PROLAPSE

Let's Talk About It...

What is your vagina supposed to look like?

I know, I said it. Out loud and everyone is uncomfortable. But let me tell you something. If you do not know what “normal” or “supposed to look like is, then how will you ever know if something is wrong or not? I mean, come on!

There are some things to consider when using the word “normal” though. First and foremost, please understand that everyone is different. All vaginas are different. All labias are different. All clitoris’s are different.

What I mean when I say “normal” is, are you seeing what you have always seen or are you seeing something out of place?

Your vagina is adaptable. You will go through changes and notice differences when you become pregnant and postpartum, menopause, etc. but you should still be in tune with what your “normal” is so that you know when seeing someone is necessary.

I have attached a video talking about just general anatomy of the vagina, but please note there are many more layers. I will be presenting this the best I can for future purposes, so keep checking my youtube channel!

Okay, so we are ready to look. I recommend either a deep squat with a mirror on the floor, or sitting with a handheld between your legs or a mirror on the floor in front of you.

What are we looking for?

After watching the video below, you want to consider these things for YOUR vagina:

  1. Color of tissue. You should have a nice pink, healthy color to your vagina, especially inside the labia "lips)

  2. Labia. Pay attention to how your tissue typically lays. Do you have the labia minora that is going further than the labia majora (this is not a negative thing), is the labia hanging down? Get to know your labia!

  3. What happens when you kegel. When you properly perform a pelvic floor contraction, do you notice a nice, healthy close and lift? If not, why?

  4. What happens when you cough. Is there tissue coming out? Is there discharge coming out with coughing? Do you close and lift with your cough?

  5. Where is your clit? I know, you’re laughing. That’s okay! But if you know where it is, you are more likely to be able to get the sensations you truly want and be able to communicate with your partner.

  6. How wide is your hole? This is important because when you become pregnant and when you give birth, this can change, but you need to be able to understand what is your normal.

Hopefully you are viewing what you need to be viewing! If you are still curious and need some help, reach out and let me know!

But with that being the normal stuff you should know about, what are some things to be concerned about?

  1. Tissue color being red, purple, or any color not pink. If there is blood or any tissue color that may be abnormal, please note you should get that checked. This includes warts, spots, moles that are abnormal, new “pimples” or spots as well.

  2. Tissue coming to the outside of your vagina. This can be an indicator of prolapse or something going on that needs to be treated.

If you notice that your anatomy does not look like that of the pictures or my video DON”T FREAK OUT! It may be totally normal. Please understand that you could have a perfectly normal vagina, just different anatomy.

I often find myself bringing out a mirror to show my patients what they should be looking for. Please let me know if you need this! I can find someone in your area to help you.

In the mean time….happy vagina searching!!

Why Are We Afraid to Talk?!

Okay. Let’s get real here. I’m getting tired of hearing, “back in the day that just wasn’t something we spoke about.” Or, “You do not speak about those things openly, it’s private.” Or, “It’s normal. It’s just stuff  we have to deal with by being a woman.”
STOP. NO. No to all of that. We do not have to be silent about having any mental, emotional, or physical issue. Yes, I am talking about it ALL here ladies. We should talk about it. We deserve to have the ability to reach out and get care for whatever it is that we are dealing with. The most important thing to remember is you are not alone. There are so many of us  keeping the silence due to fear of what others may think, the fact that our mom said not to speak about it, or because we are embarrassed.
Oh, let me back track. The things I’m speaking of are things like leaking on yourself, losing control of stool, having pain with sex, prolapse symptoms or things coming out of the vagina, looking at your vagina, saying the word vagina…
First and foremost, I can promise you that you are  not the only one dealing with what you are  dealing with. Every woman has had some kind of issue, if they say they have not they are lying! From acne, to wrinkles, to other skin problems, to fat being somewhere it shouldn’t be, to terrible menstrual cramps, to problems with hormones, to pain during sex….we all have something. Being a woman is just hard. I know. Trust me, I am one. It is not only hard sometimes physically, but emotionally and mentally as well. We are wired differently from men. Yes, we do have more emotions and we do handle things differently. We want to look nice, we care what others think, we want to feel good in our own skin.
Let’s chat about why you might be afraid. I had mentioned in my most previous post that it is not something you are making up. I do want you to know that, I feel it is important. However, we have to respect and appreciate the fact that sometimes there is a psychological aspect, I would challenge there is always one. I know for me, I was not raised where I spoke to my mother about my vagina, my pelvic floor, or my “girl” issues. I would speak with my sister some, but got very limited advice as far as, “it’s normal,” “it gets worse.” You know, the usual. I was a ballet dancer for most of my life and realized quickly that most every dancer around me had some kind of thing going on, but we did not talk about it unless it was to assure someone that it was normal.
This made me not only afraid, but really cautious about what I spoke about. I did not tell anyone what I was going through. I did not say I was feeling self conscious about my pimples. I did not say I was called fat at school and am now going to try and starve myself so I can lose weight fast. I was thinking it, doing it, but never saying it. Why? I was afraid I’d be judged. Yes, ladies, I admit to it. I did not want to be viewed differently because I was laying out of school “sick” even though it’s because I was vomiting and had extremely painful cramps, or that I got the “stomach bug” even though I really started my period for the first time and it got EVERYWHERE. I was traumatized. I felt like I was the only one who had to go through this. 
Going back to the question at the beginning of this blog. Why are we afraid? Because that is what history has allowed to be. We have felt afraid to discuss these things due to fear of what someone might think. Fear due to what someone else may feel because we say it out loud. Ladies, that era is over. It’s time to truly hear we as women roar! Do not be afraid! Let’s talk about our vaginas, they are a part of us!
I have a story. You have a story. We all have stories as women. That’s the Main reason I started this blog. I want to connect with you and your story. I want to hear how you handle things, what you think, how you feel. I want to know what is going on with you. I want to be here for you. I will continue to expose bits of my story as I become more comfortable in my own skin. Give me time, it does take time.
 
