So let’s talk about sex…with prolapse.

What exactly IS prolapse?

Prolapse occurs when one or more of the pelvic organs (vagina, uterus, cervix, bladder, or rectum) descends into the vaginal canal. This is often due to weak or inadequately supported pelvic floor muscles and is quite common following a vaginal delivery. 

And there is hope! With the support of a pelvic floor PT and pelvic floor programs like SLAM, you can learn how to fix prolapse without surgery. 

Can you have sex with uterine prolapse or a prolapsed bladder? 

Understanding this from an anatomical perspective might make you wonder if having sex is safe for someone with prolapse. Dr. Jennifer McGowan, a pelvic floor physical therapist, explains that if there is no pain with sex, penetrative intercourse is fine. 

“You can still very much enjoy your sex life even if you are dealing with prolapse,” she says. “It may even bring some prolapse relief.” (More on that in a minute.)

According to McGowan, if you are experiencing pain with intercourse, it’s less likely that it is the prolapse itself causing pain, but rather over tight pelvic floor muscles. A tight (hypertonic) pelvic floor is common among postpartum women, and it is possible to experience it alongside prolapse.

Surprising benefits of sex with pelvic organ prolapse

A study on pelvic organ prolapse (POP) type indicates it does not affect sexual function. In many cases, penetrative intercourse can even improve prolapse symptoms. Here’s why:

• Increased blood flow

Sexual arousal increases blood flow to the pelvic area. This brings more oxygen and feel-good hormones to the area, which aids in healing. 

• Support for the vaginal canal

Most people with vaginal prolapse feel better after penetrative intercourse due to the relief the support brings to the vaginal wall. 

• Orgasms help release feel-good hormones

Orgasms release oxytocin and dopamine hormones throughout the body. They help you feel attachment and love as well as pleasure, reward, and desire. Other hormones, such as endorphins, serotonin, and prolactin are also released during orgasm. They naturally increase pain relief and decrease stress. 

Risks of sex with prolapse:

The risk of having sex with a prolapse is minimal. However, sometimes women find themselves bearing down during sex or while orgasming. McGowan recommends focusing on proper breathing, or core breathing, to avoid bearing down. 

Proper core breathing is so important! Your core is a pressure system. As you breathe in your diaphragm flattens, gently pushing air down into the lungs as your belly expands. Your pelvic floor relaxes. As you exhale, the diaphragm recoils and the pelvic floor gently lifts. Proper breathing will also help your body to relax, which of course has its own benefits when it comes to sex.

How will sex feel to my partner if I have a prolapse?

Simply, it should feel good! Although you may feel self-conscious or worried about your partner, which is normal, know that they won’t feel or notice the prolapse.

Does sex cause prolapse?

In short, no. Sex is very unlikely to cause prolapse. The organs in your body are flexible and designed to move and accommodate different positions. 

In fact, Dr. McGowan says, “Prolapse doesn’t usually occur from one thing anyway. It is typically micro-traumas to the body that lead to prolapse over time.”

Pelvic organ prolapse, in any variation, is most commonly caused by: 

• Childbirth
• Heavy lifting
• Obesity
• Excessive regular straining while trying to complete a bowel movement.

Will sex cause my prolapse to worsen?

No. Sex should not cause prolapse to worsen. To reiterate, as long as there is no pain, sex should be fine – and may even help relieve symptoms. 

What are the best sex positions with prolapse?

Dr. McGowan states, “there is no “best position” for sex with prolapse because every person is unique.” She does, however, have a few tips to consider when having sex with prolapse: 

1. Sex in a lying down position (versus upright or standing) minimizes gravity pulling straight down, therefore bringing awareness to the prolapse.
2. Try placing a pillow under your hips. The increased angle adds some gravity, helping accommodate the prolapse and make room for sex.
3. Keep the communication open. Talk with your partner about what feels good and what doesn’t. It should be enjoyable for both of you.

Should I avoid certain sex positions with prolapse?

