Nearly 50 percent of women in the United States have some degree of pelvic organ prolapse, and most don’t even know it. As a young twenty something with two little kids, I had no idea that I was one of those women.
I knew that something was wrong, but when I talked to my doctor, I had a hard time putting into words that I generally felt like garbage most of the time. I chalked it up to being in the throes of motherhood: Momming is hard. Babies are hard. Little kids are hard. There are so many late nights and long days when raising children that it’s normal to be tired, isn’t it?
Most of the women in my life talked about back pain and peeing a little when they laughed or sneezed. My lower back ached after standing to wash the dishes or fold clothes. I definitely peed a little when I sneezed. More than once, I did more than pee during allergy-induced sneezing fits. As far as I knew, I was experiencing normal side effects from having children.
When my youngest little bundle of joy turned one, my life began to descend into a downward spiral as my undiagnosed and untreated pelvic organ prolapses became worse. Not only was I waking in the night to care for a pair of little boys, but I also started to need to take several trips to the bathroom. I was hardly getting any sleep.
During walks around the neighborhood with my boys and our dogs, I’d streak my shorts. When I was being active at any level, I leaked urine and fecal matter. As a lifelong runner, I found myself sequestered on the treadmill so I could hop off and go to the bathroom when the urge inevitably hit. This was happening with such increasing frequency, I didn’t dare run on my favorite trails. I wasn’t afraid I might mess my pants, I knew I would. There was no helping it, or stopping it, when nature called.
I didn’t realize that all my hurts came from the same source: my dropping pelvic organs.
To save myself from embarrassment, I stopped going out. I couldn’t sit through a movie, dinner at a restaurant, or a car ride. I came up with excuses to stay home. I withdrew from my friends, my family, and even my husband.
What’s more, sex and intimacy just weren’t the same after baby number two. I was finding it quite painful. I felt like my husband was hitting things that shouldn’t be there when he penetrated me. Other times, I felt like he was rattling around in a wide-mouthed pickle jar, because I couldn’t feel anything at all. In either case, despite his gentle and tender care, I felt battered and bruised when we finished. On several occasions, attempts at intimacy left me bloody. For a couple who are generally exhausted from the demands of work and parenting, these failed attempts were especially demoralizing.
My life was becoming lonely and sad. I had no idea what was going on. I didn’t realize that all my hurts came from the same source: my dropping pelvic organs. I had seen my doctor several times, but when I put my feet up in the stirrups for my exams, my guts would slide back into place. From my doctor’s point of view, things didn’t look too bad, and I was too modest in expressing my frustration with my body. I seemed asymptomatic, so no efforts were made to correct my course.
The trouble with all prolapses is that if left untreated, they inevitably get worse.
I thought I felt exhausted and sore because I had lost fitness after two pregnancies. So I ate smarter and worked harder. I started adding speedwork to my training runs (on the treadmill or the track). I cycled on my off days and lifted heavy weights with my husband. I dropped pounds until I was below my pre-pregnancy weight. I was running faster than I did before I had kids. I was almost squatting my body weight for the first time since high school. I was really proud of my progress, but I still felt like I was trashed. Despite noticing that my running stride was starting to falter, I trained harder.
The trouble with all prolapses is that if left untreated, they inevitably get worse. Mine did and did so suddenly.
One evening I found myself stumbling during a routine training run at the gym, feeling like someone had reached up and pulled my guts out. I shuffled to the bathroom reeling, in bloody shorts to find a giant bulge hanging out of my vagina and in my pants.
The next morning, I saw my doctor and put my feet up in the stirrups. After briefly poking around, she took her gloves off and said that yes, I experienced a minor pelvic organ prolapse, but it isn’t that bad. Two to three weeks in pelvic floor physical therapy and I would be as good as new.
My whole appointment lasted maybe five minutes. That was it. My insides were on the outside, and basically all I got was a pat on the back and a hand-off to someone else.
By the end of that week, I found myself in yet another office, half naked in another gown, with another sheet wrapped around my lap. This exam conducted by a pelvic floor specialist took much longer and was much more personally invasive than any other exam I’ve ever had. This specialist was very meticulous and looked at and palpated everything.
When she finished, she very quietly removed her gloves, washed her hands, and helped me sit up. She sat down on her stool with a sigh and broke the news.
I didn’t have a minor prolapse. In fact, I had prolapsed all of my pelvic organs quite severely. My rectum had herniated through my vaginal wall, causing the bulge I could see. Every time my husband and I got it on, he was banging into my rectal cavity making intimacy painful and often bloody.
My bladder had dropped so much that my urethra was kinked. Having kinked pipes made me accidentally urinate at times, yet be unable to relieve myself at others. Because my bladder had fallen, almost to the point of coming out as well, it was bringing my uterus down with it. There was nothing “minor” about any of this.
My pelvic floor muscles were so strained from traumatic childbirths that they couldn’t handle my aggressive training. They had failed completely. My nerves were so badly damaged that they had no control over what was left of those muscles. I couldn’t perform a Kegel. I couldn’t even lie on my back and do clamshells or extend my knees and lift my heels off of the exam table. I could hardly walk without a waddle.
The physical damage I experienced was so bad that my body could not heal itself entirely. Even after 10 grueling weeks of physical therapy to regain control of my pelvic floor muscles, I still am not back to where I used to be. I’m functional though—no more accidents. I am able to exercise, albeit with some modifications.
I’m constantly having to start over, it seems, but progress in life is hardly linear.
Reconstructive surgery is a viable option for most women. However, I don’t feel like it’s a possibility for me right now. My children are still too small and dependent on me. I can’t take at least six weeks off from being Mom to recover from a major surgery. I can’t go that long without needing to pick up a little one. Instead, I opted to be fitted for a pessary. This $40 silicon ring is vaginally inserted and provides support to my descending organs by pushing them back into place. When I have mine in, I feel almost whole again. My pessary has unkinked my pipes and I’ve regained the control and regularity I was missing. I can even leave it in during intimacy and I feel like a newlywed again.
It’s been nearly two years, and I’m still getting used to my “new normal.” I have a lengthy list of core exercises that need to be completed daily. If I skip more than a couple of days, I regress substantially and I have to start rebuilding again. I’m constantly having to start over, it seems, but progress in life is hardly linear.
Before I prolapsed completely, my husband and I had been planning to add to our family. I really, really wanted another baby. I can’t begin to put into words the devastation I felt when we decided that for my own health, it was better that we didn’t. I lack the physical structural support to safely carry another baby. As the baby grows, there’s no way to keep my organs inside of me. Even if I chose to have reconstruction surgery, my growing womb would stretch everything loose and push my organs down and out. There’s no way around that.
Almost all of this mess could have been avoided. If I had been more honest with my doctor about the severity of my symptoms, she would have realized that I was not asymptomatic and that my prolapses were interfering with the quality of my life.
Had I been pushed harder for attention to my discomfort, I could have been fitted with a pessary sooner. But I did not advocate for myself. I didn’t change doctors when I realized I wasn’t being heard. My lists of “could haves” and “should haves” are never ending.
I can’t go back and tell myself to not to train so hard and to be gentle with my body. But I can use my story to convince others that it’s crucial to give your postpartum body time to heal. And if you aren’t being heard by your doctor, find a new one and don’t stop until you’re listened to.
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