A Holistic Approach to Pelvic Organ Prolapse: A Comprehensive 6-Step Guide
Pelvic Organ Prolapse (POP) can feel overwhelming and challenging to navigate, and we send our hearts out to you! Through our clinical experience, we've learned that there is more to POP, and creating a map to grasp the underlying mechanisms greatly influences your path to healing. We've supported numerous women through pelvic floor physical therapy , witnessing encouraging results along the way. That's why we've created this holistic prolapse treatment approach—to serve as a comprehensive guide to support you on your pelvic floor healing journey. Think of this as serving as step 1 - becoming educated, mindful, and aware of what you may be experiencing. We are happy you are you <3
Step 1: Education & Mindfulness
Before diving into the specific steps, it’s essential to highlight the role of pelvic floor education, mindfulness, and awareness in managing POP. We know that prolapse diagnosis can be overwhelming, so understanding the process, sensations, and pelvic floor therapy interventions as an integral piece of our appraoch. Being mindful of your body’s signals and cultivating awareness around your daily activities can significantly impact the severity of POP symptoms. Practicing mindfulness can help you stay attuned to your body’s needs and make informed decisions about your health.
Education: About proper anatomy, sensations, and interventions.
Recognizing Body Signals: Being aware of pelvic pain, discomfort, or changes in symptoms to take timely action.
Stress Resilience: Implementing techniques such as meditation or deep breathing exercises to cope with stressors.
Conscious Breathing: Practicing proper breathing techniques to manage intra-abdominal pressure. Not this can be different from person to person, and a pelvic floor physical therapist can support you in determining the appropriate breathing pattern for you.
Mindful Movement: Paying attention to body mechanics and movements to reduce strain on the pelvic region. This is a great foundation to start on before introducing movement and pelvic floor exercises to improve your prolapse.
Body Scanning: Regularly checking in with different parts of your body to identify tension or imbalance.
Optimizing Sleep: Good sleep supports overall bodily functions and recovery. Our physical body heals during deep sleep and prioritizing rest is essential to support the healing process.
Step 2: Pelvic Floor Physical Therapy for Intrinsic Support
Intrinsic support focuses on enhancing the self-musculoskeletal and nervous system factors to improve pressure management. By targeting specific areas of the body and lifestyle habits, you can significantly reduce the symptoms of POP.
Breathing: The respiratory and pelvic diaphragm muscles are heavily utilized with intrinsic support. Learning to coordinate the multiple diaphragms of the body through breathing is one of the first steps! Re-training breathing can even be considered one of the first pelvic floor exercises!
Pelvic Floor Exercises “Kegels”: When people think of “pelvic floor exercises” or “kegels”, this is just ONE part of many interventions that are to take place when treating POP. Though kegels and specific pelvic floor exercises are purposeful in the program, there is a coordination factor that persists outside of the pelvic floor!
Core Retraining: Strengthening the core muscles (the core is diaphragm, abdominals, multifidus, and pelvic floor) provides better foundation and support for POP.
Hip Mobility: Improved hip mobility aids in balanced body mechanics. The hip influences the pelvis through a variety of ranges and being able to access your full range will aid in better body mechanics & pelvic organ positioning
Spinal Mobility: Enhancing spinal flexibility can reduce undue stress on the pelvic region.
Single-Leg Stability: The nature of single-leg stability is to reinforce overall pelvic stability through force closure by activating the pelvic floor and core muscles. This provides a stable foundation and better distribution of muscle balance activation in the core.
Hypopressives: an effective exercise tool to manage intra-abdominal pressure through certain body and breath positions with coordination of the pelvic floor muscle group. This maneuver can help naturally support and lift the pelvic organs into a better position.
Optimizing Gait: Ensuring proper walking mechanics reduces the strain on pelvic organs.
Body Mechanics: Prolapse is often influenced by our body’s internal vectors, learning your proper body mechanics can improve daily activities, such as lifting, carrying, extended standing, etc.
Step 3: Extrinsic Support
Extrinsic support involves using internal and external tools to provide comfort and additional support during healing. These aids can be temporary or long-term solutions to fall back on when needed.
Pessary Usage: A pessary can provide internal support to the pelvic organs. It comes in many different shapes and sizes. You are fitted to the right one and a pessary requires insertion and removal techniques and education. This is similar to a vaginal diaphragm.
