Confused about cystocele

Body: 

Should the front wall of your vagina bulge when you bear down or not? Is this normal or a cystocele? If I bear down the front wall bulges into my vagina "cavity" but not down and out. How can I tell if it is pushing my bladder?

Hi Gumdrop

Yes, that is the classical thing that happens with cystocele. The bladder is primarily moving backwards, not downwards. The vagina is almost vertical in WW posture but if there is any slouching and the lumbar curve lessens, the vagina will lean backwards. Whichever way it is the bladder is leaning back on the vagina, so will impinge into the vaginal 'space'. When you bear down you are increasing intraabdominal pressure. If you bear down, bent from the hip joints with your butt stuck well out the back, and a significant lumbar curve you will hardly notice your cystocele, but if you bend from the waist with your lumbar curve straightened, you will notice the cystocele straight away because you have straightened out the bend in your torso..

Yes, the bladder and uterus can eventually come 'down', but not until they have moved 'back', and gone around the corner at the level of the cervix.

This is an illustration of how WW posture can be used when you are lifting a load, coughing or doing anything requiring exertion, which increases intraabdominal pressure. WW posture protects you from too much movement by the pelvic organs, and protects your pelvic floor from more damage.

Does that explain it better?

Hi gumdrop 23,
Nothing much to add to Louise's excellent description. Just to add, it is therefore helpful to reduce whatever bearing down you do - for example when you go to the loo, lean forward and raise your legs off the loo seat or rest them lightly on the edge if you can and reduce any straining as much as possible, then your pelvic organs will forwards and the bulge into the vagina will be reduced. Similarly if you need to coughlean forwards in to a forward bend if you can. If you need to lift something try to maintain ww posture and keep the weight close to your upper body if possible, basically I am much more careful about the amount of weight I carry and how I carry it. After a while this way of living becomes 2nd nature.
Best wishes, xwholewomanuk

Yes, WholewomanUK is right on the button. When you are semi-squatting, which is what happens when you lift your bottom and legs off the seat, all the muscles inside your pelvis, that stabilise the spine, sacrum, pelvic bones and femurs in this position are in 'active tension'. They are working quite hard, and are physically quite firm, so they kind of form a firm framework inside the pelvis which in turn stabilises the positions of the pelvic organs. It is important to maintain your lumbar curve too. This keeps your organs in position and retains the bend in the torso that prevents intraabdominal pressure from pushing your bladder and uterus down your vagina.