Ladies: Read This if You Wonder What’s Up Down There

by Mixed Urinary IncontinenceOveractive BladderPelvic Floor WeaknessPelvic Organ ProlapsePOPStress Urinary IncontinenceUrge IncontinenceUrge Urinary Incontinence

Sometimes there is nothing like another person’s story to really motivate and empower us to take action for our own health. If you are concerned that you may have women’s urinary incontinence–meaning you have symptoms like urinary urgency, frequency, or leakage–the stories in this article may interest you. These stories may also interest you if you feel like something is falling out “down there”… or if your bedroom encounters have gone from “hot to not”!

If you wonder, “What IS up down there?” then read on… these stories may resonate with you plus motivate you to get the help you need!

Are You Like Jane?
Jane, in her mid-thirties, loves how kickboxing is helping restore her figure after she gave birth to her adorable son. What she doesn’t love is the amount of urine she leaks every time she kicks or boxes. In fact, the leakage happens so often that she is thinking of stopping her exercise program altogether.  Here’s what Jane doesn’t know.  She has stress urinary incontinence (also called stress incontinence), the most common form of urinary incontinence, which affects 26 percent of women over age 18 at some point in their lives. Childbirth is a major cause of stress incontinence. Most women with urine leakage wait more than six years to get help. Yet research shows that urinary incontinence in 8 out of 10 women with the condition can be improved. How long will Jane wait?

Jane solved her problem. Find out how by clicking HERE.

Are You Living Karen’s Story?
Sixty-two-year-old Karen has bathrooms on the brain. She has to urinate 10 to 12 times a day and a few times at night. Sometimes she feels a sudden urge and doesn’t make it to the bathroom in time–she then leaks a large volume of urine. Karen has to carry several changes of clothing with her and buys adult diapers in bulk. Her situation is bad, but her embarrassment about seeking help is worse, so she just keeps coping with the condition by herself.

This is what Karen should know. Karen is suffering from the most severe form of overactive bladder, called urge urinary incontinence. About 17 percent of women in the United States have urge incontinence, especially women 50 and older, but less than half seek help. Getting help is important, because about 60 percent of women with urge urinary incontinence also experience depression (though the two conditions are not always related). Help is also important because 70 percent of women with urge incontinence report symptom improvement with conservative treatments like medication or physical therapy.

Discover how Karen stopped leaking urine by reading her story HERE.

Does Jo’s Story Ring a Bell?
Jo, age 40 and very fit, faces a complex situation: she has the same symptoms as Jane and Karen, meaning she leaks urine when she exercises or laughs as well as because of sudden urges. She’s had symptoms for only 11 months but is definitely going to ask her doctor for help, even though she feels embarrassed. Her symptoms are frequent and serious.  What Jo will learn when she talks to her doctor: Jo’s doctor will tell her that she has mixed urinary incontinence, which is a combination of stress incontinence and urge incontinence or overactive bladder. Women with this mixed form of incontinence are more likely to seek help earlier because their symptoms tend to be worse and more frequent than symptoms of women who experience only stress or urge incontinence / overactive bladder. Mixed incontinence has a much stronger negative effect on quality of life, and women with this condition spend much more on laundry bills and adult diapers.

Jo was able to solve both types of urinary incontinence by using the steps outlined HERE.

Do You Share Susan’s Pain?
At age 68, Susan is suddenly experiencing low-back pain, chronic constipation, and the feeling that she is sitting on a ball. Luckily, she already has an appointment with her ob-gyn in a few weeks. She hopes her doctor will tell her what’s happening in her pelvic region.  What Susan’s ob-gyn will tell her at her appointment: Susan feels like she’s sitting on a ball because her pelvic organs have literally popped out of place. She has pelvic organ prolapse, in which one or more of her pelvic organs have moved out of place and now bulge into her vagina.  Susan’s ob-gyn will tell her that she is among the 3 to 6 percent of women who have severe pelvic organ prolapse, and will most likely need surgery to correct the problem. Surprisingly, between 43 and 76 percent of women have some degree of prolapse without knowing it and should be taking preventive action.

Susan was able to solve her pelvic organ prolapse issues with help from her doctor. Find out what Susan did HERE.

Do You Have “Not So Hot” Bedroom Encounters Like Cherie?
At age 42 Cherie is supposed to be in her sexual prime, at least according to the latest women’s magazines, but she feels far from sexy. With two children and a busy career, she considers sex to be at the bottom of her list. Further, sex with her husband just isn’t very pleasurable anymore because Cherie doesn’t feel much sensation in her sexual organs. She avoids sex as much as possible, but her husband is becoming upset and worried. She knows she needs to do something to resolve the situation, but she doesn’t know what.

How Cherie can solve her sexual problem: More than 40 percent of women are dissatisfied with their sex lives, and many of these women have decreased sexual sensation, which is what Cherie is experiencing. This decrease in sensation is often due to weak pelvic floor muscles, and the good news is that these muscles can easily be strengthened with pelvic floor muscle exercises. Studies show that women who do pelvic floor exercises reach orgasm more easily and experience more sexual desire. Cherie can improve her symptoms by following a simple pelvic floor exercise program, such as one from her physical therapist or the at-home program in chapter 7 in our book.

Cherie changed her bedroom encounters from “not, back to hot”… find out how by reading her story HERE.

Read, Plan, Do
Once you have read through these women’s’ stories, you should have a pretty good idea of what is going on with your pelvic health. Then make a plan. Will you call your family doctor for a referral to a urologist or will you visit your ob/gyn? Will you stop in and visit with your family doctor first?

