Pelvic organ prolapse (sometime referred to as POP) is a condition that many women may experience during menopause, although menopause is not usually a direct cause. This series of articles will define pelvic organ prolapse; examine the causes, symptoms and stages; and look at treatment options.

These articles are for general information only and should not be considered as personal medical advice. Readers are encouraged to gather information to take to their next doctor visit.

Pelvic organ prolapse
Pelvic organ prolapse is when a pelvic organ ‘drops’ or ‘prolapses’ from its usual spot in the abdomen and puts pressure on other organs and/or on the vulvar/genital region. Any of the pelvic organs may be affected including the bladder, urethra, uterus, genital organs, small bowel (lower intestine), and the rectum. The University of Maryland Medical Center notes that between 35 to 65% of American women will experience some form of prolapse and around 200,000 surgical procedures take place each year.

Causes of pelvic organ prolapse
Pelvic organ prolapse occurs because surrounding muscles, ligaments, and connective tissues are damaged. Damaged tissues no longer have enough strength to support a pelvic organ and that organ falls up against the abdomen walls for support.

Pelvic organ prolapse tends to run in families. Women, especially those over 50 are more prone to developing a prolapse and the most common causes include:
*Intense muscle pushing during childbirth
*Hysterectomy; absence of the uterus may mean less support for surrounding organs

Additional factors may make also contribute to a prolapse or worsen the pain and pressure in the abdominal area:
*Obesity; being at least 30 pounds overweight and carrying that weight in the waist area
*Prolonged coughing spells due to illness or smoking
*Frequent constipation and straining the bowels
*Pelvic organ tumors
*Feelings of pressure are worse when standing, lifting or using the stairs; lying down brings some relief

Menopause and pelvic organ prolapse
The menopause connection is more difficult to pinpoint, but in some women, the loss of estrogen may be a factor. Decreased estrogen levels equal lower collagen levels in the connective tissues. Collagen helps keep tissues supple so they can stretch and return to their normal position. Without sufficient collagen, the tissues become more rigid and may no longer provide enough support for the pelvic organs.

Pelvic organ prolapse symptoms
Sometimes a prolapse is relatively minor and may not be any cause for concern. Definitely consult with a healthcare professional for any of the following:
*Pressure and/or pain in the pelvic region
*A persistent feeling of fullness in the lower abdomen
*Feeling that something will fall out of the body through the vulvar opening
*Pulling and stretching in the groin or lower back regions
*Urinary leaks or feeling the need to urinate frequently
*Painful intercourse
*Bowel discomfort and constipation
*Occasionally there may be unusual vulvar spotting or bleeding

Diagnosing pelvic organ prolapse
A healthcare professional will conduct a physical examination and gather patient medical history to determine the extent of the prolapse and its underlying causes. With a proper diagnosis, an appropriate treatment option will help correct the discomfort.

The next part of this series looks at the stages of pelvic organ prolapse and suggested available treatments.

For more information, please visit www.healthlinkbc.ca.


Menopause, Your Doctor, and You