About Tulsi Desai

Name : Tulsi Desai

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Can Severe Coughing Make You More Likely To Get Pelvic Organ Prolapse (pop)?

Active Body Active Life (Physical Therapy & Wellness)

While everyone is panicking about the current world situation and it's implications on our health and our future, it would be helpful for all the women to understand the short and long-term implications of childbirth related gynecological problems they live with. 

Pelvic organ prolapse is very common in women. It is seen in at least 50% of women who have gone through pregnancy and childbirth. It is the third most common reason for hysterectomy (surgery to remove uterus).

Uterus, bladder and rectal prolapse are the most common type of prolapses in women. The severity of the prolapse can vary from stage 0 (no prolapse) to stage IV (complete prolapse). 

The muscles inside the pelvis known as Pelvic Floor Muscles (PFM) primarily support pelvic organs (mainly uterus, bladder & bowel).  A loss of this support can result into prolapse, bulging or protrusion of one or more pelvic organs into the vagina. 

Pelvic organ prolapse happens as a result of support dysfunction where the muscles and fascia providing the support to these organs to keep them in their proper alignment are compromised due to various reasons discussed below.

Common factors responsible for POP or contribute to POP in women are:

  • Childbirth (especially vaginal delivery)- increased risk of POP with instrument-assisted delivery (forceps, vacuum). Women with 3 or more vaginal delivery are 8 to 10 times more at risk for POP. Very rapid delivery (in less than 30 minutes) also increases the risk of POP. 
  • Pelvic surgeries – disrupt ligament support system
  • Respiratory problems – smoking, COPD, cystic fibrosis, viral infections (COVID-19, FLU) leading to chronic cough. 
  • Chronic constipation/straining
  • Obesity – 30% to 50% increased risk
  • Aging- tissue degeneration, estrogen depletion (postpartum, menopause)
  • Pelvic nerve damage or injury
  • Genetic factors – collagen deficiency
  • Sexual trauma 
  • High impact sports
  • Heavy lifting – carrying heavy kids with weak muscles since childbirth, heavy lifting at work

Below are the signs you can look for to decide if you may be suffering from pelvic organ prolapse. If you say yes to any of the following symptoms then it would be worth getting evaluated for it. 

  • Heaviness, feeling of “something falling out”
  • Pressure in the pelvis - Pressure worse at the end of the day especially after being on your feet for most of the day
  • Back pain
  • Bladder problems – urinary frequency, urgency. Urine leakage immediately after emptying the bladder. Feeling of incomplete emptying of bladder. 
  • Bowel problems – straining for bowel movement, incomplete emptying of bowel, inability to fully empty the bowel. 
  • Sexual problems

What could you possibly do to decrease the chances of you getting pelvic organ prolapse?

  • Constipation management
  • Avoid straining with urination and defecation
  • Weight loss
  • Kegel exercises (may not help everyone)

What can you do if none of the above helps and you continue to have the signs and symptoms mentioned above?

  • First step is to get evaluated by a pelvic floor/women's health specialist physical therapist (PT) or your OBGYN. 
  • Use pessary if recommended by your clinician – device inserted non-surgically into the vagina to provide support to pelvic organs.
  • Preventive Pelvic floor physical therapy evaluation and treatment 4-6 weeks postpartum (after childbirth) after delivering each baby is recommended. You can detect and prevent a lot of pelvic floor problems before they become life altering health problems. If it's been years since your kids were born, you can still get the treatment and prevent it from getting worse.
  • Surgery- recommended in case of complete prolapse. Remember, every surgery comes with a huge risk of complications like bleeding, nerve damage, and anesthesia side effects. Conservative (nonsurgical) treatment should be the first choice of treatment in most cases. 

Pelvic organ prolapse is a complex, multifactorial problem. It leads to diminished quality of life, social burden and financial burden.  Women suffering from severe POP commonly report feeling physically and sexually self-conscious. 

A lot of people respond well to professional help like behavioral, educational and exercise interventions. Early detection and treatment can help achieve better outcomes. Don't wait for it to get better on its own if you have been suffering from above mentioned symptoms for weeks, months or years. 

Ask for help! Don't let coughing from any illness ruin your bowel, bladder and gynecological health. 

Feel free to reach us via call/text at  (214) 210-0715 or via email at info@activebodyactivelife.com 

for any guidance you may need. You can visit www.activebodyactivelife.com 

to learn more. Follow and like us on Facebook/instagram @activebodyactivelife to get latest health updates. 