Whatever you plan that takes you closer to solving your pelvic health issues is good. Then you must DO. A plan without action is not a very useful plan. So once you have your plan, do it! Take action for your own pelvic health. You will be surprised how much your quality of life will be affected by improving your pelvic health!

If you enjoyed this post, we invite you to check out our book, leave a comment, contact us, download our free ebook, or interact with us on Twitter and Facebook.

The Importance of Pelvic Floor Health

by KegelsPelvic Floor MusclesPelvic Floor WeaknessPelvic Organ ProlapsePessaryPOPStress Urinary Incontinence

Guest Post by Linda Grayling

A healthy pelvic floor serves as the supporting structure for the pelvic organs, which include the uterus, bladder and rectum. It supports the weight of the baby during pregnancy, and plays a role in core strength and posture. A strong pelvic floor can make childbirth and recovery easier, enhance sexual sensation, and help prevent pelvic floor disorders.

The extra pressure placed on the pelvic floor from supporting the baby throughout pregnancy and the strain of delivery can weaken this support system. This can lead to pain during or the inability to have sex, urinary incontinence, trouble with bowel movements, and prolapsed or displaced pelvic organs.

High-impact activities, heavy lifting, chronic coughing, frequently straining to produce a bowel movement, obesity, and smoking can also contribute to a weakened pelvic floor and increase the chance of developing a pelvic floor disorder.

Stress Urinary Incontinence
Stress urinary incontinence (SUI) is a common pelvic floor disorder that affects at least a third of all women at some point in their lives. It occurs when the stress from normal activities–like exercise, coughing or sneezing, laughing and even sex–triggers accidental urine leakage.

Many women experience minor issues with bladder control every now and then, but when incontinence becomes more frequent or interferes with daily life, they should talk to a doctor. Incontinence is directly related to the strength of the pelvic floor. Weakened pelvic floor muscles increase the odds of developing SUI.

Performing Kegel exercises daily can resolve symptoms of incontinence in just a few weeks. Not only will women stop experiencing embarrassing leakage during sex, but Kegels also heighten sexual sensation and help achieve orgasm.

Pelvic Organ Prolapse
Pelvic organ prolapse occurs when the pelvic floor is no longer strong enough to hold the pelvic organs in their proper place, allowing them to sag against the vaginal walls–and in severe cases, protrude from the vaginal canal. Prolapse occurs in half of all childbearing women, but is frequently without symptoms, making it a non-issue.

For women who do experience symptoms, they can include a pulling feeling or pelvic pressure, low back pain, problems with bowel movements and urinary problems, pain during sex, and unusual spotting or bleeding. Symptoms can worsen over time.

Women should always try conservative treatments before considering surgery. Strengthening the pelvic floor throughout pregnancy and after childbirth is especially important in avoiding pelvic organ prolapse later in life.

Physical therapists can offer personal instruction on locating, isolating and strengthening the pelvic floor, and may employ biofeedback therapy, pelvic massage or the use of vaginal weights. Doctors may also recommend the use of a vaginal pessary to keep pelvic organs in place.

In recent years, many women have had corrective surgical procedures using transvaginal mesh to strengthen the pelvic floor. The complications associated with transvaginal mesh are not always reversible, and include organ perforation, mesh erosion and the need for revision surgery.

These complications have prompted the Food and Drug Administration (FDA) to issue a warning stating that most cases of prolapse can be corrected without mesh and that mesh can expose patients to greater risk.

Women should ask their doctors about all of their surgical repair options, which can include using the patient’s own tissues or biologic products.

Linda Grayling writes for Drugwatch.com. Linda has a number of professional interests, including keeping up with the latest developments in the medical field. Join the Drugwatch community on our Facebook page to find out more.

If you enjoyed this post, we invite you to check out our book, leave a comment, contact us, download our free ebook, or interact with us on Twitter and Facebook.

 

 

Women’s Urinary Incontinence: What You Gain When You Seek Medical Help

by Find the Right DoctorGeneral Urinary IncontinenceOveractive BladderPelvic Organ ProlapsePessaryPOPStress Urinary IncontinenceUrge IncontinenceUrge Urinary IncontinenceUrinary Incontinence

In our last article, we discussed all the quality of life aspects that go out the window when women with urinary incontinence fail to seek medical help for their condition. In this follow-up article, we take a look at all the benefits you gain when you seek medical help for women’s urinary incontinence. Yes, we know, seeking medical help involves having that “red-faced” embarrassing conversation with your doctor about urinary urgency, frequency, and leakage. But after you read through all the benefits you will gain once you get through that conversation, our bet is that you will be willing to ask your doctor for help (if you haven’t already)!

Benefit #1: A Medical Diagnosis
A lot of women with urinary incontinence know that they have a problem, but they don’t know exactly what the problem is. They know they suffer from urinary urgency or frequency or leakage, but may not necessarily know the causes of these symptoms. This lack of knowing “what’s up down there” can create a sense of tension and stress for many women. Therefore, one of the biggest benefits of getting help from your doctor is that you get a true and medically-correct diagnosis about your condition. You will find out if you have stress, urge, or mixed urinary incontinence … or just a mild form of urge incontinence called overactive bladder (OAB). You will discover whether your pelvic organs have “fallen” out of place, causing some of your symptoms. Whatever the cause of your urinary incontinence symptoms, you will emerge from your conversation with your doctor with the knowledge of what is happening with your body. Since “knowledge is power,” you will emerge from your appointment with a new sense of self-empowerment. That is a pretty neat benefit.

