Weakness or damage to the soft connective tissue or fascia of the pelvis can result in the wall between either the bladder and vagina, or rectum and vagina stretching out of shape. This can create difficulties in emptying your bladder or bowel completely and you may notice changes to bladder/bowel control.

The uterus can also prolapse down into the vagina and cause pelvic dragging, tiredness and heaviness and low back pain.

(Other gynaecological conditions such as fibroids can also cause bladder/bowel abnormalities)

The following advice is to help you to manage these symptoms and prevent things from getting worse.

 

AVOID heavy lifting if possible or modify your lifting. If you have to think about whether to lift something or not, then you should not be doing it! Try to draw up your pelvic floor and draw in your lower tummy before you lift anything e.g. grocery bags, washing baskets, small children. The biggest risks are repeated lifting (even for lighter objects) or standing for long periods (e.g. in line for groceries, airline counter)

TRY TO AVOID becoming over tired. If you are tired your muscles and ligaments are not as efficient at supporting your pelvic organs. You have probably noticed that things feel worse by the end of the day. Even just ten to fifteen minutes in the afternoon, with your feet up, can help.

Hormonal changes will affect your symptoms. During and after menopause symptoms may get worse; and before and during your period.

Correct positioning to empty your bladder and bowel completely can help. Lean forward with elbows on knees and shoulders wide, or use a small stool under your feet.

Avoid constipation or any straining on the toilet. This will just make your prolapse worse and can damage other tissues. Keep up a good fluid intake; eat plenty of fruit and fibre. Kiwi fruit are great. Regular exercise can help too.

Correct and regular exercises for your pelvic floor muscles can help a lot with relieving symptoms. These exercises can help your muscles work at the right time and can restore normal strength and endurance. You need to know how to do these correctly, so check with your physiotherapist if you are not sure.

Maintain good posture, weight control and general fitness but AVOID high impact exercise or standing for a length of time. (remember gravity is not your friend). Walking, aquasize, cycling or low impact exercise is great.

Wearing a supportive under garment can be really helpful especially when you are exercising or walking a long way or standing for a length of time. Look for control panel panties; these are easy to find in your local department store or lingerie shop.

There are some great support underwear garments available at reasonable prices:

"Hold Me Tight" available at The Warehouse or www.holdmetight.com.au

Seamless longline support underwear available at K mart

"Skins" sports compression garments available at sports shops

Advice from your Doctor/specialist regarding hormone replacement cream, vaginal ring pessary and surgical options will help you to make a plan for future management of your prolapse