worried

My girlfriend said her bladder would protrude sometimes and bleed. She lived with it for almost 12 years before having surgery and now regrets it completely!

Just telling you that first part so you won't worry so much. Definitely worth getting checked out since it is the first time you have seen blood but also want you to know it is one of the benign symptoms of POP, too... often from irritation of the tissue on underwear or against other skin when protruding.

Based on what you say about your experience with the MD, I would find another MD. That you didn't get information on Stage of prolapse worries me. You need more of a partnership; not a dictatorship!

Pelvic Organ Prolapse. POP

I have a pessary and it is very helpful in relieving pressure. I use it only for exercise at this time, though. I have Stage 2 prolapse of everything. I've heard pessaries do not work after a certain level of prolapse; I think that might be because the vaginal walls are too prolapsed/weak to hold the darn thing in! My pessary is removed/cleaned by me on a daily basis. I do not think I would want a pessary inserted and removed every few months by an MD. Post menopause (which I assume you are) means a higher likelihood of tissue ulceration from chronic pessary use. You'd probably have to use an estrogen cream even before you used a pessary to 'prime' the tissue for a foreign body. That also comes with side effects and risks!

Still, talk with your Gyn. I am glad you like him so much and I hope he offers you an opportunity to talk and ask questions. He might refer you to a specialist. If he isn't familiar with fitting pessaries then find someone who is.

I also forget posture. I am a serial stomach sucker-inner. Now that my stomach pooches out from the prolapse my trained brain wants to suck it in even more!

There are many kinds of pessaries and if your doctor is not well-versed in the types and drawbacks then it sounds to me like you might need a different doctor. Have you tried using a pea-sized dab of honey instead of the hormone cream? I do not use pessary or cream (or honey for that matter) but much has been written here on the wonderful success of honey for those that suffer dryness and other issues. Best wishes to you!

This doesn't sound like a healthy doctor/patient relationship, Angee. Just remember that this is yourbody, not his.

OK, so you are more afraid of the unknown, of the implications of what he might say/recommend, rather than being afraid of him (and his power to heal or harm you). That's OK. Everyone is entitled to fear the unknown. If you feel scared when you first go into the consulting room, just mentally undress him. That might make you feel a little stronger. The thought of a gynaecologist wearing only his bow tie and his shoes and socks, and trying to pretend that he isn't naked, isn't going to send shivers of fear through you. Just try not to laugh at him.

If he says stuff that does make you fearful, don't be afraid to ask lots of questions. If you are tempted to consent to surgery, just back out gracefully, and think about it calmly in the comfort of your own home.

You can decide to have surgery at any time in the future, but using Whole Woman techniques is not going to be as easy or as effective after you have had surgery, ie it doesn't work the other way around. I know you don't want surgery.

I am sure you will feel more confident about your ability to improve your own prolapses when you have a little taste of success.

Louise

If he is 'not too concerned', why would he postulate about another situation where he would be more concerned. This man is self-centred, not patient centred. Doctors have no business planting fear in patients' minds, without good reason.

To illustrate, I am postmenopause. I had a PAP smear about 12 months ago. It came back as abnormal because there were not enough healthy cells to say that unequivocally there were no abnormal cells. The smear was classed 'abnormal' because they were atrophied. Der. They had my date of birth, surely, and could tell that I would be postmenopause. My doctor said it was a predictble result, and that I shouldn't worry; that I should come back for another smear in 6 months time. She wrote a prescription for Vagifem pessaries and asked me to use them for a month before the smear. (!!!) After googling this I made a personal decision to use them for a week because everything I could find indicated that this would be enough (rightly or wrongly), particularly as I was not keen to have one extra bit of oestradiol running around in my body. The end of the story was that the second smear, which I put off because I lost the Vagifem prescription in my deep litter filing system, was OK.

However, an educated woman like me knows that my doctor said not to worry after the first smear, but I was worried because of the fact that they did think I was risky enough to call back for another smear. This ate away at me until I could get the second smear organised.

It also bothered me that I would have to put inflammatory oestradiol in my vagina, to plump up my cervix which had already had an 'abnormal' label attached to it. Would this make any real abnormal cells more abnormal? Could the oestadiol that the doctor told me to use contribute to a positive PAP smear?

This concern about the oestradiol worsened when I started putting these little white pills in my vagina nightly. I started having hot flushes during the ten days I was using them before the smear, so I knew that the oestradiol was getting into my system, rather than only acting locally as we are told. As soon as I stopped using the oestradiol the hot flushes stopped.

Would I go back for another PAP smear in twelve months, knowing that I would have to pay $35 out of pocket for a consultation just to get a prescription for oestadiol again, just so the doctor could get a good sample?

I am not sure that I will go back. All these cumulative fears, which may or may not be totally irrational, are eating away at me. All the public health information I see tells me to keep having AP smears.

I am a healthy woman. I exhibit only two of the twelve risk factors, having three full term pregnancies, and having maybe (like almost all women) been exposed to HPV. The other ten risk factors don't apply. I don't have a family history either.

That still doesn't stop the fear nibble away at me, but I know I really don't have a lot to worry about. Perhaps I should worry about things I can turn into action to make a big difference to the world, rather than worry about a very small risk for me.

Doctors cut out fears, and treat fears with medication. This is how they make a living. Your doctor is no different from a mechanic who tells you the brakes may need some work when you pick up your car after it has been serviced.

Don't let him get to you. I suggest that you get a new gyn.