Benefit #2: Knowledge of Treatment Options
Once your healthcare provider discovers the cause of your symptoms, such as urinary urgency or leakage, the next step is obviously to discuss treatment options. Depending on the type and severity of your symptoms, your doctor may recommend either conservative or surgical treatment options. Conservative options may include lifestyle changes, such as smoking cessation, weight loss, and dietary changes. Other conservative therapies include bladder retraining, pelvic floor muscle rehabilitation, acupuncture, pessaries, and percutaneous tibial nerve stimulation.

If your condition is more severe, especially if one or more of your pelvic organs has fallen out of place (a condition called pelvic organ prolapse, or POP), then your doctor may recommend some surgical options to treat your condition. The good news is that most of the surgical procedures for women’s urinary incontinence are minimally-invasive, plus have a high rate of success.  Most healthcare providers will recommend that you start with the most conservative therapy possible, and consider surgery only if your condition is not treatable with conservative approaches.

Benefit #3: Support on the Journey Back to Health
While talking to your doctor about your urinary symptoms may be embarrassing, you will find that most medical professionals are quite knowledgeable and compassionate about women’s urinary incontinence. By seeking help from your doctor, you will not only get the help you need to restore yourself to continence, but you will gain the knowledge that you are not alone. As the baby boomer generation ages, more and more doctors are helping women with urinary incontinence issues. Your doctor will not only provide you with solutions that will treat your condition, but can also reassure you that you are not alone. Your doctor may even be able to recommend resources, both online and offline, where you can find additional support from women dealing with the same kinds of symptoms.

Big Benefits from Seeking Help
As you can probably tell, seeking help from your doctor will yield some pretty major benefits for you. Not only will you be able to address your physical symptoms, but you will also be able to ease your mind as you gain knowledge about urinary incontinence. The more you know, the more control you will have over your condition. The more control you have, the less stress you will experience. All of these are major contributors to a good quality of life. Doesn’t that make a short conversation with your doctor worthwhile?

 

If you enjoyed this post, we invite you to check out our book, leave a comment, contact us, download our free ebook, or interact with us on Twitter and Facebook.

 

Acupuncture for Urinary Urgency and Other Embarrassing Symptoms

by General Urinary IncontinencePelvic Organ ProlapsePOPUrge IncontinenceUrge Urinary Incontinence

This blog is part 10 of an 11 article series of 11 New Year’s resolutions that actually work and WILL improve your pelvic health. Get the full list of all 11 New Year’s resolutions HERE.

What’s worse? A few tiny needles the width of a human hair or experiencing that embarrassing “wet pants” look that comes with urinary urgency (and other symptoms of urinary incontinence)?

We don’t know about you, but for women with urinary incontinence, a few tiny acupuncture needles may seem like a very small price to pay for a reduction in symptoms. Acupuncture, a well-respected healing technique from the East, has long been considered an excellent “middle of the road” option for women with urinary incontinence symptoms like urinary urgency, frequency, and leakage. This conservative therapy has also proven effective for women with pelvic organ prolapse. More importantly, acupuncture is a wonderful solution for women who, for whatever reasons, choose not to take medication or cannot make lifestyle changes, such as weight loss and smoking cessation.
What is Acupuncture, Exactly?
If you are considering using acupuncture to solve symptoms such as urinary urgency and frequency, then you probably want to know exactly what this kind of therapy entails. We don’t blame you! When someone starts talking about using a bunch of needles to alleviate symptoms of urinary incontinence, you probably want to know more–specifically, the details!

According to the National Institutes of Health, acupuncture is defined as follows:

“The term ‘acupuncture’ describes a family of procedures involving the stimulation of points on the body using a variety of techniques. The acupuncture technique that has been most often studied scientifically involves penetrating the skin with thin, solid, metallic needles that are manipulated by the hands or by electrical stimulation. Practiced in China and other Asian countries for thousands of years, acupuncture is one of the key components of traditional Chinese medicine.”

The use of acupuncture is very widespread–more than you may think. According to the National Health Interview Survey, in 2007 an estimated 3.1 million U.S. adults and 150,000 children received acupuncture treatments within the past year. And that number has only been on the rise since the 2007 study.

As for actual treatments, practitioners use either very fine acupuncture needles or mild electrical stimulation (meant to mimic the stimulation provided by needle insertion) to increase the flow of energy in the body. Needles are inserted at specific points located along meridian lines that circulate energy throughout the body, and specific combinations of points can be used to create healing effects. While many people know about the use of acupuncture for pain relief, fewer people recognize the effectiveness of this conservative therapy for other conditions, such as urinary incontinence, constipation, and pelvic organ prolapse.

How Effective is Acupuncture for Urinary Urgency and Other Symptoms?
Acupuncture has been shown to be just as effective for relieving urinary urgency and other symptoms of urinary incontinence as dry or behavior therapy (Oregon Health and Science University). According to researchers Sandra Emmons, M.D. and Lesley Otto, M.D., “Acupuncture perhaps can offer a middle ground for the appropriate patient who prefers not to take daily medication but is unable to commit to the active involvement of behavioral therapy.”

If you have found the side effects of drug therapy intolerable and, for whatever reasons, cannot make lifestyle or behavioral changes to alleviate your symptoms of women’s urinary incontinence, you may want to look into acupuncture. In addition to board-certified acupuncturists, many physicians also now practice medical acupuncture. Check with your family doctor for a referral, and check with your insurance company to see if acupuncture services are covered. Some insurance companies will cover acupuncture services provided by an in-network physician, but not by an acupuncturist, so be sure to ask.

Most acupuncture “programs” for relieving urinary urgency, frequency, and leakage last from five to eight weeks, and you should see a noticeable reduction of your symptoms within that time period. Because each woman has differing symptom patterns and severity, your physician or acupuncturist will design a specialized program just for your needs.

