Older Women at Higher Risk of Pelvic Organ Prolapse
By Jasmine McCarthy
As women approach middle age and menopause, health care professionals generally warn them of a number of diseases and health conditions that become more likely during this phase of life.
However, one very common risk often goes unmentioned , a pelvic floor disorder known as pelvic organ prolapse, or POP. Caused by diminishing tone and strength in pelvic floor muscles and connective tissues, POP will affect half of all women who have given birth, and its symptoms are most likely to appear in women who are 50 or older.
Pelvic Organ Prolapse
The pelvic floor is the support structure of the pelvis, keeping organs like the bladder and rectum in their proper places so that they can perform their functions efficiently. Pelvic organ prolapse happens when the pelvic floor becomes weakened or stretched, allowing one or more of those organs to droop low in the pelvis, placing pressure on the vagina.
This can cause symptoms that include pain and pressure in the pelvic or vaginal area, pain during sexual intercourse, urinary incontinence and problems with bowel functions. Women might notice a bulge in the vagina or see tissue begin to protrude from the vaginal opening. Not all women with POP have symptoms, and in those who do, the type and intensity of those symptoms varies widely from one woman to another.
Why Older Women are at Higher Risk
The reason that older women are at higher risk for pelvic organ prolapse is that the condition generally takes a number of years to develop. The weakening of the pelvic floor that is at the root of POP takes place gradually over the years, a process that is typically set in motion by the strain of pregnancy and childbirth, then contributed to by other factors, such as obesity, heavy lifting, frequent constipation, chronic coughing or high-impact sports or activities.
Then, menopause arrives, bringing with it decreased levels of estrogen that cause muscles and tissues to lose elasticity, which further weakens an already compromised pelvic floor, allowing the onset of pelvic organ prolapse.
Many women with mild to moderate POP symptoms have had success with pelvic floor exercise, a method that gets the best results when overseen by physical therapists. Weight loss can reduce symptoms, since excess weight increases strain on the pelvic floor, and well-balanced nutrition is important, since vitamin and mineral deficiencies can affect muscle strength and function. Using a pessary has made many women more comfortable, which is a device that is inserted into the vagina for support.
Women who have severe symptoms may need corrective surgery. However, if you are considering surgical POP repair, it is essential that you know that there are several types of procedures that your surgeon can use, and some are riskier than others.
Procedures that use transvaginal mesh implants for POP repair have been associated with serious complications in thousands of women, such as mesh erosion, protrusion of mesh through vaginal walls, mesh contraction, organ perforation and infection. These symptoms are so severe that thousands of affected women have sought justice through the filing of vaginal mesh lawsuits against mesh manufacturer.The Food and Drug Administration (FDA) advises that these procedures haven’t been shown to yield any better clinical results than traditional surgery, and urges surgeons and patients to consider procedures that do not use transvaginal mesh.