Recurrence 2 years post-partum?

Submitted by chicamom on January 26, 2010 - 10:56am
Body: 

Hi all, I am glad to have found this forum, there is so little easily accessible information out there on this issue. I am 2 years post-partum, and had a "mild" prolapse (uterine I think, though my doctor at the time never really clarified that) after my son was born. The biggest issue for me was the feeling of pressure, which improved with time, and I found that doing inner core work and mat pilates really helped (though now I read maybe I should have been doing that??). I had improved to the point where I felt like it had mostly resolved, other than having to be conscious of lifting my pelvic floor before coughing an sneezing, and I hadn't yet felt comfortable returning to running (which I enjoyed before pregnancy).

Then, over the holidays I was skiing and, for lack of a better way to explain it, I jammed down hard into a dip I wasn't expecting, and experienced some leaking of urine and thought "uh oh, that didn't feel right". I thought at the time I might have hurt my lower back, but then by the time we finished for the day I felt fine so figured it was nothing. Except now over the last month I have experienced a recurrence of my prolapse. I'm now, for the first time, having trouble with tampons feeling like they aren't staying in properly (this hadn't been an issue since AF returned at 15 months post-partum). The feeling of pressure has returned and while not painful, it is noticeable and bothers me. I feel like I have more bloating and generalized pain in the abdomen than normal. It's all so frustrating and upsetting, especially since we were thinking of trying for baby #2 soon and now, the thought of being pregnant and making this worse is beyond depressing.

Anyway, I have some specific questions I am hoping someone can help me with.

1. Is it possible that the ski incident caused the worsening of the prolapse? That just seems so crazy to me. It was hardly anything at all, how could it have such a dramatic effect??
2. I stopped breastfeeding my son around the same time or shortly before I started noticing the worsening of the prolapse a few weeks ago. As a result of the hormonal changes I've really been struggling with anxiety/PPD since then, which I probably should have seen coming but it's just something I had NOT expected (he was only nursing once a day so I assumed it wouldn't affect me that much - wrong!). My question is whether anyone has experienced a worsening, not an improvement, of prolapse with weaning? It seems everything I read says weaning should improve the prolapse and that has not been my experience so far.

Thanks for any input anyone can offer. With the anxiety/PPD, this has just been such a difficult thing to deal with. The anxiety seems to be slowly improving and I know it will take time for my hormones to stabilize, but in the meantime I just feel totally hopeless about everything and worried something more serious is wrong, etc. (I have been to my doctor, who examined me and confirmed I have a mild prolapse - which I already knew - and it wasn't something she'd noticed at my last pelvic exam a few months previous. She called it "mild" and when I said it didn't feel mild she suggested maybe I am more aware of my body than most people. Which I think it definitely true but still, that's not helpful!! Anyway, she is sending me for an ultrasound and to see an ob/gyn who specializes in prolapse for follow up. Of course it's taking forever to get in for either.).

chicamom

January 26, 2010 - 11:22am

Sorry, that should have read maybe I should NOT have been doing mat pilates.

Christine

January 27, 2010 - 11:28am

I will get back with you a bit later to respond to your questions. Am swamped atm, but want to let you know you aren't being ignored!

:) Christine

chicamom

January 27, 2010 - 1:22pm

Thanks Christine - it's all I can think about these days and I really appreciate finally having found somewhere where people are going through the same thing. It's so frustrating to be told "it's mild so don't worry" - it's NOT mild, at least not in terms of impact on me, both physically and emotionally. It's also so frustrating that no one seems to be able to ever answer my questions. I asked my dr the questions above, and she basically said "I don't know, I guess it's possible there is a connection". SO not helpful.

Christine

January 27, 2010 - 3:24pm

Hi again, Chicamom,

Your story reminds me of the strength of the female body and how often postpartum prolapse improves with time. Many of the women here find that traditional core work exacerbates rather than improves symptoms. However, most young, Pilates-loving women certainly don’t have that experience and you are an example of a postpartum woman who feels core work helped your symptoms.

So, there seems to be a mystery here. Was your natural pelvic organ support system becoming more stabilized through core work (and I am guessing zip-n-tuck posture) or actually more compromised - even though natural postpartum involution was enough to get you back to an anatomical baseline that allowed for improvement in your symptoms?