Louise

Dear Loused,

I can only say that my ignorance and disengagement from reality, have been fortuitous. I remember my mother saying that ignorance was bliss. Oh, how I raged internally at that statement. I wanted knowledge. I was so aware of my ignorance and incapacity to understand what others just seemed to assume. I felt like a horse who wore blinkers and could only see the narrow path before him and failed or was prevented from seeing the whole wide universe surrounding him in that arch of the horizon that promised so much reality. Here you are in all earnestness trying to do the right thing, trying to understand where the doctor is coming from and co-operating as much as you can and being messed around.

Compare me who avoids fears, who does not go to doctors, one who has been a coward, the proverbial ostrich with its head in the sand, refusing to believe that there were any further difficulties to be disposed on me. A blind faith, a blind negotiation with the god we all in our various lives finish up negotiating with and absolute luck tiding me through. A high blood pressure I have ignored for thirty years, pap smears I have not indulged and the list goes on. It has been fortuitous circumstances. Not something I would recommend to others, but something I would say comes from your knowingness. What do you really think?

Ok angee
We were talking just some little while ago about uterine prolapse and some pale pink/brown stain on the pad. This was uterine prolapse when things get dry, as they do from time to time somewhat inexplicably, (but be assured there is some constipation involved), and your pelvic organs begin to rub.

Now in your case with all prolapses rubbing you can expect a little pink/brown depending on how long it is since you bled and then noticed. It aint anything to worry over unduly. The thing to do is to stop being so dry. Red clover tea if you are post menopause which at 62 you probably are, or are approaching.

Now Angee you have to think about the degree of your prolapse. If it is third degree coming out from your labia then it is so strong pushing downward that it won’t countenance the pessary, it is too strong for it. But that does not mean I am saying don’t try a pessary. Just to be aware that with stage 1 or stage 2 prolapse, pessaries might work straight up for you, stage three then it will be harder to get the right fit. Perseverance will then be the thing.

Without a pessary it is possible to find blood on your pad because of the dryness of organs rubbing on each other. It does not necessarily mean cancer. For your health sake, have tests to eliminate the possibility of cancer. Then if there is nothing revealed, work on the dryness and the rubbing.

Best wishes, Fab

Fab, You mean about doctors, and early cancer detection tests, and whether we really need doctors for all this stuff that we fear?

I think it is all shades of grey. There is no right or wrong. We all have to just find the path that is right for each of us. I tend to be knowledge hungry, and I do not have a lot of respect for those who try to pull the wool over my eyes or simply bulls*** their way through answers to my questions, instead of saying, "I don't know, but I will find out".

I don't for one minute think that PAP smears and breast checks are cancer preventing. They are simply ways we can detect signs of cancer early, when it is treatable with good outcomes. Having to use oestrogen pessaries to make my cervix easier to collect sufficient cells from was a bit weird, but apart from that I don't think they do any harm for ten days every couple of years. Likewise breast checks. I also went through a whole barrage of cardiovascular tests and monitoring after a high blood pressure reading one day. Result - normal. Again.

I really think they are looking for sickness where there is none in my case, rather than picking it up early and treating the higher risk person, so they don't become an invalid (rather than an income tax payer) or become a resident of a cardiac or oncology ward before my time. I think it is all driven by the cost to the taxpayer of the hospital and medical system, with so many beds occupied by chronic illness sufferers.

Is that what you mean?

Louise

something along those lines. Thanks for putting it out there. I'm getting tangled up in healthy neglect and unhealthy risk taking. Each case can be a minefield. It was about knowing the difference, I guess, which is an impossible question to expect anyone to answer.

best wishes, Fab

For me, when I see how fallible conventional medicine is re POP it makes me question the fallibility of other aspects of medical treatment, but particularly mass screening, mass immunisation and the like. I don't think you are wrong deciding (even by 'neglect') not do partake in these publicly funded (in Australia anyway) programs. I think we all have to look at the risks and the benefits to us personally, of both having and not having screening, and look at our personal risk factors, and decide for ourselves. Hey, I am not a great gambler or risk taker but I take risks getting in my car and driving to work, and the risk in that is probably *much* greater than one mammogram every couple of years, but it doesn't stop me from driving to work. I don't even consider that risk. I just get in the car and drive!

However, I am the driver in my car, and my driving is in my control. That is a different type of risk than having a sophisticated medical imaging procedure, where i don't have any control at all over any of it. It is driving me!

I have a discharge and have had it for several weeks. My gyn does not seem concerned. I have a cervical prolapse and a cystocele, and my cervix peeks out. My gyn says that a small amount of blood is probably from the friction of the bladder against the vagina. I calmed down a bit after learning that she wasn't worried about it; the discharge doesn't smell and varies in amount of pinkness. I wear a thin pad. If you get the kind with wings then there isn't a rub where the elastic legs of your panties poke in. ALso, the longer pad for nightwear can help camoflage your POP if you are wearing pants. Just a suggestion. WHen you sit, try to make sure you are paying attention to where your POP is going. Good luck.

When sitting down, I suggest that you back up to the seat and hip hinge with bent knees, so that you can get your pelvic organs organised into your lower belly before your put your butt on the seat, then make your upper body come up to vertical. Always choose a seat that is horizontal rather than sloping back, ie dining chair, but not comfy sofa. Your body will thank you. If you are forced to sit in a comfy sofa, perching on the edge is usually better for POP, if your knees can take it.