My Pelvic Bra: Offers external core and pelvic support to help manage symptoms https://www.mypelvicbra.shop/
“It’s You Babe” V2: A supportive garment designed for pelvic support. https://a.co/d/5g6OUFJ
“BraceAbility”: Provides compression and support to the pelvic region https://a.co/d/28Tr7N9
“Underworks” Brief: Specialized briefs that offer additional support. https://a.co/d/gLPdrm7
Revive Support: A reusable bladder device, it’s a cross between a pessary and a tampon and is a physical support that is inserted similarly to a tampon. https://a.co/d/79S4bPH
Poise Impressa: Similar material to a tampon but different architecture. As the impressa expands to provide support to the vaginal wall, best used for stage 1 and 2 prolapse. https://a.co/d/dbsFM9E
Sea Sponge Pearls by Jade & Pearl: Designed for internal support and comes from a natural renewable source. Due to sponge properties can mold better to your vaginal cavity. https://a.co/d/6iWYJF0
Step 4: Estrogen Support
Low estrogen levels can lead to the weakening of connective tissues, muscle atrophy, and other changes that impact POP. Supporting estrogen levels can help mitigate these effects. In regards to intrinsic support, the vaginal tissue will be more likely to respond well to other support if the tissue has a rich blood supply and the vulvar and vaginal tissue has quality integrity, which can be supported through estrogen applications.
Cycle Optimization: If you are still cycling, looking into hormone health can set the stage for cyclical symptoms. Using cycle charting can determine what areas need balancing.
Vaginal Creams: Options include Estrace or bio-identical to provide localized estrogen support.
Phytoestrogen Foods: Incorporating foods rich in phytoestrogens can help naturally boost estrogen levels.
Collagen: Supports tissue health and strength.
Herbs: Certain herbs can help support hormone levels and overall health.
Step 5: Gut Health Support
Gut health plays a crucial role in managing pressure and inflammation within the body, which can impact prolapse symptoms. Bowels that are “backed up” must expand, and the uterus and bladder sit right in front of it which means more weight and pressure down on them.
Clearing Constipation: Effective management of constipation reduces pressure on the pelvic organs.
Clearing IBS/IBD/SIBO: Addressing underlying gut issues helps alleviate pelvic organ prolapse symptoms.
Optimizing Microbiome Function: A healthy microbiome supports overall bodily functions.
Optimizing Nutrition: Proper nutrition is vital for maintaining gut health and overall well-being.
Step 6: Surgical Route and Options
Surgery is generally considered if symptoms do not improve with other treatments, and choosing surgery does not indicate failure but rather a step towards the support you need for better health. Prolapse can be repaired using either your own ligaments (native-tissue) or with mesh (mesh-augmented), and the choice of procedure will depend on your medical history and your doctor’s recommendations. After surgery, many patients report significant relief, including reduced vaginal heaviness or bulge and improved urination. Although there is a small chance of prolapse recurrence, the likelihood of needing a second surgery is less than 10%.
Prolapse surgery is one of several treatment options available for managing prolapse. While some may choose surgery as their preferred approach, others might explore alternative treatments first. Consulting with a trusted surgeon is advisable to determine if there are any urgent reasons for surgery and to discuss the best options.
This section is provided by Dr. Olivia Chang, M.D at UCI Newport Beach, CA. Dr. Chang’s specialty is Urogynecology, Pelvic Reconstructive Surgery, Female Urology, Urinary Incontinence, Transgender Care. A trusted physician and surgeon of Tonic & Phasic Holistic Pelvic Health in Costa Mesa.
Types of POP surgeries:
Native-tissue prolapse surgeries: Surgeries that uses natural ligaments to resuspend the pelvic organs to its original position
Mesh-augmented surgeries: Surgeries that use mesh for more durable treatment outcome.
Contact Us in Costa Mesa, CA for our Pelvic Organ Prolapse Treatment
Managing Pelvic Organ Prolapse requires a multifaceted approach that includes education, mindfulness, intrinsic support, extrinsic support, estrogen support, gut health, and potentially surgery. If you were diagnosed with POP or feel like you may have it, we want you to know that there is an end. It isn't easy but it is worth it! We are rooting for you!!
If any of this hits home or if you have any questions book a free 15-minute discovery call with us at 949-612-7695. We would be honored to support you.