If acupuncture sounds like a conservative therapy you would like to try, but maybe scares you a little bit, just remember that acupuncture needles are very fine–about the width of one of your hairs! That’s pretty tiny!
If you enjoyed this post, we invite you to check out our book, leave a comment, contact us, download our free ebook, or interact with us on Twitter and Facebook.

 

Diet Modification for Women’s Urinary Incontinence, Part II – Avoid Constipation

by General Urinary IncontinencePelvic Floor MusclesPelvic Organ ProlapsePOPUrinary Incontinence

This blog is part 7 of an 11 article series of 11 New Year’s resolutions that actually work and WILL improve your pelvic health. Get the full list of all 11 New Year’s resolutions HERE.

Women with urinary incontinence know all about the discomfort of urinary leakage, frequency, and urge–but a lot of these same women also know the discomfort of constipation symptoms. Constipation symptoms such as straining, needing to push on the abdomen, or waiting an unusually long time on the toilet are all bad news for women with urinary incontinence. All these symptoms of constipation put a lot of pressure on the pelvic organs and muscles, which can worsen symptoms of urinary incontinence. If you have any of these constipation symptoms, then read on. We have solutions to help you avoid this problem, which may in turn relieve some of your urinary incontinence symptoms.

What is Constipation?
Before we can talk about how to avoid constipation, we first have to define constipation. Put simply, constipation includes difficulty having a bowel movement, or long periods of delay between bowel movements. What is considered a “normal” frequency for bowel movements varies from person to person, depending on age, lifestyle, and diet. Most medical experts consider bowel movements ranging from three per day to three per week as “normal.” Fewer bowel movements may constitute chronic constipation.

For women with urinary incontinence, the frequency of bowel movements is definitely important. In addition, what may be even more important is to avoid straining when having a bowel movement. Straining or pushing are symptoms of constipation, and both can further weaken pelvic muscles that are already stretched or damaged. Straining and pushing can also push pelvic organs that have “fallen” out of place further from their correct anatomical position. All of these may result in or worsen symptoms of women’s urinary incontinence or pelvic organ prolapse.

How to Avoid Constipation
If you have symptoms of constipation, we have several solutions that can relieve these symptoms. These are simple lifestyle changes that you can easily integrate into your daily schedule, no matter how busy you may be.

  • Fiber: Eat plenty of fruits or veggies. If you are not a fan of these, add a fiber supplement (gradually) to your daily regimen.
  • Exercise: Moving your body will help your digestive system, since your food has to pass through about 20 feet of intestine.
  • Hydrate: Water is essential to keeping your stools soft enough to pass easily. To figure out the right amount of water to drink, read this article
  • Medication: Check with your doctor whether any medications you take might be causing constipation (since many drugs can cause symptoms of constipation)
  • Go with the Urge: Many women are “too busy” to go to the bathroom for a bowel movement when they feel the urge. This can cause your digestive system to shut down, leading to constipation. Avoid this by going to the bathroom immediately when you feel the urge for a bowel movement.

Mix Your Own Fiber Supplement
One of the recommendations we make to patients in our practice for maintaining bowel regularity is this homemade recipe for a fiber supplement. Combine the following ingredients and drink the resulting mixture immediately:

  • 1/2 cup apple juice
  • 1/4 cup freshly ground flaxseed
  • 1/4 cup aloe vera juice

Pretty simple, right? Making any of the above listed lifestyle changes to help you avoid constipation symptoms is important to relieving women’s urinary incontinence. Because these lifestyle changes are so easy, they make a good trade-off if they help you stay “high and dry”!

If you enjoyed this post, we invite you to check out our book, leave a comment, contact us, download our free ebook, or interact with us on Twitter and Facebook.

 

Pelvic Floor Exercises: How a Physical Therapist Can Help Improve Your Results

by KegelsPelvic Floor MusclesPelvic Floor Weakness

This blog is part of an 11 article series of 11 New Year’s resolutions that actually work and WILL improve your pelvic health. Get the full list of all 11 New Year’s resolutions HERE.

Get this: 50% of women cannot identify or contract the appropriate muscles to do pelvic floor exercises correctly by following only written results.

That’s right … we said 50%! No wonder there are so many women out there who think that pelvic floor exercises (also called Kegels) don’t work. Chances are that at least 50% of these women are not contracting their pelvic floor muscles properly, or not even contracting their pelvic floor muscles at all. In fact, women commonly contract other muscles–such as thigh or buttock muscles–instead of pelvic floor muscles. The result is that their thighs and buttocks are nicely toned, but their pelvic floor muscles remain neglected and out-of-shape! The other result is that if you have a New Year’s resolution to improve your pelvic health, you won’t achieve your goal if you are exercising your pelvic floor muscles incorrectly.

Do You Know How to Do a Kegel?
This might be a difficult question for you to answer. After all, if you are following written instructions on how to do a Kegel, you might THINK you are doing the exercise correctly, but how do you really know? One of the best ways to find out whether you are exercising your pelvic floor muscles correctly is to have a specialist test you.

Examples of specialists include physical therapists specializing in women’s pelvic health, urologists, and ob/gyns. All of these medical professionals will test the strength and correctness of your Kegel by asking you to tighten your pelvic floor muscles around a finger inserted into your vagina. While this does not sound like the most fun experience in the world, this test WILL help you determine whether you have been properly exercising your pelvic floor muscles … or just wasting your time!

If you have been wasting your time, the good news is that your specialist can either help you correct the way you do your Kegels, or recommend someone who can work with you. For instance, many women who cannot do a correct Kegel are referred to physical therapists who specialize in women’s pelvic health.

