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.
Being more intentional with exercise and learning when to scale movements.
Working with a knowledgeable coach to learn different strategies that work for her.
Backing off/changing the type of or how often exercise is being performed based on how her energy, stress, nausea, etc. levels are.
Ending a workout or a long day of standing with an inversion (i.e. legs up the wall-lying on your back against a wall with a pillow or rolled up towel under your hips and legs supported on the wall) to allow gravity to help out.
It is unrealistic for women with POP to “not lift over 15lbs”, even in pregnancy, because most women have to pick up loads more than 15lbs in their everyday life. Learning how to still do different types of exercise and making adjustments as needed to help her better manage symptoms can be so helpful for a woman’s mental and physical health in pregnancy.
Having pelvic organ prolapse can often be tough to navigate both mentally and physically, especially going into and learning how to manage symptoms in a pregnancy. It can sometimes feel isolating and frustrating, but know that there are valuable resources out there to provide you guidance and support and that you are not alone.
Going through these experiences with pelvic organ prolapses, I completely understand the spectrum of emotions that can come with navigating these seemingly foreign waters. That is why I knew I had to learn better and do better to be able to provide realistic guidance and support for other women experiencing the same things I did/am. Having a supportive "team" in your corner that has your goals and best interest in the forefront is invaluable.
Want more info on how you can navigate symptoms, exercise, and your journey? Fill out this form to schedule a FREE call with me to discuss how you can get better guidance with exercise and managing symptoms in pregnancy!