What to do about pelvic organ prolapse
In my last article, I described the different forms of pelvic organ prolapse and their respective symptoms. The uppermost question on women’s minds when it comes to prolapse is: how do I treat it? The good news is that there are several treatment methods, ranging from surgical to non-surgical options.
How do you make the choice? Well, you decide with your doctor, of course. He or she will look at the type and severity of the prolapse, your health status, your age, whether or not you want to have children, and which option you’re most comfortable with. In this article, I will elaborate on the non-surgical treatment options for prolapse.
The first course of treatment for mild to moderate prolapse is physiotherapy. This involves mainly pelvic floor exercises or Kegel exercises, which I have previously written about. Kegel exercises help to strengthen your pelvic floor muscles – remember, when these muscles are weak, your pelvic organs are more likely to prolapse. I have written about Kegel exercises previously – they are simple, but have to be done correctly and regularly. You have to be patient, as improvement in your condition may take a few months.
Hormone Replacement Therapy (HRT)
Mild or more advanced forms of prolapse in post-menopausal women may be treated with HRT or localised oestrogen cream . This treatment increases the levels of oestrogen and collagen in the body. These hormones can help to strengthen the vaginal walls and pelvic floor muscles, and together with the pelvic floor exercise may help to treat prolapse. However, there are certain risks associated with HRT and oestrogen cream in some women. Ask your doctor whether HRT or oestrogen cream is suitable for you.
Another form of non-surgical treatment is vaginal pessaries. A pessary is a small device, almost like a diaphragm or cervical cap, which is inserted into the vagina to hold the prolapsed organs in place. Pessaries are a good option for women who do not want to have surgery, who are pregnant, or who still want to have children or who are not fit for surgery.
They are made of latex or silicone, and come in different shapes and sizes. Which type will suit you? Well, you will have to try on several types to decide. Your doctor will help you to insert the pessary, and then you should “test” several positions to make sure that the pessary is comfortable and won’t fall out. If you are suffering any side effects from the pessary, you must tell your doctor. For instance, you may be experiencing discomfort, unusual discharge, bleeding or pain.
Unusual discharge means that you have more discharge than usual while using the pessary. If the discharge is foul-smelling, you may have an infection caused by the pessary creating ulcers on the vaginal walls. Pessaries may also cause discomfort with sexual intercourse, some more than others. Ask your doctor about this, and discuss it with your partner. Lastly, if you are allergic to latex, you should tell your doctor as pessaries will not be suitable for you. If it fits well and does not cause any side effects, you can wear the pessary for up to three or six months. During these intervals, you should see your doctor for check-ups. Your doctor will examine your prolapse and insert a new pessary.
It is very important that you follow your doctor’s advice about how and when to remove, clean and re-insert your pessary. If your doctor has taught you how to do it by yourself, follow the instructions carefully. You can visit your doctor regularly to have this done. Do not leave a pessary in for longer than advised, as it can cause infections. Each of these treatments has its benefits and risks. Make sure you get all the necessary information from your doctor before deciding on which treatment to go for.
A prolapse can be uncomfortable, or at worst, painful. Do not hesitate to see your doctor to get the right treatment.