Do You Need a Physical Therapist to Help You Correctly Exercise Your Pelvic Floor Muscles?
Physical therapists specializing in women’s pelvic health work with women over a number of sessions to locate and properly contract the correct pelvic floor muscles. What can a physical therapist do for you that you can’t do for yourself? A physical therapist can help you in many ways.

First, the therapist will most likely take a “hands on” approach, which means that they will put their hands in various areas of your pelvic region to help you “feel” when you contract the correct pelvic floor muscles, as well as helping you “feel” when you are contracting the wrong muscles, such as your buttock or thigh muscles. Just having the sensation of a therapist’s hands in your pelvic region can help your brain make the connection to the correct pelvic floor muscles for a Kegel.

Second, your specialist has tools that you don’t that can help further help you identify and contract the right pelvic floor muscles. Two commonly used tools include biofeedback machines and electrical stimulation devices. Biofeedback machines are simple devices that give you either visual or auditory feedback when you contract the right muscles. This additional feedback helps you learn to contract the right muscles more quickly. The electrical stimulation device involves placing electrodes in your vagina or rectum for short periods of time. The device delivers very mild electrical stimulation, which actually lightly contracts and tones the correct pelvic floor muscles. This form of stimulation is especially useful for women who have little or no sensation in their pelvic floor muscles, and are thus unable to contract those muscles. Your specialist may also have you use vaginal weights, which are weighted plastic cones inserted into the vagina for short periods of time. As you hold the weights inside your vagina to prevent them from dropping out, you tighten and tone your pelvic floor muscles. As your muscles become stronger, your specialist will increase the weight until you can hold heavier weights.

The third way your specialist can help you is by designing a pelvic floor muscle exercise program customized to your current level of pelvic fitness. This prevents you from exercising your pelvic muscles too little or too much. Too much exercise can lead to excessive tightening of your pelvic floor muscles, which can result in pelvic pain and other unwanted side effects. Doing too few contractions means that your pelvic floor muscles won’t get toned, and you won’t get the results that you want.

By working with a custom program, you exercise your pelvic muscles at just the right level. As your muscles get stronger and have more stamina, your specialist will change your program to match by increasing the number of contractions or the length that you hold each contraction. With this kind of customized support, you are much more likely to achieve the results you want, whether that means alleviating symptoms of urine leakage, reducing signs of pelvic organ prolapse, or improving your sexual sensation.

Women’s Pelvic Health and Your New Year’s Resolution
Is women’s pelvic health still a New Year’s Resolution? If so, good for you! And, if you have are having difficulty achieving the results you want by doing pelvic floor muscle exercises at your home, it may be time to get help from a specialist. A women’s pelvic health specialist can teach you how to do a Kegel correctly, can design a custom program just for you, and has a wide range of tools that can help you achieve lasting results. You may need to get a referral for this kind of specialist from your family doctor, urologist, or ob/gyn, so we encourage you to call for an appointment to get the ball rolling right away!

If you enjoyed this post, we invite you to check out our book, leave a comment, contact us, download our free ebook, or interact with us on Twitter and Facebook.

 

Women’s Pelvic Health: The Best Gift You Can Give Yourself!

by Decreased Sexual SensationGeneral Urinary IncontinencePelvic Floor MusclesPelvic Floor WeaknessPelvic Organ ProlapsePOPWomen's Healthcare

When it comes to women’s health, pelvic health is often a matter of “out of sight, out of mind”! Unlike saggy underarms, facial wrinkles, or body fat, our pelvic organs do not act as visible motivators for us to change our lifestyles to improve our health. But women’s pelvic health does matter–a lot! This is especially true since poor pelvic health can lead to women’s urinary incontinence, pelvic organ prolapse, or decreased sexual sensation.

The fact of the matter is that you may have poor pelvic health and not even know it until symptoms show up suddenly in your life!

Women’s Pelvic Health: Treat Yourself Right This Holiday
In our fast-paced world, we are often advised to “treat ourselves right” by meditating, getting a massage, or reading a good book. In other words, we need periods of time in which we slow down and smell the roses if we want to stay healthy and fit. These are considered little gifts that we give to ourselves so that we can remain vibrant and healthy in our lives.

All of these are great gifts, and we would like to suggest one more to consider: get a pelvic exam!

While shoving one’s legs into those metal stirrups for a pelvic exam does not SEEM like a great gift to yourself (who actually enjoys that kind of experience?), this kind of preventative exam can really be a gift that keeps on giving. A pelvic exam can determine whether all of your pelvic organs are still in place or whether they have “fallen” or prolapsed. This kind of exam can also determine what type of urinary incontinence you have if you have started experiencing some urinary leakage on occasion. If your sex life isn’t what you want it to be, a pelvic exam can also reveal whether your pelvic floor muscles are weak, thus decreasing sexual sensation and enjoyment.

“But I don’t have any problems down there!” you wail, hating the thought of those cold stirrups. The truth is that you may or may not know about problems in your pelvic area. Only a thorough pelvic exam can reveal the state of your pelvic health. For instance, a high percentage of women (some experts estimate more than 70%) have prolapsed organs and don’t even know it. Other women experience less-than-pleasurable sex because their pelvic floor muscles lack tone and strength. But these women would not KNOW that they had a problem without a pelvic exam.

Women’s Pelvic Health: The Gift That Keeps on Giving
If you really want to treat yourself right this holiday season, give yourself the gift of pelvic health. Call your ob/gyn or urologist to schedule a pelvic exam for the first of the year. The exam, uncomfortable as it might be, will tell you what you need to know about the state of your pelvic organs. Depending on what is revealed, the exam can also inspire you to set some worthy New Year’s Resolutions that will benefit not only your pelvic health, but your whole life. Examples include weight loss, smoking cessation, avoiding certain foods or beverages, and getting toned and fit all over (inside and out).

