Picture yourself in ancient Greece, suffering from a bothersome and uncomfortable bulge in your vagina and being told by your esteemed and toga-clad physician to insert half a pomegranate soaked with vinegar into your hoo-ha to ease your discomfort and push the pesky protuberance back into place. Or lifting your heavy, velvet medieval skirts to insert a ball of wax-covered linen, well lubed with oil or butter and intended to keep your troublesome bladder in place. These little treats were called pessaries and were used for centuries to relieve the pain and pressure of pelvic organ prolapse (POP).
We’ve come such a long way, baby.
Today, pessaries are still one of the treatment options for women with pelvic organ prolapse, which occurs when the pelvic floor muscles grow weak and can no longer properly support the bladder, uterus, small bowel or rectum. Without adequate muscle support, simple gravity can make these organs press against the vaginal and rectal walls, causing discomfort, urinary leakage and sexual dysfunction. In severe cases of prolapse, the function of the bladder and bowel can be impacted and unsupported pelvic organs can bulge into the vaginal wall or actually descend into the vagina or anus.
That pomegranate doesn’t sound quite so crazy now, does it?
Pelvic organ prolapse affects approximately three-fourths of women at some point with most having 1st or 2nd stage prolapse, and some can slip into the much rarer and more severe 3rd stage of prolapse, whereupon the organs, such as the uterus, can descend to the point of protruding outside the body. Prolapse has been such a common “woman’s problem” that generations of us have had to accept post-menopausal bladder leaks, pelvic “heaviness” and sexual discomfort as “just something that happens” as a result of aging and decreasing hormones. This is so not true, and relief may be closer – and simpler – than you think.
NOT YOUR GREAT-GRANDMOTHER'S PROLAPSE
Over 377,000 women undergo surgery each year for pelvic organ prolapse to address bladder control and sexual dysfunction complaints, both of which can have very negative impacts on a woman’s self-image and sexual confidence. And while your great-grandmother likely knew well what a pessary was, and perhaps had a trick or two up her sleeve for making one, these are some of the more common options for dealing with pelvic organ prolapse:
- Silicone Pessary – yes, these are still a viable, inexpensive and relatively non-invasive option for keeping pelvic organs in place. Modern pessaries come in a variety of shapes – most commonly a ring or donut – and can be removed, cleaned and reinserted at home, after the initial fitting and check up by a gynecologist. But pessaries do not actually fix the problem, they just make it a little more comfortable by temporarily holding the organ up and in.
- Surgery – more advanced cases of organ require surgical repositioning of the pelvic organs - or even hysterectomy – to relieve symptoms
- Pelvic Mesh – this sling procedure attaches a mesh material to the vaginal walls, where tissue can overgrow it, lifting the pelvic organs back into proper position. (This procedure was prohibited by the FDA in early 2019).
Each of these options has its limitations, however. Hundreds of millions of dollars are spent on over 377,000 pelvic organ prolapse surgeries each year in the US alone, adding to the rising cost of healthcare. The much-heralded pelvic mesh procedure became litigious - and rightfully so - after women around the globe were afflicted with more pain, incontinence and sexual function issues than they had experienced before the procedure. Pessaries can work for some women, but not all, and can be unpleasant to insert and remove.
But pomegranate pessary or no, your great-grandmother’s prolapse experience does not have to be yours. We are much more open about issues “down there” than she ever was, and open discourse with your gynecologist about your pelvic health concerns can change your life and save you grief, discomfort, time and money in the process.
SPEAK UP AND STOP THE MADNESS
Diagnosis of prolapse is made based on patient symptoms only about 3 – 5% of the time, despite lessening of the social stigma surrounding bladder leakage and more open discourse about sexual dysfunction. More than half the time, diagnosis is made based solely on physical examination, thanks to some symptoms and side effects of prolapse that are not quite as openly discussed. Symptoms can include:
- Pressure or fullness in the pelvic area
- Low back ache or pain
- Painful intercourse
- Feeling of “something falling out” of the vagina
- Urinary urgency and incontinence
- Constipation
The time has come to erase the stigma surrounding our pelvic health and relieve the unresolved problems that so negatively impact our lives. There is no shame in admitting to “a few leaks”, a constant feeling of pressure, or a change in your sexual experience, and not all prolapse treatment options require medical intervention. There is one non-invasive, inexpensive and simple therapeutic option for early stage pelvic organ prolapse, and one that any gynecologist worth her salt will suggest before discussing surgery, and you can do it in the privacy of your own home.
SQUEEZING TO AVOID SURGERY
Toss aside the bladder pads and absorbent underwear, and put that pomegranate on your plate, where it belongs. Pelvic floor exercises can relieve symptoms of prolapse in just a few weeks, as muscles gain the strength to hold organs in place and prevent further downward motion.
Strengthening pelvic floor muscles can prevent – and in some cases, reverse – prolapse and all the inconvenient and unpleasant symptoms that come with it. All major medical associations agree that pelvic floor strengthening exercises are the first line of treatment for urinary incontinence and sexual dysfunction issues that can signal early to moderate stage prolapse.
But the exercises must be done properly and for the long-term in order to prevent relapse or worsening of symptoms, and most women can't easily identify the right muscles to tighten and end up doing more harm than good.
That’s where Kegelbell comes in.
The Kegelbell system is a pelvic muscle strengthening program that takes the guesswork out of the exercises and very simply and elegantly solves many problems at once. By targeting the exact muscles to squeeze and allowing precise and controlled contractions, Kegelbell can improve the tone and condition of the pelvic bowl with just five minutes a day, three time a week. And the weights are totally customizable to your need, allowing for incremental increases as strength improves and keeping the bladder, bowel and uterus where they belong, improving organ function and quality of life at the same time.
You may have your great-grandmother’s eyes, your grandmother’s boobs and your mother’s sense of humor, but you don’t have to have their prolapse experience. Take control of your pelvic health, and lift where it counts – with Kegebell.
