At times, we get so caught up in our day to day rituals that we miss signals our bodies send us. Sometimes those signals are related to basic bodily functions, such as the need to urinate, defecate, or pass gas. But other times, subtle signals may be indicative of significant health issues, such as pelvic organ prolapse (POP), which is estimated to impact 50% of women.
We women tend to our professional and employment duties, our household chores, and the needs of our children or grandchildren. We tend to the stack of bills sitting on our desks. We tend to our lawns and gardens. The one thing we typically don’t tend to is our health, or if we do, we push it to the bottom of our list.
Like most health concerns, the sooner pelvic organ prolapse is recognized and treated, the easier and less invasive it may be to treat. Most women aren’t aware POP exists prior to diagnosis, and that is problematic. How can women seek diagnosis and treatment for a condition they aren’t even aware occurs? Prior to my diagnosis I’d never heard of pelvic organ prolapse; I was absolutely a part of the status quo.
Most women are aware of urinary incontinence (UI), but don’t realize that a failure in the internal female health structure may be the cause. UI doesn’t just “happen”. Often that system failure is pelvic organ prolapse. Urinary incontinence is only one of many symptoms of POP, and is more often than not related to weak pelvic floor muscles.
Most women are aware of constipation (boy are they ever if they have a rectocele), but don’t realize that a failure in the internal female health structure can cause chronic constipation. Again, that failure is often pelvic organ prolapse. A hernia bulging from the side of the rectum creates a pocket where stool nests, refusing to move on down the line.
And what about vaginal pressure? Fecal incontinence? Rectal pressure? Pain with intimacy? Inability to start the urine stream? Lack of intimate sensation? Tampons pushing out? No one tells women that these symptoms mean something, that they have significance, that they are flags that something is not functioning properly in their pelvic cavity. And women are seldom asked the appropriate POP symptom questions during the little time clinicians are expected to perform routine pelvic exams.
While women may not know they have POP, they absolutely recognize symptoms they are experiencing, and want an explanation of what those sensations mean. Unfortunately, they often are unable to capture validation that what they feel is real. Women may share POP symptoms with diagnostic clinicians, but because a POP system check is not part of a routine pelvic exam, unless symptoms lead a clinician to explore more deeply, POP is often not recognized during routine pelvic exams. Symptoms shared may not raise flags to the degree of generating a POP screen. At times women are told they are likely fatigued or stressed, and the physical manifestations of POP are dismissed if a standard pelvic exam or inappropriate diagnostic tests do not clarify POP. Few things are more frustrating to a woman than being told by a clinician that symptoms she is experiencing are in her head, especially when they are as invasive as POP symptoms can be.
I learned at a relatively young age to pay close attention to body signals, one of the blessings of navigating multiple sclerosis (MS). By the time I was diagnosed with POP, it was easy to translate the lessons I learned from my MS journey to my POP journey. Every step of my POP experience from discovery through diagnosis, surgery, post-surgical heal curve, and current maintenance for life mode, I’ve paid close attention to pelvic, core, and floor sensations. As an advocate, I’ve also paid close attention to what other women in APOPS following have shared regarding their journeys.
Women know what they feel. They simply don’t always know that specific symptoms are indicative of pelvic organ prolapse. POP is not talked about or routinely screened for despite two of the most significant life events women experience, childbirth and menopause, being the leading causal factors.
Patient Voice Matters. If we want to know what is occurring in a patient’s body, it is imperative we ask the right questions, and listen attentively to the answers. Pelvic organ prolapse has been on medical record for nearly 4000 years. Patient voice is the instrument that will break down the wall of silence.