If you are still not convinced that a pelvic exam is a great gift for yourself, consider these benefits. A pelvic exam can:

  • open the door for you and your doctor to have an honest discussion about your pelvic health
  • reveal any potential problems with your pelvic organs
  • help you handle any potential problems before symptoms, such as urinary leakage or serious prolapse, occur
  • inspire you to exercise your pelvic floor muscles, which can improve your experience in the bedroom
  • assist you in resolving any symptoms of poor pelvic health that may have already appeared (such as light urinary leakage)
  • give you a baseline against which you and your doctor can compare future exams, ensuring your future pelvic health
  • motivate you to live a healthier lifestyle

Those are seven great reasons to make an appointment for a pelvic exam. These seven great gifts will keep your pelvic organs healthy as you move through many more holidays, especially as you experience life changes such as pregnancy, aging, travel, getting serious about exercise, and so forth.

So have yourself a happy holiday and give yourself the gift of pelvic health (or at least an appointment to check your health) before the New Year arrives … that way you will definitely have something to celebrate when you ring in the New Year!

If you enjoyed this post, we invite you to leave a comment, contact us, download our free ebook, or interact with us on Twitter and Facebook.

 

Pelvic Organ Prolapse – 5 Questions to Ask Yourself

by Pelvic Organ ProlapsePOP

Has something “fallen out” in your pelvic region? Do you feel like something has shifted down there? If so, you may have pelvic organ prolapse, otherwise known as POP. What is POP? POP is the condition in which one or more of your pelvic organs has slipped or fallen out of its original location. Pelvic organs that can prolapse include the bladder, small intestine, rectum or large bowel, and uterus. Each of these types of prolapse has a specific name:

— bladder (cystocele)
— small intestine or bowel (enterocele)
— rectum or large bowel (rectocele)
— uterus (procidentia)

Now that you know about the different types of POP, the next step is to figure out if you have POP, especially if you feel that your pelvic organs have shifted or changed in some way.

5 Questions About POP
If you are unsure about whether you have symptoms of POP, here are 5 questions you should ask yourself:

  1. Do you feel pulling, stretching, or pressure in your low back or groin?
  2. Do you see a bulge pushing out of your vagina or feel as if something is falling out of your vagina? (you may need to use a small hand mirror to answer this question)
  3. Do you experience painful sex?
  4. Do you feel the pressure of pelvic organs pushing into your vagina or do you feel as if you are sitting on a ball?
  5. Do you suffer from constipation or difficult urination that is improved when you press your fingers into your abdomen or vagina?

If you answered “Yes” to two or more of these questions, then you very likely have POP. If so, then you should definitely seek medical help from your urologist or ob/gyn. If you are not currently under the care of a urologist, you may need to get a referral from your family doctor.

Even if you did not answer “Yes” to any of the above questions, you may wish to visit your ob/gyn for a checkup. Between 43% and 76% of women who have POP do not experience any symptoms. The only way these women can be correctly diagnosed with POP is with a pelvic exam from an ob/gyn, urologist, or other medical practitioner specializing in women’s pelvic health. If you have not had a routine pelvic exam recently, now is a great time to schedule one. Why? Because treatments for POP are more effective when started early. So get on the phone and schedule an appointment with your healthcare provider of choice just to check that nothing has “popped” out of place down there. It’s the best holiday gift you can give yourself!

 

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woman lifting monitor

Pelvic Organ Prolapse: What’s With All the Heavy Lifting?

by Pelvic Floor WeaknessPelvic Organ ProlapsePOPUrinary Incontinence

woman lifting monitorIf you have been diagnosed with pelvic organ prolapse (POP) and you lead an active lifestyle or have a physically-demanding job, chances are good that your lifestyle and/or your job may have contributed to your condition.

Pelvic organ prolapse describes the condition in which one or more of your pelvic organs sags downward, or “falls” out of place. Pelvic organs that can prolapse include the bladder, small intestine, large intestine, or uterus. How many women have POP? Between 43% and 76% of women have POP, but don’t experience any symptoms. Less than 10% of women with POP notice symptoms, such as feeling pressure on the vaginal wall, feeling as if one is sitting on a ball, seeing a bulge falling out of the vagina, urinary incontinence, difficulty urinating, being constipated, low back pain, or feeling pain during sex.

POP and Heavy Lifting
While there are many risk factors for POP, a surprising number of those risk factors are associated with heavy lifting of one sort or another. Pregnancy and childbirth (either vaginal or Cesarean) top the list of factors. If you think about it, pregnancy is one of the most vigorous kinds of heavy lifting a woman can do. Plus, this form of heavy lifting is long-term–about nine continuous months!

Another kind of heavy lifting that can contribute to POP is work-related. If your job requires you to lift, move, or otherwise handle heavy objects on a regular basis, your work may be a big contributing factor to POP. All of this lifting puts pressure and strain on the pelvic organs and their supporting tendons, ligaments, and muscles. When the strain becomes too much, one or more pelvic organs will literally slip out of place, causing the symptoms described above.

Constipation causes straining similar to that of frequently lifting heavy objects. If you suffer from chronic constipation, then you are putting pressure on your pelvic organs several times per day. That’s a lot of heavy lifting for your pelvic organ support system.

Finally, your weight is a consideration. When it comes to your pelvic floor muscles, every pound of weight you carry about your pelvic region exerts a strong downward push. That means your pelvic floor support system has to do “heavy lifting” whenever you are sitting or standing. This is doubly true if you have an active or athletic lifestyle. Bouncing around in an aerobics class adds heavy impact into the equation, more than doubling the strain on your pelvic floor.