Avoid positions where gravity isn’t on your side. Depending on the type of prolapse, this may mean avoiding sex in a standing position or being on top because they can lead to discomfort.

Bottom line, sex with a pelvic organ prolapse is completely possible. It won’t affect the prolapse, and it’s unlikely your partner will notice it. Keep the lines of communication open with your partner and you can have a satisfying sex life. 

If you have further questions, or are experiencing pain with sex, please reach out to a medical professional or a pelvic floor physical therapist for help. 

The post Can You Have Sex with Prolapse? appeared first on Get Mom Strong.

Prolapse occurs when one or more of the pelvic organs descends into the vaginal canal. It is a common occurrence among women, especially those who have experienced a vaginal birth. There are a few types of prolapse:

• Uterine prolapse
• Bladder prolapse
• Rectal prolapse
• Vaginal vault prolapse

There are treatments for pelvic organ prolapse that don’t require surgery. Proper body mechanics, pelvic floor muscle coordination, exercises and muscle releases can help treat your prolapse and improve symptoms significantly.

Lifestyle Changes and Everyday Posture

Healing a prolapse and minimizing symptoms takes a whole-body approach. Posture plays a huge role in pelvic health, particularly when it comes to prolapse.

According to Dr. Jennifer McGowan, pelvic floor physical therapist and owner of ReGenerate Physio, many women adopt a “butt-tucked” posture in pregnancy, which greatly impacts prolapse.

“During pregnancy, many women start to tuck their butt under to compensate for the growing belly. Studies have shown that this position allows your pelvic organs to descend more,” she explains. “Much of the time this posture carries over long after baby arrives, and it can exacerbate prolapse.”

Dr. McGowan goes on to explain that you can’t simply change your posture with mindfulness alone.

“You need to work on body awareness, but you also need to strengthen certain muscles and release other muscles to bring balance back to the body,” she says.

Often, returning to more neutral spine posture requires glute, hip flexor and core strengthening, along with hamstring and glute medius release work.

The Strong Like A Mother program focuses on these body mechanics to help relieve prolapse symptoms.

Untuck Your Butt

One simple shift in combating the butt-tucked posture is to stagger your stance and switch positions often.

It is much harder to hold tension in the pelvis when standing with one foot out and slightly bend at the knees.

Stop Sucking In

Many women, especially postpartum, suck in their tummy in hopes of hiding the postpartum belly pooch.

Sucking in actually makes a prolapse much worse. Your core is a pressure system. When you suck in, the displaced pressure has to go somewhere. Often, this pressure goes down, worsening prolapse symptoms.

Stop sucking in, wearing corsets, and overly tight clothing.

Carrying Kids

Kids can weigh a lot and it is common to fall into poor posture when holding babies and toddlers. One tip Dr. McGowan advises is to hold the child in the center of the body.

“You don’t want to create a shelf by either jutting your hip out or tucking and thrusting your hips forward,” she says. “Instead, keep the child in close to your body and consider wearing a baby carrier for more support.”

Get Fitted for a Vaginal Pessary 

A pessary is a small silicone device inserted into the vagina and provides support for the vaginal wall, muscles, and tissues displaced by pelvic organ prolapse.

“Think of it like a sports bra for your pelvic muscles,” says Dr. Margo Kwiatkowski, an orthopedic and pelvic floor physical therapist. “It can give you the support you need so that you can work on strengthening the rest of your body without worrying about worsening your prolapse.”

A recent study actually found that using a pessary has many benefits and no side effects. The study found a reduction in prolapse symptoms, making it more likely to avoid surgery for pelvic organ prolapse eminently and long term.

According to Dr. McGowan, a pessary doesn’t need to be used all the time, but can be particularly helpful when performing heavy lifting, feeling symptomatic, or when an active day is ahead.

Learn to Manage Intra-Abdominal Pressure

Prolapse can be worsened from too much pressure on the pelvic floor, but the good news is– it can also be improved with more optimal core engagement.