Tulsi Desai  Apr-2020   373   0


Tulsi Desai is a license physical therapist who specializes in pelvic floor and women’s health. She graduated from Loma Linda University, CA. She has worked in different health setting in Michigan, New York and now in Dallas, TX.

Tulsi has over 10 years of experience as a physical therapist treating variety of orthopedic conditions as well as women’s health/pelvic floor problems. While working in New York City, she worked with some of the leading orthopedic surgeons and women’s health specialist physicians at NYU, the Hospital for special surgery and private practice physicians giving her unique opportunities to learn advanced evaluation and treatment techniques. She has attended various courses and conferences including NYU Dance Injury Rehabilitation Program and NYU Running Injury Symposium. 

Tulsi is the owner of Active Body Active Life (Physical Therapy & Wellness) clinic located in Coppell, TX. It is a specialty clinic that offers women’s health and pelvic floor rehabilitation.

Pelvic floor physical therapy is a specialty where a physical therapist is trained specifically to treat conditions related to pregnancy(back pain, sciatica, joint separation), postpartum (scar healing, tearing, back pain, tailbone pain, urine leak, organ prolapse), and age-related pelvic floor problems (organ prolapse, urinary leak with coughing, laughing sneezing, different problems during menopause). Pelvic floor physical therapy can help with acute or chronic back pain, sciatica, joint alignment and instability problems, post-pregnancy scar healing (c-section, episiotomy), organ prolapse as well as pelvic pain. It can help with endometriosis, pain with sex, urinary/bladder problems (incontinence/leakage, frequency, urgency, hesitancy) and constipation. Above are just some examples of conditions that can be treated with pelvic floor physical therapy and it’s just the tip of an iceberg. To learn more please visit her website www.activebodyactivelife.com and facebook page @activebodyactivelife. Tulsi loves to educate all her patients and empower them with the right knowledge about their own health, exercise, posture, and fitness so that they are well equipped to make right choices at home and at work even when she is not around. Her patients really appreciate her passion for women’s health, honest opinion, and the fact that she spends a lot of time listening to what they have to say and what they have gone through rather than rush them out. All her appointments are oneon-one every single visit for one hour. 

She does a lot of workshops at local libraries, yoga studios, fitness studios, to local mom’s group and women business owner groups to educate women on their health and treatment options so that they are well informed when they have to make health decisions. If anyone reading this article would like her to come to your organization or mom’s groups to educate your employees and members on pelvic health/women’s health, please feel free to reach her directly. If anyone is interested in attending one of the free workshops, please visit her facebook page @activebodyactivelife and “LIKE” the page to get updates on upcoming events as well as get updates on latest health related articles/information.

Due to lack of awareness on pelvic health and available treatment options even among medical providers, a lot of times patients suffer through pain, incontinence, prolapse and various other problems for years feeling frustrated and helpless. So many times, patients find Tulsi directly for their chronic back pain, sciatica and/or other pelvic floor problems that never got better with medication & other traditional treatments (general physical therapy, chiropractic, acupuncture etc) because no one is addressing the dysfunction/problem inside the pelvis. On an average, a woman spends 6-8 years of trying different doctors and spending a lot of money on different investigations with little to no help before she learns about pelvic floor rehabilitation. Pelvic floor problems can happen to anyone even if they are not related to pregnancy. If you are suspecting that you may have some pelvic floor problems then it is very important to have an evaluation done by a pelvic floor physical therapist in order to determine root cause of the problem. You can call/text us at (214)210- 0715 or email @info@activebodyactivelife.com and let us know what you are looking for, we would love to help you and guide you in the right direction.

Ideally, every woman should get pelvic floor evaluation after each pregnancy in order to get optimal care and healing they deserve. Prevention is better than cure. We have an opioid epidemic going on in United States. So many people are afraid of getting addicted to strong medicines. Physical therapy can hugely help to avoid opioid use/addiction and help people achieve recovery that will last for long time. A lot of people are looking for quick fix for their health problems, but they need to realize that a lot of times it took months/years of small traumas before the body started hurting. Popping a pill is not going to give long lasting results. If you want along term results then you will have to invest in your health and go for a few physical therapy sessions to learn how to use your body correctly and how to heal properly for a healthy life ahead.

One size fits all doesn’t work when it comes to our health. At Active Body Active Life (Physical Therapy & Wellness) clinic we create individualized treatment plans that include full body rehabilitation to optimize overall function. We are eager to help those who are looking for quality care to achieve long-term results, and not a short cut for temporary solution.