Lifestyle Changes to Reduce the Risk of POP
If you are at risk for POP because of any of the reasons listed above, it’s not too late to make some lifestyle changes. Simple changes that will help can include:

  • lose weight
  • change jobs to avoid lifting heavy objects
  • increase fiber intake to reduce constipation
  • switch from high-impact exercise to low-impact exercise (such as swimming or walking)
  • start doing pelvic floor exercises (like Kegels), especially if you have had children
  • consider using a pessary to temporarily increase support for your pelvic organs

These are all simple conservative measures that can prevent further sagging of your pelvic organs, and can often relieve symptoms of POP. These measures have almost no side effects, and studies have shown them to be quite effective. POP doesn’t have to consign you to being an armchair athlete. Instead, try these conservative approaches and see just how active you can be. You will be surprised!

Photo Credit: http://www.flickr.com/photos/76029035@N02/6829303627/

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Women’s Pelvic Health: Not Sure What’s Up Down There?

by Decreased Sexual SensationGeneralGeneral Urinary IncontinencePelvic Organ Prolapse

For many women, anatomy “down there” in the pelvic region is a complete mystery. And when something goes wrong down there, these same women have no idea what’s happening … or what to do. If you resemble the women referred to in the last sentence, then here’s a quickie guide to help you get acquainted with your own pelvic anatomy, plus a peek at what might be happening down there.

A Quick Guide to Pelvic Anatomy – Video
http://youtu.be/K1WL6MIq5HA

A Quick Guide to the Female Urinary System – Video
http://youtu.be/aro36vaiWmA

Women’s Poor Pelvic Health: Are You Affected? – Video
http://youtu.be/JEz2JlExShc

3 Types of Women’s Urinary Incontinence – Video
http://youtu.be/UYr8xrvQ48Q

Pelvic Organ Prolapse
http://bit.ly/ZAIja4

Do You Have Decreased Sexual Sensation? – Video
http://youtu.be/Zh5_Bp3s35U

 

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Women’s Urinary Incontinence: Overcoming Your Fear of Surgery

by Find the Right DoctorGeneral Urinary IncontinencePessary

When it comes to women’s urinary incontinence, embarrassment tops the list of reasons that affected women don’t seek help. Another major reason these women don’t seek help is this: fear of surgery. Affected women are afraid that seeking a medical diagnosis from a physician will automatically lead to surgery. Many people, not just women with urinary incontinence, have a fear of surgery. Luckily, these fears are mostly unjustified.

Women’s Urinary Incontinence: Try Conservative Methods First
Do you suffer from women’s urinary incontinence, and are you afraid that your doctor might suggest that you have surgery? If so, then we have good news for you. Unless your condition is very severe, most physicians will suggest that you try the least invasive and most conservative therapies first. These include pelvic floor retraining, lifestyle changes (such as weight loss, diet changes, and smoking cessation), bladder retraining, taking medication, using a pessary, and acupuncture. They may even suggest you try a combination of these therapies until you find what works to relieve your symptoms.

An interesting note about these conservative therapies is that they are more effective when used early on–that is, as soon as you notice the first signs of pelvic floor weakness. These therapies are effective for relieving symptoms of all three types of women’s urinary incontinence, as well as alleviating symptoms of pelvic organ prolapse and decreased sexual sensation. This information should definitely motivate you to seek medical help as soon as you begin experiencing problems with your pelvic health.

Overcoming Your Fear of Surgery
But what happens if conservative therapies are not effective for relieving your symptoms? In that case, you may need surgery to address the problem. If your condition is severe, such as when one or more of your pelvic organs have significantly shifted out of position (prolapsed), your physician may recommend surgery as the first step towards curing your condition. Or you may find that conservative therapies are effective for many years, but cease to work over time. This can occur because of aging, menopause, and the continued downward pull of gravity on your pelvic organs. In this case, you may also need surgery to alleviate symptoms that were formerly relieved by conservative therapies.

If your physician does recommend surgery, don’t hit the panic button just yet. We have some statistics about women’s pelvic surgeries that should help you breathe a sigh of relief, especially if you have a fear of surgery. We have categorized the different types of surgeries according to the condition treated, and we describe the level of invasiveness for each procedure as well as the success rate. Minimally-invasive surgeries are usually done as outpatient procedures, and you often go home the same day. Surgical procedures with a moderate level of invasiveness may require a short stay in the hospital.

Surgeries for Stress Urinary Incontinence
Number of Procedures: 6
Names: Transobturator tape, single-incision transobturator tape, tension-free vaginal tape, pubovaginal sling, Burch procedure, Marshall-Marchetti-Krantz procedure
Invasiveness: The first three procedures are minimally invasive, the last three are considered moderate.
Success Rates: No procedure has less than a 66% success rates, and most have success rates between 70% and 95%.

Surgeries for Overactive Bladder, Urge Urinary Incontinence, Urge-Dominant Mixed Incontinence, and Urinary Retention
Number of Procedures: 1
Name: Sacral neuro-modulation
Invasiveness: Minimal
Success Rates: 31% to 65%

Surgeries for Pelvic Organ Prolapse
Number of Procedures: 4
Names: Cystocele repair (bladder hernia), rectocele repair (large intestine hernia), enterocele repair (small intestine hernia), sacral colpopexy (vaginal vault prolapse)
Invasiveness: All are considered moderate
Success Rates: 80% to 96%

As you can see, almost all the surgeries have a very high success rate, and the majority are minimally-invasive. This list of women’s pelvic surgeries should give you a starting point for discussing your surgical options with your physician. If you have a significant fear of surgery or simply want to avoid surgery for any reason, you may wish to seek a second opinion from another specialist. Additionally, you may want to ask your physician whether a different type or a different combination of conservative therapies would be useful to try before having surgery. For many women, the first few conservative therapies tried are not completely successful at relieving symptoms. The women who have the most success with conservative therapies are those willing to try multiple approaches or multiple combinations of therapies until they find something that works. Persistence is often the key to success when working with conservative therapies.

