Symptoms related to pelvic organ prolapse can ebb and flow throughout a woman’s life naturally, with times that symptoms feel worse and other times that symptoms are well-managed. Things like hormones, the menstrual cycle, pregnancy, stress levels, sleep, etc. can all be factors that can have an effect on symptoms.
Going into a pregnancy (or a diagnosis in pregnancy) with pelvic organ prolapse can feel a bit discouraging at times, so knowing that there are things you can do that may help you better manage symptoms can be helpful.
First off, let’s quickly go over what pelvic organ prolapse is.
Pelvic organ prolapse, or POP, is the descent of the one (or more) pelvic organs (the uterus, bladder, rectum, urethra, or vaginal vault) into the vaginal canal. Common symptoms of POP can be a heaviness or dragging feeling in the vagina, seeing or feeling a bulge, incontinence (urinary or fecal), pressure in the pelvic region, and painful intercourse.
Some research states that up to 50% of women have some degree of a prolapse during their lifetime (although it’s likely that it often goes unreported because many women don’t know they have a prolapse because it doesn’t cause them issues).
It’s important to note that POP cannot be reversed, HOWEVER, symptoms can be improved greatly to the point of being asymptomatic. The grade can also improve, but the symptoms are likely to provide much better feedback on improvement than grade will.
Working with a pelvic floor physical therapist can be a very helpful part of learning to manage symptoms, as is working with a coach that is knowledgeable in POP and training considerations with it. (To find a pelvic floor physical therapist near you, search the directory at pelvicguru.com)
Now, let’s get into how we can manage symptoms in early pregnancy.
In early pregnancy, symptoms will likely vary quite a bit from woman to woman. Based on how she is feeling, how her stress and energy levels are, if she’s experiencing nausea and vomiting, etc., she may notice an uptick, no change, or even a decrease in symptoms.
For the women that experience nausea and vomiting in the first trimester (and even later for the lucky few of us that it doesn’t let up with…I’m with you sister!), finding ways to help manage symptoms can sometimes take some trial and error, but there are options!
Vomiting can cause a pretty violent and extreme downward pressure and when you have POP, we want to try to provide as much support to the pelvic floor as we can.
Here are a few different ways you can do this:
Use a pessary if you have one and it is appropriate for you/your doctor has approved use of it in pregnancy.
Cross your legs and squeeze them together.
Provide manual support/counter pressure with your hand or a towel.
Kegel right before vomiting.
Brace yourself using your arms against the toilet/trash can for external support.
*If you experience stress urinary (or fecal) incontinence with vomiting as well, these options may be helpful for that too.
As a woman that suffered from hyperemesis gravidarum (excessive vomiting throughout the whole pregnancy), I completely understand that sometimes you just don’t have the time, or energy, to try to provide some extra support for your pelvic floor beforehand. And it’s okay. Just do what you can and if you can occasionally try any of these things before vomiting, you may find one or multiple ways to provide you some better support.
When it comes to exercise with POP in early pregnancy,
it is going to be very dependent on the woman, how she is feeling, what her symptoms are like, etc. Some women may be fine continuing whatever she was doing before while managing symptoms in early pregnancy. Other women may find that they need to make a few adjustments in one or multiple ways listed:
Wearing a pessary with exercise (as is appropriate and approved by her physician).
Working with a pelvic floor physical therapist to get a better handle on any changes in her symptoms to continue some form of exercise.