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

Tulsi Desai Apr 22, 2020 353 Views   0 Comments

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. 

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