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Women's Health Brianne Grogan February 9, 2021 pelvic floor, women's health, prolapse, pelvic pain

Ask Brianne, Move Every Day: Women'..., Posts from 2009-2013, Women's Health Brianne February 5, 2021

Visit my new website: Dr. Bri’s Vibrant Pelvic Health
I created an at-home program that is perfect for people with prolapse or bladder leakage. Only 10-15 minutes a day will help you reduce (or even reverse) symptoms and learn how to love life again with prolapse.
"When I was reading your book , something stuck with me. When you described your mild pelvic organ prolapse, you said that you grabbed a hand-held mirror and to your dismay you realized that you had it. I'm worried because I had a rough labor with my daughter who is now four. She was actually born with forceps. It was so painful and I could feel the tearing. I'm worried that it messed everything up "down there!" But I'm confused. Maybe it's naive of me but I went to look at my lady bits with a hand held mirror and I had no idea what I was supposed to be looking for... Can you help? What does prolapse look like?"
If you do a search for pelvic organ prolapse images on google, you're going to be shocked. Most images that pop up portray extremely ADVANCED prolapse; prolapse that requires surgical intervention. Images that portray mild to moderate prolapse are harder to find.
If you think you might have prolapse, then schedule a consultation with your gynecologist or with a women's health physical therapist. Here's a link to a women's health PT locator for the United States . These practitioners can give you a solid diagnosis and direct you to the next best steps. However, IT'S REALLY IMPORTANT TO KNOW YOUR OWN BODY, so I definitely encourage you to check yourself, first.
Wash your hands. Sit comfortably on a toilet, or on the floor with your hips and knees bent. Make sure you're in a well-lit room, and have a handheld mirror handy. Gently part your labia (the outer and inner "lips" of your vulva) and use a handheld mirror to look inside the vaginal canal.
Do you see anything? If you see a "bulge" that protrudes to the level of — or outside of — the vaginal entrance, then you probably have pelvic organ prolapse (which could be a prolapsed bladder, uterus, vaginal vault, or rectum). Make an appointment with your healthcare provider for further evaluation.
If you DO NOT see a significant bulge, but you still think that something feels “off,” or if it looks like something is “out of place,” then gently bear down. You can also try coughing (without contracting your pelvic floor first) and see what happens. If gently bearing down and/or coughing produces a bulge, then you might have pelvic organ prolapse.
Finish by checking the same things standing up. After all, we live our life in upright positions... Not lying down on an examination table! It's important to check for prolapse in functional positions such as sitting and standing.
As for specifics about what prolapse looks like, please note that for all women there will be "texture" on the inside of the vaginal canal. You should note wrinkled or "ridged" looking reddish-pinkish tissues (this is called vaginal rugae). This is okay and totally normal! It's also normal to feel/see your vaginal wall descend SLIGHTLY when and if you experiment with bearing down or coughing. However, it is NOT normal to see a golf ball-like bulge that goes to the level of — or protrudes out of — your vaginal opening.
Real quick… Wondering about “grades” of prolapse? The following (italicized text) is adapted from WebMD , and applies to prolapsed bladders since this is the most common type of prolapse.
Prolapsed bladders (cystoceles) are separated into four grades. The grades are based on how much the bladder presses into the front vaginal wall. Please note that a prolapsed bladder does not actually protrude through vaginal wall, it simply presses into it, which is what causes the protrusion or “bulge.”
Grade 1 (mild): Only a small portion of the bladder droops into the vagina.
Grade 2 (moderate): The bladder droops enough to be able to reach the opening of the vagina.
Grade 3 (severe): The bladder protrudes from the body through the vaginal opening.
Grade 4 (complete): The entire bladder protrudes completely outside the vagina; often associated with other forms of pelvic organ prolapse (uterine prolapse, rectocele, enterocele). (See Reference 1)
"My mother-in-law has a prolapse and her doctor gave her a device a lot like a diaphragm, but no exercises! Do you have any recommendations for her?"
