“From the time women are 12 years of age, we face many female problems: menstruation, pregnancy, childbirth, and menopause. Then we reach 65 and feel that all of this is behind us and we’re home free—only to find our insides are falling down. I was shocked when this happened to me, as I had never even heard that it could happen.
“My gynecologist booked surgery to repair a prolapsed bladder and told me he would also remove my ovaries and uterus because I ‘no longer needed them.’ Four of my friends had already undergone this surgery and all of them got infections. One gal was even hospitalized for many weeks due to complications. I decided to cancel the operation, and when I did, my doctor told me I should go see a psychiatrist!
“I want to know why doctors only suggest surgery and don’t mention other options for these female problems. Are there alternatives? I hope you can help me. I want to be able to pass information on to others who are struggling with this horrible issue. Knowing what my life has been like, I can honestly say that I would not choose to be a female if I had the choice.”
This letter, from a 76-year-old woman I’ll call Lorraine, articulates a very common female problem, especially among older women: pelvic organ prolapse. And as Lorraine suggests, the knee-jerk reaction of conventional physicians is often surgery. Sometimes operations are necessary, but they are certainly not the first or only treatment option. Let’s look at drug- and surgery-free solutions that stand to benefit millions of women with this common female problem.
What Is Pelvic Organ Prolapse?
The bladder, uterus, vagina, and other organs in the pelvic region are held in position by muscles and ligaments. Pelvic organ prolapse occurs when these structures are unable to support the organs and they descend downward. Several conditions may contribute to this common female problem, including obesity and nerve disorders, but the leading cause is stretching and weakening of the musculature during childbirth.
According to the National Association For Continence (NAFC), at least half of all women who have given birth to one or more children will eventually experience some degree of pelvic organ prolapse. And it usually comes on later in life as hormone levels decline and muscles and other tissues become weaker and lose their elasticity.
Symptoms of pelvic organ prolapse include heaviness and pressure—a feeling Lorraine described as her “insides falling down.” In severe cases, the rectum (rectocele), bladder (cystocele), or uterus (uterine prolapse) may even protrude through the vaginal opening. The strain exerted on these organs may cause painful intercourse, constipation and other bowel problems, or, most commonly, stress incontinence—that embarrassing leakage of urine brought on by exercise, sneezing, coughing, or other activities.
Exercise Your Pelvic Muscles
Because pelvic organ prolapse is most often the result of weakened muscles, pelvic floor muscle training, commonly called Kegels, should be a first-line treatment. Many women tend to dismiss the importance of this simple exercise, but it works wonders for strengthening and toning the muscles that hold the pelvic organs in place. Every woman, regardless of age, should do Kegel exercises for five minutes a day to help prevent pelvic organ prolapse and urinary incontinence or to lessen symptoms if they are already present.
Although Kegels aren’t difficult, they can be tricky until you get the hang of it—and you have to remember to do them. Ask your doctor to help you identify the muscles and make sure you’re doing them right. Biofeedback, which reinforces proper technique, is very helpful, as are weighted vaginal cones that force you to use these muscles to hold the cones in place. Another option is electrical stimulation via a probe inserted into the vagina, which strengthens the muscles through involuntary contraction.
Other Noninvasive Therapies for Pelvic Organ Prolapse
For more advanced prolapse, a vaginal pessary may be indicated. Pessaries are removable devices typically made of rubber, latex, plastic, or silicone that come in a wide range of sizes and shapes. Inserted into the vagina, they provide support for the pelvic organs and are a useful tool for both preventing prolapse and controlling incontinence. Although they don’t work for everybody, many women report improvements, especially with stress incontinence, when they are worn continuously or during exercise or other activities that exacerbate symptoms.
I know of no prescription drugs specifically for pelvic organ prolapse, and studies do not support the use of hormone replacement therapy for this condition. However, topical estrogen definitely restores vaginal tone and is reported to reduce incontinence in many women.
We’ve also had pretty good success at Whitaker Wellness with acupuncture. I recall one patient who was seeing our acupuncturist for an unrelated condition when her stress incontinence unexpectedly improved.
On the supplement front, a proprietary combination of soy isoflavones and pumpkin seed extract called Go-Less is another option. These ingredients support hormonal balance that in turn strengthens bladder and pelvic muscles (to help stop leakage) and relaxes these muscles to support more effective emptying of the bladder (which reduces urinary urges and frequency).
In clinical trials, Go-Less has been shown to reduce the number of trips to the bathroom—by 40 percent during the night and 16 percent during the day—and improve urinary leakage by up to 80 percent.
Preventing Pelvic Organ Prolapse
Then there’s surgery to strengthen the ligaments or repair the pelvic floor. I cannot comment on the appropriateness of Lorraine’s recommendation for surgery except to say that her doctor’s remark about removing her ovaries and uterus because she “no longer needed them” is preposterous. I would not disagree that surgery is sometimes the best treatment, but I want to share a shocking statistic. Experts estimate that by age 80-85, 11-19 percent of women in the US will have surgery for pelvic organ prolapse or urinary incontinence, and 30 percent of them will require repeat surgeries!
These figures needn’t be so high. We must bring pelvic organ prolapse—which many women are too embarrassed to talk about—out of the closet. Lorraine is incensed that she didn’t know anything about it and that she was offered nothing but surgery. She has a point. Ladies, you need to be aware of this very common female problem and learn what you can do to prevent it. And physicians need to exhaust all treatment options before recommending invasive procedures.
Thanks, Lorraine, for shedding some much-needed light on this issue.
Female Health Problems Recap
You can find detailed instructions—for both men and women—on how to perform pelvic floor muscle training (Kegels) correctly here.
Talk to your doctor about biofeedback, vaginal cones, and electrical stimulation. Pessaries must be fitted and monitored by a physician. Topical estrogen requires a prescription and can be ordered from compounding pharmacies.
If you live in the Orange County area and are interested in acupuncture, make an appointment with us by calling 866-944-8253. To find a licensed acupuncturist in your area, visit the National Certification Commission for Acupuncture and Oriental Medicine’s Web site at nccaom.org.
Go-Less can be found in a number of combination products in health food stores and online. To order the product we use at the clinic, call 800-810-6655. Use as directed.