Your diaphragm and pelvic floor work together. Ideally, as you inhale, the rib cage expands laterally and the pelvic floor gently relaxes. As you exhale, the pelvic floor naturally recoils.

Understanding this can make it easy to understand why holding your breath, especially when lifting things, can worsen a prolapse.

“That pressure has to go somewhere, and if you hold your breath…chances are it will go out or down,” says Dr. Kwiatkowski.

When lifting things (weights during a workout or picking up a kid), inhale down into the body as you bend down to lift. As you lift, exhale audibly out your mouth with a “haaaa” or “shhhhh” sound. This will help your pelvic floor lift to support the load.

Pelvic Floor Exercises to Improve Prolapse

In addition to learning to manage core pressure, there are a number of exercises to help strengthen the pelvic floor and surrounding muscles. Kegel exercises aren’t the answer for most. Instead, Dr. Kwiatkowski recommends whole-body exercises that are functional.

“You need to know how to use your core and pelvic floor in functional movements,” she says. “As moms, we are constantly bending over, picking up kids, and lifting things.”

It is important to focus on core breathing, and strengthening support muscles like the glutes, hip flexors, and inner thighs to bring about more pelvic stabilization.

Poop Mechanics Matter with Prolapse

If you struggle with prolapse, constipation is your worst nightmare. Healthy bowel movements and bathroom mechanics means less strain down on your pelvic floor and prolapse.

Dr. McGowan recommends using a potty stool like a Squatty Potty. This puts your body in a better position to excavate without straining.

Eat lots of fiber and stay hydrated.

“Examine your bowel movements. They should soft and formed, like a banana.,” Dr. McGowan says. “You shouldn’t strain when going to the bathroom.”

If you do need to push to get your bowels out, she recommends exhaling gently as you push. Use a “shhhhh” or “fffff” sound.

She also warns about sitting on the toilet too long, concluding, “It should come out within a few minutes. If it isn’t coming out, get up and move along. Sitting and straining is not good.”

Can Postpartum Prolapse Heal Itself?

In some cases, prolapse symptoms can resolve or lessen after postpartum healing from childbirth occurs. For most, a proactive approach to healing is needed.

According to Dr. Kwiatkowski, postpartum prolapse might improve temporarily without intervention, but she questions what will happen with aging if left unresolved.

“What happens when you enter menopause?” she asks. “Coughing, constipation, and poor pressure management, coupled with hormonal shifts that can already compromise pelvic muscle integrity…it is a recipe for problems.”

Prolapse Hope Without Surgery

Most women can significantly improve prolapse without surgical treatment. There are many alternative treatment options including pelvic floor physical therapy and prolapse-centered exercise programs.

“Prolapse isn’t a disease, it is almost like saying you have a rotator cuff strain. It is a musculoskeletal strain and with time and training, we can reduce the symptoms,” says Dr. McGowan.

Strong Like A Mother (SLAM) has helped thousands of women improve prolapse symptoms without surgery.

The post How To Fix A Prolapse Without Surgery appeared first on Get Mom Strong.

A postpartum diagnosis of prolapse can feel scary, but have hope. Prolapse after childbirth can typically be improved with proper training and body mechanics.

Prolapse After Childbirth

Postpartum prolapse occurs when the muscles and tissues that support your pelvic region weaken and stretch. As a result, one or more of the pelvic organs may sag or protrude into the vagina.

According to Dr. Margo Kwiatkowski, an orthopedic and pelvic floor physical therapist, pregnancy and childbirth is a common time to develop prolapse as the weight of the baby and strain of delivery can create additional damage to the fascia and ligaments in the pelvic region.

“Our tissues stretch three times their resting state during pregnancy. To expect our bodies to simply bounce right back postpartum without any implications isn’t realistic for many moms,” she said. “The good news is, with proper education and exercises, many women can improve their prolapse symptoms.”

Are There Different Types of Prolapse?

Yes. There are a few different types of prolapse. A pelvic floor physical therapist can evaluate to determine the prolapse type and the grade.

Cystocele: Bladder drops into the vagina.

