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Femina Physical Therapy blogThe Staff of Femina Physical Therapy Blogs About Vaginismus, Pregnancy and Postpartum Best Practices, Treatments for Incontinence, and More

Heather Jeffcoat, DPT was a special guest on the popular and thought provoking podcast hosted by Dr. Emily Morse. Topics include Heather's book "Sex Without Pain", painful sex issues due to vaginismus, injury, pregnancy, and other issues, returning to a healthy postpartum sex life after childbirth, and much more.

From the show's notes on SexWithEmily.com:

Read more: Heather Jeffcoat on the "Sex With Emily" Show with Dr. Emily Morse

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Yoga can help manage pelvic organ prolapse, but there are also some poses, movements and breathing methods that could make the condition worse.

What is a Pelvic Organ Prolapse?

"Prolapse" refers to a descending or drooping of organs. Pelvic organ prolapse (POP) refers to the prolapse or drooping of any of the pelvic floor organs, including:  the bladder, uterus, vagina, small bowel, or rectum. These organs are said to prolapse if they descend into or outside of the vaginal canal or anus.

Read our previous blog for more information on prolapse and how pelvic floor therapy can help.

Which yoga poses will help and which poses will make it worse?

Yoga has been found to help women with urinary incontinence, but will it help with prolapse?

There are hundreds of yoga poses as well as breathing exercises in the practice of yoga. Some of these poses can help manage or reduce the negative sensation felt with organ prolapse. Other poses and breathwork, however, may make the condition worse. This is due to the role of intra-abdominal pressure (IAP) on the organs and the pelvic floor. Prolapse occurs when pressure in the abdomen is greater than the strength of the pelvic floor, the connective tissue, and deep core muscles that help keep organs in their place.

Read more: Pelvic Organ Prolapse and the Role of Yoga

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Happy Pride Month! Femina Physical Therapy is proud to be a supportive and inclusive orthopaedic and pelvic health center. Earlier this month, I had the privilege to attend the first ever physical therapist-specific course for LGBTQ in the US, with an emphasis on transgender care. The course covered, amongst many things, pre-operative, intra-operative and postoperative recovery guidelines. While this is the second course I have taken on transgender care (with a third coming up in a few months), it was the first that was held primarily for the benefit of training physical therapists.

This course was led by Holly Herman, and supported by other physical therapists, nurses and physicians.

Read more: Transgender Pelvic Health and Orthopaedic Services at Femina PT

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Rectal Prolapse or Hemorrhoids?

We continue Pelvic Organ Prolapse Awareness Month by talking about Rectal Prolapse and hemorrhoids, two conditions that are commonly mistaken for one another. 

Rectal prolapse and hemorrhoids can both cause irritation, discomfort, and pain in the anal region. However the causes and treatment can be different for both conditions.

Hemorrhoids

Hemorrhoids are veins in the lower rectum that become swollen or stretched. They are similar to varicose veins in the lower legs. There are two types of hemorrhoids: internal and external.

Internal hemorrhoids are swollen veins inside the rectum. Sometimes these swollen veins begin to descend and come out through the anal sphincter.

External hemorrhoids: are swollen veins that can be seen and often felt under the skin outside around the anal sphincter. Usually they look like a small bulge and are the same color as the skin.

Hemorrhoid Symptoms

The most common signs of hemorrhoids are:

  • Bright red blood on toilet paper
  • Drops of blood in the stool
  • Pain at the anus
  • Burning, pressure, or intense itchiness at the anus

About 75% of adults in America will have hemorrhoids at some point in their lives.

Read more: Is It Rectal Prolapse or Hemorrhoids?

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Yoga for Incontinence

A study presented at the annual meeting of the American Urological Association this past May of 2018 shows that a 3-month yoga intervention can reduce the frequency of urinary incontinence (UI) in women aged 50 years or older.

In the randomized trial completed by Dr. Alison Huang, MD and colleagues, a 3 month yoga therapy program was conducted with a group of 56 ambulatory women aged 50 years or older. These women had previously reported daily leaks and were not using any other clinical UI treatments.

The yoga program consisted of classes twice a week and one session of home practice weekly for three months. The therapeutic yoga classes were based out of the BKS Iyengar style of yoga.

After the three month trial, researchers saw a 74% decrease in daily leakage reported by the women in the yoga class. The women reported no negative outcomes related to the yoga practice. 

Read more: Yoga Reduces Urinary Incontinence in Older Women

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Body Mechanics and Posture for Prolapse Management

Do you feel a bulge or feel like you are sitting on a ball in the pelvic area?  What should you do? Don’t freak out, there is help for you! Here are some things to get you started:

See your gynecologist

Not all prolapses are the same. They can vary based on which organ is descending and how far it has descended (grade).

Prolapse will be diagnosed based on which organ is descending:

  • Cystocele: The bladder falls backward into the front (anterior) vaginal wall, the most common type of prolapse
  • Urethrocele: A prolapse of the urethra (the tube that carries urine)
  • Uterine prolapse: A prolapse of the uterus
  • Vaginal vault prolapse: prolapse of the vagina
  • Enterocele: Small bowel prolapse
  • Rectocele: 
    the rectum falls forward into the back (or posterior) vaginal wall

Read more: I Have a Prolapse. What Should I Do?

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