It's great to hear that your mother-in-law was prescribed a PESSARY (the diaphragm-like device that essentially keeps the prolapsed organ in its rightful place), but it's a bummer that she wasn't also provided exercises!
In my book , I address prolapse specifically, and the "inner core energizer" exercise routine (in the book) would be perfect for her to do while using/wearing her pessary since it strengthens ALL of the core muscles.
In the meantime, please have your mother-in-law do the following:
Have her do some beginner core exercises and corkscrew kegels to "wake up" her core muscles
Encourage her to sign up to get the first week of “Lift,” my pelvic support series, for free . It’s a wonderful program that has helped thousands of women reduce — or even reverse — their symptoms of prolapse.
Lastly, know that there are many MYTHS surrounding prolapse! Here’s a look at the top three:
When it comes to prolapse, just know that there is hope, and there is help!
Making positive lifestyle changes and learning some basic pelvic floor and core exercises can help women OF ANY AGE live a more active, less symptomatic life. And even if surgery is required at some point in the future, going into it STRONG and armed with knowledge will make the outcomes much more successful.
If you’re interested in Lift, my at-home program for prolapse, click here to learn more .
1. Prolapsed Bladder, WebMD. Retrieved from http://www.webmd.com/women/guide/prolapsed-bladder. Last accessed Feb 3, 2021.
*NOTE: This website in general, and this article specifically, is for general information and educational purposes only. It is not intended to diagnose or treat any medical condition, but rather to understand what options are available. Please seek the advice of a physician to properly diagnose your symptoms.
I am a doctor of physical therapy and a women's health and nutrition coach, but what I'm most excited to tell you is that I'm a regular gal — just like you — with my own health challenges ... And I've learned a lot along the way. Connect with me over on Instagram and check out all of my videos on YouTube!
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Cohee MW, et al. Benign anorectal conditions: Evaluation and management. American Family Physician. 2020;101:24.
Rectal prolapse. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/anatomic-problems-lower-gi-tract/rectal-prolapse. Accessed March 26, 2021.
Rectal prolapse. American Society of Colon & Rectal Surgeons. https://fascrs.org/patients/diseases-and-conditions/a-z/rectal-prolapse-expanded-version. Accessed March 22, 2021.
Tsunoda A. Surgical treatment of rectal prolapse in the laparoscopic era; A review of the literature. Journal of the Anus, Rectum and Colon. 2020; doi:10.23922/jarc.2019-035.
Varma MG, et al. Surgical approach to rectal procidentia (rectal prolapse). https://www.uptodate.com/contents/search. Accessed March 26, 2021.
Varma MG, et al. Overview of rectal procidentia (rectal prolapse). https://www.uptodate.com/contents/search. Accessed March 26, 2021.
Morrow ES. Allscripts EPSi. Mayo Clinic. April 16, 2021.

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Rectal prolapse occurs when the rectum becomes stretched out and protrudes from the anus.
Rectal prolapse occurs when part of the large intestine's lowest section (rectum) slips outside the muscular opening at the end of the digestive tract (anus). While rectal prolapse may cause discomfort, it's rarely a medical emergency.
Rectal prolapse can sometimes be treated with stool softeners, suppositories and other medications. But surgery is usually needed to treat rectal prolapse.
If you have rectal prolapse, you may notice a reddish mass that comes out of the anus, often while straining during a bowel movement. The mass may slip back inside the anus, or it may remain visible.
The cause for rectal prolapse is unclear. Though it's a common assumption that rectal prolapse is associated with childbirth, about one-third of women with the condition have never had children.
Certain factors may increase your risk of developing rectal prolapse, including:
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My Vagina Fell Out During Sex (And Here Are All The Gory Details)
By Alex Alexander — Written on Jul 21, 2017
Ever have a romp with a man who was so wild and so rough? Well, the truth is that it is possible to have sex that’s rough enough to pull your vagina out of your body .
