end in themselves, but a means by which you can exercise in that same framework.

Read whatever you can to help you understand your pelvic anatomy. The more you learn the better you will understand why your body reacts either positively or negatively to certain types of tasks and movements, so you can invent your own ways of moving that will reinforce and not undo your ability to retain your organs.

It is like learning about how foods combine and work together with their flavours, textures and chemical characteristics, as opposed to buying your food in packets and just adding water or cooking straight out a recipe book without tasting as you prepare.

With understanding comes knowledge and the ability to integrate it into your life and pass it on to other women.

Hope these guidelines help.

Louise

Hi Tintagel

I think I should probably apologise for my blanket encouragement to you to walk a lot now, just because it has helped me and quite a few other people here. I think we may be dealing with different sorts/ degrees or symptoms of pop.
Just to let you know what I have and how walking and sitting in posture helps: I have what I assume is a urethrocele - or it may be a cystocele - my GP didn't really know I suspect. It's basically a bulge the size of a grape right at the bottom front of my vagina. I've never had any bladder symptoms or pain with it - apart from maybe when it first appeared ( before disappearing for a long spell) after a baby nine or so years ago. At that time I would have sensation of incomplete emptying. That flared up again when I became re-aware of my pop last summer - bit it wasn't much - really just annoying because it took a while to settle to sleep.

My cele (whichever it is), sometimes peeks about a centimetre out of my vagina - usually after my period ( I'm forty seven and a bit perimenopausal I suspect) - bit it never hurts or rubs on my clothing - it's still tucked nearly out of sight. I never feel it when I'm sitting in posture or walking, but sometimes if i have to stand around for a long while. When it's 'in' which is most of the time now, it's sometimes level with the entrance or sometimes about a centimetre up, Because it's small and right at the bottom of my vagina anyway, these little changes are all I see - it couldn't go up over the pubic bone but I hope that with all the ww work my bladder does. Basically I'm just dealing with a bit of stretched jumper effect now rather than a prolapsed organ, I think.

I'm not sure what you're dealing with. If it's a bigger bulge, made up of a bigger proportion of your vaginal wall, I can imagine it will feel uncomfortably full in your vagina, or maybe the bulge is higher than mine, but falling down further, which again might be uncomfortable. Does it some down low enough to peek out? While this is just a minor niggle for a very small, localised low bulge, I can imagine that it would be more uncomfortable for something else.

So I suppose I'm saying, maybe I had it easy with the smallness, lack of discomfort and finding walking helped from the beginning. Could someone else help here? ( Feeling the limits of my very little expertise!)
Has any long standing member dealt with unpleasant bladder/urethra symptoms like Tintagel - or had a bigger pop/ a pop coming down from higher up and causing more discomfort than I describe? What helped you most in those early panicked weeks or months?

In anticipation

Doubtful