Peek-a-Boo! What to Do About Prolapse
When I heard about the new Discovery Health show Big Babies, I admit I was apprehensive. The show trailer kind of seems to be piling on obese pregnant women -- which is something I have no interest in doing (judge for yourself -- the show is running this week). However, while I've never experienced prolapse (where your bladder, rectum or uterus, um, "falls" out your vagina), it sounds scary and has all sorts of risk factors ranging from obesity to any kind of pregnancy to constipation to coughing to bodybuilding.
To learn more about prolapse, I talked to Dr. William Porter, a doctor who specializes in this sort of thing. He told me actually we're all at risk, but anything that puts pressure on the pelvic floor -- including pregnancy, especially pregnancy with a "big baby" -- can result in prolapse. C-sections don't really make a difference -- it's the pregnancy itself that causes the pressure.
It was sort of a horrifying conversation. I've never thought about anything falling out of my vagina besides a baby -- and then only if I were like pushing -- and the thought of other organs showing up to say hi really surprised me. Dr. Porter says 25 percent of women who give birth in the U.S. are affected by pelvic floor disorder of some sort.
My next question was so how big is a big baby? Turns out it's how big the baby is in relation to you, not how big the baby is, period. So if I'm a medium-frame woman and I have a seven-pound baby, not big. If I'm four feet tall, a seven-pound baby is big. And, to boot, your baby's size is usually determined by how big you were as a baby, so, well, you're kind of screwed, I guess.
There are some things you can do to decrease your chances of having problems with prolapse after pregnancy, according to Dr. Porter. Control diabetes, control gestational diabetes, manage obesity. (I interrupted several times to tell him I really tried to only gain 25 pounds with my daughter and packed on 45 despite working out five times a week all through the pregnancy.) Because seriously, please do not tell me to only gain a perfect amount of weight with a baby. Like you can finesse that sort of thing. It all seemed a little blame-the-victim to me.
I asked if Kegels help. I remember thinking Kegels were going to save me from a world of problems with my lady bits. I did them religiously while pumping. I was worried about incontinence, mostly, but then again, I did not know about prolapse. Dr. Porter says they really can only do so much -- just like the bat wings you develop under your arms, as we age, we have less elasticity in our connective tissue. Then I started thinking about turkey necks, too, and once again cursed gravity and the female form.
There is good news here. Kidding aside, there are basically three ways to treat prolapse.
- Do nothing. Dr. Porter says if it's not bothering you -- if you can still empty your bladder and colon and nothing gets stuck, it actually won't hurt you. While I can't imagine ignoring my organs out in the open like that, I do believe in being conservative when it comes to medical problems that are actually not causing you pain or morphing into something more horrible.
- Use a pessary. Dr. Porter told me women actually -- in the olden days -- used to use stones, potatoes and pomegranates as pessaries. Lately some women will use a tampon. After I picked myself up off the floor wondering what superhuman woman can hold a stone inside her vagina all day, I asked what modern ones look like -- a diaphragm. "So it's like a bra for your vagina?" I asked.
- Get surgery -- vaginal, abdominal, laporoscopic. Today's surgeries have about an 85 percent success rate, according to Dr. Porter, but they carry all the risks of, well, surgery.
This pessary business seemed like the logical solution to me. After a lifetime of using tampons and even the Nuva ring for a while, I'm not squeamish about useful things in my vagina. What I took away from my conversation with Dr. Porter was this: You don't have to be afraid to get some support. The worst side effect of the pessary is additional vaginal discharge, according to Dr. Porter. But then again, he's never worn one.
Bloggers Writing About Prolapse
Do you have prolapse? Does anyone you know struggle with this? What are the pros and cons to different types of treatment?