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Non-Surgical Treatments for Pelvic Organ Prolapse | Image Courtesy of Annie Spratt via Unsplash
Non-Surgical Treatments for Pelvic Organ Prolapse | Image Courtesy of Annie Spratt via Unsplash

Are There Non-Surgical Treatments for Pelvic Organ Prolapse?

That constant heavy feeling in your pelvic area. That embarrassing urine leakage. That bulge ‘down there’.

It took a while, but you found the courage to talk to your doctor about your symptoms. (Good for you!) Now you know your condition has a name – pelvic organ prolapse – and a treatment. But is surgery really the best option?

Research estimates that 50% of all women who give birth will develop pelvic organ prolapse at some point in life; but while pregnancy and childbirth top the list of risk factors, the condition usually develops over time from a combination of factors that can also include anything from frequent strenuous gym workouts to smoking to menopause (and even genetics).

For years, surgery was the go-to treatment plan; and it is helpful for some women. But complications are possible – and horror stories, especially about newer synthetic mesh surgeries, have trended more than once on social media in the last few years. That bad publicity, and the number of younger women seeking treatment, have led to an increase in the popularity of some non-surgical treatments for pelvic organ prolapse – pessaries and pelvic floor physical therapy.

Non-Surgical Treatment Options for Pelvic Organ Prolapse

What is a Pessary?

In simplest terms, a pessary is "a device inserted into the vagina to provide structural support". They come in a variety of shapes to meet different structural needs and control a woman’s specific symptoms. The best pessary candidates are POP patients who are pregnant or want to have children in the future, and those who prefer to start with a more conservative treatment approach. In fact, pessaries have traditionally been used with patients waiting for surgery; but half the women in one study who experienced symptom relief from a well-fitted pessary chose to delay surgery for a year or more. Additionally, although many doctors still consider pessaries a short-term solution, at least one recent study found that they are a good long-term treatment option for sexually active women. And – here’s the best news – researchers say pessary use can “significantly improve desire, lubrication, and sexual satisfaction” in POP patients. Not surprisingly, the same study found those women also reported improved quality of life.

The downside to pessary use is more of a cautionary tale than horror story. Not every patient is a candidate (22% of patients can’t be fitted for various reasons). Successful use takes a certain amount of self-management, including proper removal, cleaning, re-insertion, and reporting any complications. About three-quarters of women using a pessary to treat pelvic organ prolapse will experience a complication at some point; but most of those are minor and the majority of patients say they are still satisfied with the improved quality of life a pessary provides.

Not all pessaries are created equal, especially when it comes to sexual activity. Some need to be removed for intercourse, and a few don’t allow intercourse at all. If you’re considering short- or long-term pessary use, it’s important to be very open with your healthcare professional and your partner(s) about your sexual activity and what to expect from the device that is best for you.

PFMT or Pelvic Floor Muscle Training

But there’s another treatment option for women who suffer from pelvic organ prolapse – pelvic floor physical therapy, specifically pelvic floor muscle training (PFMT). It’s performed in-office by a licensed and experienced pelvic health physical therapist and often involves home exercises as well. While it can’t reverse pelvic organ prolapse, significant research shows it can put the brakes on the condition – keep it from advancing, reduce the symptoms, and improve sexual activity. Many POP patients are highly satisfied with the results of pelvic floor physical therapy, especially when compared to the risks and lifestyle effects of surgery. Experts agree that it is an excellent first step in treating the condition.

Femina PT's Approach to Pelvic Organ Prolapse Treatment


At Femina PT, pelvic floor physical therapy is the hallmark of our treatment program… and it works for more than POP! Whether you’re looking for non-surgical treatments for pelvic organ prolapse, are experiencing urinary incontinence, or dealing with painful sex – our expertly trained and highly experienced therapists can help.

References

Rantell A. 2019. Vaginal Pessaries for Pelvic Organ Prolapse and Their Impact on Sexual Function. Sexual Medicine Reviews 7:4 597-603.

What Our Patients Have to Say

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Testimonial by M.M.

My husband and I were married for 5 years and unable to have intercourse, but I never knew why. After numerous awful experiences at doctor’s offices (where many doctors told me I “just needed to relax”), a surgery that didn’t fix the problem, and a year of owning dilators that didn’t get me anywhere, someone finally referred me to Heather for Physical Therapy. I finally had answers and information from someone who knew exactly what I was dealing with!

Read more: Testimonial by M.M.

Testimonial by R.D., age 38

"I had a severe tear during childbirth that was not stitched together correctly and therefore healed poorly. Even after having a surgery a year later to remove the scar tissue, I was still having pain, and no one could explain why -- there was no overt 'reason' to explain the pain. I had tried other 'specialists' and even saw another physical therapist who had me do hip / leg stretches -- what a joke! I was about to give up and just 'live with it' until thankfully I kept searching online and found Heather.

Read more: Testimonial by R.D., age 38

Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by T.C.

While pregnant with my twins, Heather took care with keeping me on my feet and pain free. She saved my back, my sanity and the holidays! I would recommend her to every “mom” looking to stay on her feet during pregnancy and post-partum.

-- T.C.

Testimonial by R.D., age 38

"I had a severe tear during childbirth that was not stitched together correctly and therefore healed poorly. Even after having a surgery a year later to remove the scar tissue, I was still having pain, and no one could explain why -- there was no overt 'reason' to explain the pain. I had tried other 'specialists' and even saw another physical therapist who had me do hip / leg stretches -- what a joke! I was about to give up and just 'live with it' until thankfully I kept searching online and found Heather.

Read more: Testimonial by R.D., age 38

Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

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