Here is what I think. Our bodies are okay with zip-n-tuck - sometimes forever - but when push comes to shove there is a natural anatomy that is actually much more supportive of pelvic organs. We know this because when prolapsed women adopt WW posture (which I believe to be true and natural human female posture), their symptoms improve. Most postpartum prolapse improves “on its own”, but is this improvement enough to prevent symptoms for the rest of their lives?

Your skiing experience is such a fine example. Assuming the shape of your Pilates-sculpted body is wrapped around spinal flexion (this is the very common look of flat butt, flat stomach, and slightly rounded upper back), jamming down onto bent-knees is going to send tremendous intraabdominal pressure through your pelvis, and out your lumbar spine, in an unnatural way. To test this, simply take that very position (1) with your belly pulled in - now cough. Then (2) with your belly relaxed and your butt sticking out - now cough. In which position do your pelvic organs feel most supported? The overwhelming majority of us will tell you that our experience is #2. Raising intraabdominal pressure while in WW posture stabilizes pelvic organ support. This is why the skiing accident worsened your symptoms. From my perspective, your organs were perched atop very precarious anatomy, and the fall would have happened sooner or later. As you will learn, the pelvic organs fall Back, not Down, and we need to return to our innate posture, which keeps them positioned right behind the lower abdominal wall. The hole is at the Back. All is well when the organs are carried at the Front and away from the abyss. Core work pushes them toward the Back. WW posture keeps them toward the Front, in the hollow of the natural, rounded lower belly. Do you see?

I do not agree with Aza (hugs, Aza!) that the key to healing is to find whatever works for you. To some extent that is true, however, we have this innate, highly evolved pelvic organ support system that every woman needs to know about and utilize. Will you still be able to do some core work in addition to learning how breath, spine and gravity work to stabilize organ support? Sure, if you are strong enough and spend most of your time directing your organs where your DNA has meant for them to go. Actually though, many of us give up on the heavy ab work in favor of more natural exercise. As Louise said, how can they call it a neutral pelvis when we have to “do something” to get it there? Anyway, the neutral, anterior, or posteriorly rotated pelvis is a figment of the imagination. The pelvis is already rotated completely forward - just like in cats and dogs and horses and lizards. To have legs is to have a forward facing pelvis.

I am going to let our resident moms put your mind at ease with their answers to your second question.

Welcome to Whole Woman and I have no doubt you will be one more mummy who goes on to birth babies, shake your bootie, hold your head high, and rejoice in your recovery from prolapse - for the rest of your life!

Christine

P.S. This is not something your ob/gyn is going to be the least bit familiar with - unless he/she has read the book! :)

kiki

January 27, 2010 - 3:35pm

HI Chicamom,
I'm sorry things are worse for you at the moment. But, have faith, these are but bumps along the way. I used to really stress about every relapse, now i know it is just par for the course and that i can get myself back to baseline. I don't know if you have the DVD, but if you don't it is great--the excercises are super good, and firebreathing and nauli really help to lift things. also really good when i have a worsening of symptoms for whatever reason--gets things back to where they should be.

re weaning. my POP didn't get worse, but despite like you being down to 1 feed a day, when i weaned my body went crazy. my cycles went bonkers, i gained lots of weight, and my premenstrual irritability got much worse. i've been working with a homeopath who really helped to regulate me again which was so helpful. but i too was amazed that going from 1 feed to none could do that. but it clearly did...

and re baby no. 2. there are lots of women here who have gone on to have babies post POP, with POPs worse than what your sounds like (not to say yours isn't causing you problems / distress!). you might want to become very familiar with WW posture first, feel really strong in it, and get to a place where you feel stabilised before you get pregnant. That way, even if you feel worse during your pregnancy (which you might not!) you have a baseline to return to post baby...
hope that helps!
kiki

chicamom

January 27, 2010 - 4:23pm

Thanks so much for your input, everyone. I think the most frustrating thing for me right now is that I had thought this was an issue that was resolved a long time ago - I didn't know that it was something that could recur so I was completely unprepared for it. Looking back there were signs that the prolapse was still an issue, after the return of ovulation I would have pressure/heaviness during ovulation that felt similar to what I experienced during AF pre-pregnancy/prolapse. I just assumed it was some sort of post-partum change in my body, but never made the connection to the prolapse until I started reading here about some people's symptoms varying with their cycle. I also would on occasion since having my son have very sharp pains in my abdominal muscles, but it would resolve after a short time (within half an hour) and again, I thought it was a post-partum thing related to my body getting everything back into place, but never made the connection to the prolapse - now I suspect it's entirely related.