If you’re wondering, yes, I know this from personal experience, and yes, I’m going to tell you how this vaginal prolapse happened. (By the way, this can happen to anyone, assuming that the right circumstances are lined up to have it happen.)
Before you run away screaming from anything with a penis , I should explain that there were a couple of things that happened that made this all possible. After all, this isn’t something that typically happens with sex, even if your vagina has seen its fair amount of things in its days.
First off, I had recently gone under the knife in order to get a partial hysterectomy and I also had my tubes tied. I also had given birth a couple of years prior. Oh, and my partner just so happens to have a member roughly the size of a can of Monster energy drink. (I'm not sure if that last part had anything to do with it, though it probably didn't help.)
Now let’s get into how my vagina fell out. This particular day, he and I had gotten particularly rough, and we had forgotten to use lube. Sex was painful, primarily because he kept hitting my cervix. However, I enjoy pain down there, so that wasn't the issue. Once sex was wrapped up, he pulled out — and that’s when I felt something was not quite right.
Unlike every other time we’ve done it, I started to dry heave. I couldn’t figure out what had happened to make me nauseous. Was I in pain? Was it something I ate? Though I did have a little bit of after-sex pain, it wasn’t really clicking with me that this was what was causing my nausea.
Soon after the heaving stopped, I noticed that there was a heaviness “down there.” The best way to describe it is that it felt like I was “fuller” down below, almost as if there was extra equipment that I just magically grew in the span of 5 minutes.
My cervix was sore, but aside from that, I didn’t really feel any pain. It’s a lot less painful than you’d expect it to be.
When I got up to pee, I headed to the bathroom... and nothing. I felt the need to pee, but for the life of me, I couldn’t urinate. I ended up having to push hard just to be able to pee. Something was definitely wrong.
My boyfriend , noticing the heaving and urinary problems, turned to me and asked, “Honey, are you okay?”
“I don’t know,” I said as I got back onto the bed.
Then he gasped. He looked down and asked me what that “weird pink donut thing” is. I asked him what he meant. He took a photo, and lo and behold, there was a huge pink mass that was dipping out of me. That’s when I realized that my vagina fell out .
So, what actually happened here? Technically, the term for what happened is a pelvic organ prolapse, or a vaginal prolapse, and approximately 40 percent of all women will experience it to some degree, due to a number of reasons. It happens when your pelvic muscles weaken and fall out of their rightful place. It happens with women who give birth, women who have hysterectomies, as well as older women.
Is it as horrifying as it sounds? Truthfully, it’s actually not as bad as it sounds. Mostly, I just felt heavy “down there,” had a little bit of a hard time peeing, and occasionally peed when I sneezed . Most of my symptoms were mild discomfort but the pain was way worse when it fully fell out.
Fixing a vaginal prolapse takes time, especially for women who have had a full prolapse like I did. A pessary, which is a small insertable support, can be used to help keep things in place, and if you commit yourself to exercising, a lot of the issues that cause prolapse can lessen over time.
However, surgery often is the best fix, but I didn’t opt for that, myself. Depending on the situation, surgery can involve sewing up your vagina or actually surgically putting things back into place. It was just too invasive for me.
In my extremely rare case, my vaginal prolapse did get better over a relatively short amount of time, especially after I put everything back in. The pain got less, things started to shift back into place, and there's not as much discomfort as there once was. And, better still, I haven't seen the inside of my vagina after sitting down in recent weeks.
However, it’s still a struggle and I still have a way to go. Things are still not completely normal down there, and peeing is still a struggle.
Nowadays, I make sure my boyfriend is gentle with me down there and I have to keep a certain lifestyle in order to make sure nothing falls out again. In order to help improve my pelvic muscles , I have to hit the gym and keep a low weight. I have to be very careful having sex until things are fully (or almost fully) healed, and well, I also have to do Kegels every night.
But, at the very least, things are coming along fine and in the future, things should probably all be back into place once more.
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