“I have a grade 2 prolapse and the symptoms are better but I still have it.”

“Can I carry my 35lb 2 year old if I have a prolapse or does my life need to stop?”

“I had a cough and now my prolapse feels worse. I thought it was healed!”

If you’ve hung around here long enough you’ve probably heard me say that prolapse is the four-letter word that isn’t actually a four-letter word at all. It can be confusing. It’s often times scary. It can make both you and I question if our bodies are broken. BUT. And it’s a big BUT…prolapse doesn’t have to be scary and it doesn’t mean you’re broken. It also doesn’t mean it is easy - the emotional and psychological toll of prolapse can often feel very overwhelming.

So here’s four things I want every person with a vagina to know about what’s going on down there:

1. Your prolapse grade does NOT equal severity. This one is real pain in the butt/vagina for most of us because usually grading = severity and it’s this beautiful linear picture in our minds. In a picture-perfect world a grade 1 prolapse would mean you have hardly any symptoms and a grade 2 would mean you have a few and so on. But we aren’t in a picture-perfect world because each of us is different and increased grading of prolapse doesn’t mean you will have more signs or symptoms! Some people can have a grade 2 or 3 prolapse and have no symptoms or only a few symptoms. On the flip side, some people can have a grade 1 prolapse and the symptoms can be debilitating.

2. Symptoms mean more than diagnosis. Maybe you started with a grade 2 prolapse, you used to leak when you ran, it hurt to pick up your kid and you’ve done everything right…the leaking has stopped or is a lot better, you can play with your kiddo without pain but the prolapse itself has remains a Grade 2. This doesn’t mean your body is broken - it may simply means that this is where your body naturally functions. Another way to think of it is in terms of flexibility. My husband jokes that I am Gumby (man, oh man, I hope you get this reference) and I always have been. Other people are naturally “stiff as a board”. It doesn’t mean that one of us is broken and the other is “right” — it simply means that we have different levels of flexibility and our bladders and uteruses are no different!

3. Some researchers and doctors argue that we may not even want to grade a prolapse. You may be thinking, “Excuse me…what!?!? How can we treat something if we don’t know what it is?” But here’s the thing about prolapse - some studies have shown that it is “practically universal” in people nearing menopause. SOO the bigger question is - why focus on a diagnosis rather than symptoms and quality of life? If you sprained your ankle 8 weeks ago but now have zero symptoms, you’re able to run and jump and kick a ball at the same speed and strength as you were before the sprain, you wouldn’t say your ankle is “bad” or “broken”. You’d say you healed the ankle sprain…even if it is still a little bruised or more flexible than it was before the sprain. Our pelvic floors shouldn’t be any different! Instead of focusing on the number let’s focus on what it CAN do.

4. Prolapse - it’s not just about the muscles and ligaments. Maybe you’ve been feeling better and your prolapse grading itself has improved or the symptoms are getting better until something happens and you suddenly have a flare up of prolapse symptoms. You can have a flare of prolapse symptoms without an increase in prolapse stage.
   
   We often think that a prolapse is all about the muscles and ligaments. But here’s the catch - those muscles and ligaments are influenced by SO. MUCH. MORE. Prolapse grading and symptoms are so much more than what is happening to the tissue at that moment — changes in hormones (aka menses, ovulation, perimenopause, menopause, postpartum, pregnancy), stress, fatigue/sleep, hydration, nutrition, constipation, daily habits, breathing, medication, or even coughing — all of these things have the ability to influence our pelvic floors and have an effect on symptoms. So maybe you didn’t sleep well last night or you’re getting over a wicked cough or you'

So, here’s a shot of bourbon to you…for your strength. For your resiliency. And for knowing that your life doesn’t have to stop because of a prolapse.

If you want to know more about what’s going on down there, check out our program - What’s Going on Down There to help you feel more confident in knowing and connecting down there.

XOXO- Dr. Lauren

References:

https://pubmed.ncbi.nlm.nih.gov/14749630/