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What is that falling out?!

So. Ladies. Let’s get really honest here. Everyone, hopefully, has heard of the term “prolapse” but who truly knows what it is? Do you? Are you able to explain exactly what is happening, what is causing it, or what it is? If not, have you heard of anyone suffering from prolapse? Yes, suffering. Prolapse can be very dysfunctional to a persons life due to mental, emotional, or physical impairments caused by it. I feel this is something that needs to be addressed not only to our ladies whom are pregnant, but elderly, and even our young teens.
The most interesting thing is:

You do not have to be pregnant, or older to have a prolapse. It can happen at any age, male or female. 

Yes. I said it. It can happen in a child. A 15 year old. An 18 year old. A 25 year old. A new mother. A mother of 5. Men. It is unfortunately not rare. Let’s discuss a few things about what it is, types of it, what may cause it, and possible things to do for improvement.
A prolapse is defined as, “a slipping forward or down of one of the parts or organs of the body,” by the dictionary. The way I describe it to patients is as so,
“When something internally moves, causing tissue to push to the outside of your body.” 
Sounds intense, I know. But unfortunately it happens and it can happen. It can happen with a movement of your bladder (cystocele), your rectum (rectocele), or even your cervix (apical). The symptoms are as follows:

  •  pressure in the lower abdomen

  • actual protrusion (ball like structure) on the outside

    • you can actually feel as if you are sitting on a ball)

  • bleeding or reddened/irritated tissue

  • increased discharge

  • problems with sex

    • pain

    • feeling as if something is in the way

  • heavy pulling in the pelvis

  • constipation

If you have 2 or more of the above, get in to see a pelvic PT! You do not have to suffer. There is help!
Let’s talk about some causes of prolapse.

  • Pelvic floor muscle weakness and inability to support the organs.

  • pregnancy

    • large baby

    • long and hard labor

    • long period of time with pushing

    • position during delivery

  • increased pressure in the pelvic floor (coughing, sneezing) when there is not support or strength

  • bearing down during trying to have a BM

  • increased surgical procedures performed in the lower abdomen or pelvic region

You can hopefully at this point see the importance of being educated on your pelvic floor. Everyone is different. So as mentioned before, you do not have to go straight into kegels because that may not be the best option for you.
I know you all have the same questions, “How can I treat it?” “can I make it go back in?” “can I fix it?” “what do I do with it?” Well, first and foremost:
This post is not intended for medical instruction or use. You need to see a pelvic PT for proper diagnosis and treatment of YOUR prolapse.
But. The treatment varies. We discuss behavioral modifications, eating habits, water habits, positioning while on the toilet, positioning during intercourse, how to “put it back in” when necessary, and so many other things. It also depends on what “grade” of prolapse you are given. This ranges from 1-4: 1 is nothing, 2 is where the tissue comes to the whole of the vagina but not out, 3 is where it comes halfway out, 4 is completely out. The later grades sometimes will require a surgical repair, and PT can only assist along the way. However, the lower grades have been shown to really help! I always say if you can function, don’t have the surgery!! 
As far as everything else, we treat the constipation first. If you have a weak pelvic floor, we will certainly address that. But we must also look at how you breathe, how strong your core and low back is, your hip strength and mobility, etc. There is not one treatment approach that works, you must work on everything as a whole for a full treatment approach.
First and foremost. ACCEPT it. This has happened. You are not prolapse though, you just have it. Keep your mindset in the proper place and try your best to limit negativity and fear/anxiety of the unknown.
Get into a Pelvic PT for assessment and treatment and GET IT ADDRESSED!
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