In part I am relieved to learn that prolapse can recur, because I had been assuming it must be something more serious going on (ie tumours). On the other hand, as a generally healthy active person I am depressed to learn that prolapse is considered a chronic condition. I had assumed there would be a quick fix I could implement and solve all the problems. Not so, I am realizing. Sigh.

Anyway, I really appreciate the support and welcome anyone else's views regarding my questions. It still seems just so crazy, that hitting a bump the wrong way on the ski hill could cause such a significant relapse. I obviously haven't quite got my head around it all yet.

louiseds

January 27, 2010 - 7:45pm

Hi Chicamom

Yes, prolapse is chronic, but may be assymptomatic or manageable, or ignorable for many years. In a few weeks or months, I think you will find that this skiing incident was just a setback, a signal for you to get your body organised to prevent future incidents like this. We all have the odd setback, but once your body is reorganised it can recover more quickly to its previous state.

Chin up (but not literally)!

Louise

alemama

January 27, 2010 - 11:05pm

Hey Chicamam, welcome to wholewoman. Don't let this prolapse thing freak you out. Yes you can have reversal of symptoms and yes you can sustain that reversal once you know what to do. I bet your skiing incidence did not cause your prolapse to come back- it was already there- it just bugged it-
We all do things that bug our prolapse- but you can bounce back from that don't worry at all :)
What I can tell you about weaning and prolapse is that as long as you are having normal, regular periods your estrogen levels are back to normal- and estrogen is the hormone doctors are talking about when they suggest weaning may help prolapse. What they don't know is that periods actually cause a prolapse to be much more symptomatic than when a woman is not having periods.
Your increased psychological distress symptoms can be attributed to loss of prolactin and oxytocin- which are both amazing feel good substances!
Don't even think about another baby right now-give yourself at least 2 months of Wholewoman techniques before you get pregnant again so that you can feel confident. You can have more children for sure.
Here is my experience- pregnancy and birth make my prolapse worse for a time (and by worse I mean- I see it more, it feels bigger when I do the self-exam, and I feel pressure in my perineum) BUT....at 10 months post partum with baby #4 my prolapse is less noticeable than it was at this same time with baby #3- and with baby #3 I had almost complete reversal of all symptoms (including the bulge) by 18 months postpartum.
So for me having another baby is like signing up for 2 years of working with my prolapse to get it to the point of being totally insignificant- and honestly much of that time is pretty darn good (like right now for example- I can feel the bulge with my fingers- but don't really notice it- and it is tucked up inside the labia). It is a decision I do not make lightly and I do always worry about my perineum tearing during birth and how that will make my recovery harder etc...but man these sweet children are so worth it to me! I figure- what is two years in the long run? pretty much a blink of the eye.

louiseds

January 27, 2010 - 11:46pm

Spot on.

So, are Alemama's knees crossed for ever, or do we watch this space? ;-)

L

clavicula

January 28, 2010 - 2:09am

Setbacks, yeha, we all have them, they come and go. It is a 2 steps forward one step back journey for the most of us. I am still tandem nursing my 3 yo and my 15 mo and my POP improved tons since the birth so I have no idea what will happen after the weaning.
I have setbacks along with stress, puking (haha), minor worsening around period, or after my power yoga class (only if I am not aware of the posture, I modify some asanas as Christine suggested). But there is recovery all the time along the way.

We are here for you, don't be discouraged, wou can live well with this.
Liv

aza

January 28, 2010 - 2:55am

Hi chicamom, welcome! Sometimes we hit bumps and our backs go out, sometimes we hit them and our knees buckle, and sometimes our innards shift around with the force. Knees and backs don't hit us to the core of being a woman quite the same though, eh? But for reasons outlined in these forums, this is the part of your body that bore the brunt of that bump and it is great that you have found this info.

And for the record...I don't believe that the key to healing is to find whatever works for you, exactly. Well, of course it is to an extent...but it is a no-brainer that healing won't come with faulty methods, of which WW is clearly not. My point in the other thread was to never take the word of another as gospel, even the advice a 'professional' if it doesn't resonate. If rigidly adhering to something is not working, reshape the rigidity. Isn't this how WW came to be and what makes it so effective? Trial and error and independent thought and listening to what works and what doesn't and what we experience in our own bodies? Chicamom, I love your reaction to your 'official diagnosis' of a simply mild prolapse which obviously does not ring true for you. And like many wise women, you are seeking out the info that you know you need. It is all about taking responsibility for our own healing.