This post contains a lot of information that could be listed in the "too much" category (as in TMI).

After posting about the discovery of what I think may be a prolapsed bladder last week, I started to officially freak out. How did this happen? How long will it last? What can I do about it? What will make it worse? If it gets worse will I need surgery? And the list of my freak-out questions goes on. But most of all I was wondering: Why didn't I know about this before?And it seems that many of you have wondered the same thing. So in an effort to help us all, I decided to roll up my sleeves and do a little digging to find out the answer to all my "freak-out-questions."

It started with a phone call to my midwife, I explained the symptoms to her and the first thing she said was: "You can stop freaking out." She knows me too well--which is why I love her!

She went on to explain that after childbirth women are in a low-estrogen state which means the vaginal wall is lacking the hormones which help keep it firm and strong. Add to that, the fact that the tissues in the vagina experiences some serious trauma as the body of a little human pass through it. She assured me that with time it will probably take care of itself once estrogen levels rise and my body has had sufficient time to heal. She then chastised me for running when she had really only given me permission to "walk briskly." I guess I took her permission to increase intensity and ran with it...quite literally. Walking briskly is practically running, right? No, Sarah it is NOT. Stupid me.

She assured me she would check it out next time I was in and if it was serious enough she would refer me to a physical therapist who specialized in women's health. But in the mean time, take it easy! OK. OK. I get it.

So I got my How did this happen? question answered, but it left me wanting answers to my other questions.

How long will it last? The answer to this question varies based on the severity of each case. There are four different levels of prolapse, here they are as secribed by WebMD.com

Grade 1 (mild): Only a small portion of the bladder droops into the vagina.
Grade 2 (moderate): The bladder droops enough to be able to reach the opening of the vagina.
Grade 3 (severe): The bladder protrudes from the body through the vaginal opening.
Grade 4 (complete): The entire bladder protrudes completely outside the vagina; usually associated with other forms of pelvic organ prolapse (uterine prolapse, rectocele, enterocele).

For many women who suffer proplapse due to childbirth the symptoms subside with time as the tissue heals and as estrogen levels rise. But childbirth isn't the only way a woman can experience prolapse, it can result from dropping estrogen levels during menopause. I won't know how bad it is or how long I'll be dealing with it until I have an appointment with my midwife. But I have a feeling it is somewhere between in the Grade 1-2 range. And now that I know what it is and can associated the symptoms with the prolapse I believe I had the same thing with my first pregnancy but ignored it and ran/exercised through it (which has probably made it worse this time around). This may be a significant factor in my recovery time.

What can I do about it? It seems that physical therapy to strengthen the pelvic floor and supporting core muscles is the answer. Some more severe cases require surgery (lets hope this isn't what I need). For now, I plan on performing the pelvic floor strengthening exercises that are in the Hab It DVD to help speed recovery. The DVD workouts incorporate kegels and other core strength movements that target the glutes, lower abdominal muscles and the hip adductors and abductors. If more serious physical therapy is needed then I'll do that too.

What will make it worse? Running. Running will has made it worse. As will any aerobic exercise with a high impact. Heavy lifting is also discouraged as it puts stress on the pelvic floor. I also came across a list of ab/core exercises NOT to do and some of those exercises were ones I was doing! Apparently moves like leg raises, plank pose, hanging knee raises and crunches can put stress on the pelvic floor. I wish I had known this before because I would have avoided these activities postpartum. But exercises like the bird-dog and bridge are perfectly safe and encouraged. I've sworn off running and hard-core core training, but I have been riding a recumbent bike and doing light strength training (5lb dumbbells) while seated on the exercise ball. It seems that these activities are safe.

If it gets worse will I need surgery? It is possible, but I won't know the answer until I see my midwife. But the feedback I've received from other sufferers of PFD and my midwife leads me to believe that physical therapy will be enough.

I turns out I'm not the only one either: 30-40% of women suffer some kind of Pelvic Floor Disorder (PFD). So clearly I'm not alone in my condition and probably not in my freak-out questions either. In fact this thread was recently posted on Run Like A Mother: The BookFacebook page:

What surprises me is how little information women seem to have on this topic. I heard no mention of PFD or organ prolapse in the birthing classes we took or in any of the books I read in preparation for my natural childbirth. And judging by the "TMI" label we all (myself included) keep using, as women we think it's something we can't discuss.

Want more information? Check out these links:

Hab-It Pelvic Floor Physical Therapy

Pelvic Floor Exercises YouTube Channel with Michelle Kenway

Why don't more women know about PFD? And why are women so afraid to talk about it?

--Sarah

Disclaimer: I am not a licensed medical provider. The information in this post is not to be taken as medical advise. If you think you are suffering from PFD you should consult your physician.

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