In her personal time, Tulsi enjoys spending time with her family. She adores her 5 year old son who loves to laugh all the time. Working at Active Body Active Life helps her create a work-life balance that lets her spend quality time with her family while she is still able to provide the best quality one on one care to her patients.

Tulsi Desai  Jul-2019   826   0

Are you worried about peeing your pants ? by Tulsi Desai
Do you or someone you know suffers from urine leak with coughing, laughing, or sneezing? Are you embarrassed about leaking and worried about going to social events? If yes, then you are not alone. Urinary incontinence (UI) is very common. 1 in 10 women have UI postpartum. In USA, 25 million suffer from UI and 75-80% are women.

Tulsi Desai is a physical therapist at Active Body Active Life (Physical therapy and Wellness) who specializes in pelvic floor treatment and women’s health. She regularly treats patients with urinary ncontinence and variety of other pelvic floor problems.

Urinary incontinence is involuntary loss of urine.  There are 3 main types. Urge incontinence is increased frequency of urination where a person would be going more than 10 times in a 24 hr period (normal range is 6-8 times in 24 hrs). Stress Incontinence is the loss of urine with sneezing, coughing, jumping, running or any kind of heavy physical activity. Third one is Mixed incontinence which is the combination of Urge and Stress incontinence.

Stress incontinence (SI) is more common in women than men. 15 million adult women in USA suffer from SI. It happens with physical activities that put stress or pressure on your bladder and you are unable to control the urine. When a person has stress incontinence, she may experience urine leak with coughing, laughing, sneezing, exercise (run, yoga, fitness class), standing up from sitting, during sex and while lifting/carrying something heavy. It can be occasional or frequent based on the severity of the problem. SI is especially very common during or after pregnancy. For some it improves after delivering the baby. But in many cases, it may not improve or go away completely. If ignored for a long time then it can lead to more severe consequences like chronic or frequent urinary tract infections.

A person may feel embarrassed and may start avoiding social events due to fear of having an accident of not being able to control urine. A lot of women stop going to yoga, exercise class or to the gym due to fear of leaking and eventually start having secondary health problems due to sedentary lifestyle. It can lead to emotional and psychological stress as well if one feels isolated, ashamed and helpless.

The good news is that it can be treated. A lot of women have full recovery with complete bladder control even years after having their babies if they seek proper professional help. Pelvic Floor PT can help you achieve full control of your bladder, stop the involuntary urine leak and help you regain control of your life where you feel empowered and you don’t have to limit yourself to avoid embarrassment from the leakage. 

There are many misconceptions about treatment options today.

1. A lot of women are being told that this is normal part of having babies and they have to live with it. But in reality, this problem can be fully treated without needing medicine or surgery.

2. A lot of women go through unnecessary medications and surgeries due to lack of proper knowledge. 

3. Some are being told to do Kegel exercises. While Kegel exercises can help some women, it always isn’t the solution. A thorough evaluation by a physical therapist (PT) who specializes in pelvic floor will help determine the root cause of the problem and then appropriate treatment by the specialist can really help treat the urine leak for long term solution.

4. There are different online fitness programs being offered which claim to help. In some cases, without proper evaluation, fitness exercises can exacerbate problems.

On an average it takes 6-8 years of trying different things and different doctors before a woman finds her way to a pelvic floor PT as most are not being offered this option in the first place. It can be extremely frustrating when all you are being told is to live with it just because you had a baby.

There are a few things that can help:
1. Start a bladder diary and discuss it with a pelvic expert physical therapist.
2. If Kegel exercises haven’t helped you or by any chance if they made your symptoms worse, then you may want to stop doing them and consult a pelvic floor exert physical therapist.
3. Limit bladder irritants like coffee, tea, alcohol, citrus fruits, nicotine, and artificial sweeteners from your diet.

If you have been struggling with incontinence for longer than a few weeks and you want to learn more about what the ‘root cause’ could be? At Active Body Active Life we offer a Free Phone consultation with our clinician to find out if you are the right candidate for this treatment option.

All you need to do is contact us via phone at (214) 210- 0715 or send us an email at info@activebodyactivelife.com and tell us a bit more about what’s going on, and we will have a conversation about how we may be able to help.

P.S. If you’d simply like more information, check out our website www.activebodyactivelife.com and follow facebook/instagram page @activebodyactivelife.
Tulsi Desai  May-2019   1449   5