If you ultimately decide to undergo surgery for your pelvic health condition, rest assured that success rates are high and most procedures pose a fairly low risk. Be sure to discuss any questions or concerns with your physician until you feel completely comfortable with any proposed surgery. In this case, educating yourself about your condition and your options is the best medicine!

 

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The Doctor Is In: Women’s Pelvic Health, Fact or Fiction?

by GeneralKegelsPelvic Floor MusclesPelvic Organ Prolapse

1. Urinary incontinence (an indicator of poor pelvic health) is a normal sign of aging.

Fiction: Urinary incontinence or leakage is not normal at any age. Acceptance of this health condition as a normal sign of aging is the second most common reason women don’t seek help from a physician. Embarrassment about talking to a doctor about urine leakage tops the list, followed by women thinking that urinary incontinence “wasn’t enough of a problem.” As a result, less than 50% of women with urinary incontinence seek medical help, and those who do get help wait almost seven years. The good news for women who do seek help is that urinary incontinence can be improved in 8 out of 10 cases according to the Agency of Healthcare Research and Policy.

2. Kegels and similar pelvic floor exercises can improve a woman’s pelvic health.

Fact: Studies show that pelvic floor exercises, when done correctly and according to a woman’s state of pelvic muscle fitness, can relieve symptoms of all three types of urinary incontinence (stress, overactive bladder/urge, and mixed), pelvic organ prolapse, decreased sexual sensation or response, and general pelvic floor weakness. Women often feel that pelvic floor exercises such as Kegels are ineffective because these women are not doing the exercises properly. In fact, studies show that almost 50% of women cannot do a correct pelvic floor muscle contraction with only basic written instructions for guidance. Incorrectly done, these muscle contractions are indeed ineffective and may even worsen some symptoms of poor pelvic health.

3. Conservative therapies for poor pelvic health (urinary incontinence, pelvic organ prolapse, and decreased sexual sensation) are not effective.

Fiction (with some fact): While it is true that not every conservative approach for relieving symptoms will work for every woman, it is also true that most women will be able to find relief with one or more of these approaches. Some women are able to reduce symptoms by using a combination of conservative therapies, such as taking medication plus stopping smoking and losing weight. Other women find success by trying multiple different therapies until they find an effective approach. Persistence is often the key to success. Some women, however, may have such an advanced condition (as with severe pelvic organ prolapse) that surgery is a better option. Research indicates that conservative therapies are more effective when used as soon as the first symptoms occur.

4. Childbirth does not put women at risk for poor pelvic health.

Fiction: Childbirth is a major risk factor for urinary incontinence, pelvic organ prolapse, and decreased sexual sensation. In fact, giving birth is a major reason that women are twice as likely to suffer from urinary incontinence as men. Despite recent controversy over the subject, studies indicate that the method of delivery–vaginal versus Caesarian–has little effect on whether a mother will have urine leakage symptoms post-partum.

5. A woman will know if she has poor pelvic health.

Fiction: Research indicates that between 43 and 76 percent of women have some degree of pelvic organ prolapse (in which one or more pelvic organs have “fallen” out of position). At the same time, many of these women are not aware that they have this condition because they have no apparent symptoms. Some women may experience symptoms of prolapse, such as low back pain or chronic constipation, but not know the cause. Similarly, many women with naturally weak pelvic floor muscles, another form of poor pelvic health, may not be aware that they are not having the best possible sexual experience.

6. Most women can benefit from doing a pelvic floor muscle exercise program.

Fact: Pelvic floor muscles are like any other muscle in the body: they benefit from regular exercise. Because pelvic muscles are not visible, most women tend to forget about exercising them, even if they have engaged in a pelvic muscle exercise program in the past. The phrase “Out of sight, out of mind” is very applicable to pelvic floor muscles, as is the phrase, “Use ’em or lose ’em!” (especially after menopause). Women who should not start a pelvic muscle exercise program on their own include women who are under a physician’s care for a medical condition, women who have hyper-toned pelvic muscles, or women whose pelvic floor muscles are too weak to do a proper Kegel-type contraction. If you are not sure whether you should proceed with a self-guided program, check in with your doctor first and seek help from a physical therapist specializing in women’s pelvic health.

7. Surgeries to alleviate symptoms of poor pelvic health conditions are risky.

Fiction: While all surgery carries a certain amount of risk, most surgical procedures for urinary incontinence (the most common form of poor pelvic health) are minimally-invasive, low-risk, and can be done on an outpatient basis. Surgeries for pelvic organ prolapse and some forms of urinary incontinence can be more complex, but have a high rate of success and few complications. As with all types of surgery, you will get the most effective treatment by researching and finding the surgeon who best understands and can accommodate your needs. In addition, pelvic surgery, like conservative therapies, is more effective when performed sooner rather than later. This means that you should seek medical attention the moment you become aware that you may have one or more symptoms of poor pelvic health.

Elizabeth E. Houser, M.D., a board-certified urologist in private practice for many years, is now a consultant in the field of women’s pelvic health. Stephanie Riley Hahn, P.T. is a physical therapist specializing in women’s pelvic health. Their book, A Woman’s Guide to Pelvic Health: Expert Advice for Women of All Ages, is now available for pre-order from the JHU Press.

You can also see this blog post as well as other terrific content on the John Hopkin’s University Press blog.

 

 

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