Rectocele: The rectum bulges into the vagina.

Uterine Prolapse: Uterus drops into the vagina.

Vaginal Vault Prolapse: The top of the vagina loses its support and drops.

What are the Signs and Symptoms of Prolapse?

Common signs include:

• A feeling of heaviness around your lower tummy
• A sensation of a tampon falling out or something being “stuck” inside the vagina
• Feeling or seeing a bulge or lump coming out of your vagina
• Difficulties emptying bowels
• Significant urinary incontinence, feeling like your bladder is not emptying, or increased trips to the bathroom.

According to Dr. Kwiatkowski it is important to get checked out by a medical professional. “It is so important to have a pelvic floor physical therapist or physician do an examination because many of the prolapse symptoms can also be symptoms of a tight pelvic floor,” she said. “It may or may not be prolapse, so knowledge is power.”

How is a Prolapse Diagnosed?

You can check yourself for pelvic organ prolapse at home. However, it is recommended to see a physician or pelvic floor physical therapist for a proper diagnosis. A pelvic floor physical therapist will usually check you in the laying and upright position.

The practitioner is looking to see how far the pelvic organ descends past the hymen.

Prolapse is graded (0-4) by how far the organ drops into the vaginal canal.

“The grade of prolapse doesn’t necessarily correlate with the symptoms. Someone with a grade 1 prolapse may experience significant symptoms, while someone with a grade 2 may barely notice,” Dr. K says.

Grade 1

The uterus or vaginal walls have dropped slightly. Many women don’t even notice and it is diagnosed during a routine exam.

Grade 2

The uterus or vaginal walls have dropped further into the vagina and the bulge can be seen at the vaginal opening.

Grade 3

Most of the uterus or vaginal wall has fallen through the vaginal opening.

Grade 4

The organ is completely outside the entrance of the vagina.

What Causes Prolapse?

As mentioned, prolapse occurs when the muscles, connective tissue and ligaments that are supposed to hold our organs up—don’t.

A vaginal delivery is one of the most common direct causes of developing a prolapse. Other contributing factors include:

• Chronic constipation or straining during bowel movements
• Chronic coughing
• Heavy lifting without proper core engagement
• Menopause

“I don’t want women walking around thinking it is something they did or didn’t do in any given moment. You have to think about prolapse like a bunch of micro-traumas that led to the macro-trauma,” says Dr. Kwiatkowski. “You didn’t cause your prolapse, it just happened.”

Is Postpartum Prolapse Normal?

Prolapse after childbirth is very common, but is not necessarily normal. You can improve a prolapse and its symptoms with proper core pressure management, posture, exercises and support.

Prolapse is not life threatening, but can affect quality of life. If you feel symptomatic, it is important to get help.

How to Find Relief From Prolapse Symptoms

It is important to take a total body approach to prolapse healing.

1. Wear a pessary or support garment.

A pessary is small silicone device that is inserted into the vagina and used to support the pelvic organs. This can help you feel supported as you work on total body strength. A doctor or physical therapist can help you get fitted for one.

2. Learn to manage intra-abdominal pressure.

Your core is a pressure system. It is important to learn to breathe and engage your core during every day activities, especially when lifting.

3. Focus on improving posture.

If you are consistently slumped in daily life, it puts pressure down on your pelvic floor. Try to sit and stand more upright, especially when nursing and holding baby.

4. Learn to relax and contract your pelvic floor.

Many women guard their pelvic floor after being diagnosed with prolapse. Holding your pelvic floor tight can actually cause more issues and worsen prolapse symptoms.

5. Use gravity assisted positions when feeling symptomatic.

Place a pillow underneath your backside and elevate feet onto couch or chair. Focus on taking deep breaths to relax your pelvic floor.

Life After a Prolapse Diagnosis

Prolapse after childbirth is common, but there are many treatment options. A whole-body approach to healing is key. Strong Like A Mother has helped thousands of women improve their prolapse.

The post Prolapse After Childbirth: Symptoms & Relief appeared first on Get Mom Strong.