As told to Jacquelyne Froeber
June is Pelvic Organ Prolapse Awareness Month
Sitting in a waiting room with mostly 80-year-old men, I wondered how I got here.
I was 50. Active. In good health. But apparently my bladder thought I was twice my age. The urge to pee was taking over my life. No matter where I was or what I was doing, I had to pee at least once an hour — more than 30 times a day on a good day. And the more I thought about it, the worse it got.
My full and happy life was already changing when this bladder bully showed up in early 2023. Over the past few years, my family and I had moved to a new neighborhood, my daughter moved away for college and my teenage son was getting ready to leave too. I started to feel insecure and unsure of my next purpose in life. My inner critic was always firing major bullets my way, telling me I wasn’t good enough. What was going to happen when my job as a hands-on mom was being downsized? I was scared to find out.
The ongoing conflict inside my brain was causing a lot of overall tension in my mind and body. Even if I could relax enough to sleep, I’d still have to get up throughout the night to pee. I was desperately trying to keep it all together, but the pressure in my pelvis was pushing me to a breaking point.
I was frank about this with the urologist during that office visit. “This is unbearable,” I said. He was the latest healthcare provider to listen to my symptoms. Six weeks earlier I was treated for a UTI, but three rounds of antibiotics didn’t really help. Now the pressure was so intense, it felt like a boulder sitting on my pelvis. It would roll to the side when I went to the bathroom, but it always returned a few minutes later.
The urologist diagnosed me with an overactive bladder. But that didn’t add up to me. Why did it come on so suddenly? He didn’t have any answers except that I was menopausal and these things happen with age.
My doubts lingered. I told my friend that I didn’t feel like the doctor was listening to me and she suggested I go to a urogynecologist who specializes in bladder issues. When I called the office, the receptionist said they were only seeing patients with severe pelvic floor issues or prolapse. I asked her to repeat the word. I’d never heard of prolapse before — maybe this was what was happening to me? I went straight to the internet. I learned pelvic organ prolapse (POP) is when your pelvic organs can drop and bulge into your vagina. This was, of course, scary to think about, but overall I was disappointed. I had some symptoms of POP, like the feeling of fullness in my lower stomach, but it didn’t sound like this was what was happening to me.
The very next night I was in the bathroom — per usual — when I felt an odd sensation like a tampon coming out of me. It didn’t hurt, but something was not right. I screamed downstairs for my husband. “My insides are falling out!” It felt like a bulging in my vagina. Wait, where had I heard that before? All at once it dawned on me that I was experiencing prolapse. I knew from the research I’d done the day before that I wasn’t dying and I didn’t have to go to the emergency room. (But I could call that urogynecologist now.)
And something miraculous happened. For the first time in weeks, the pelvic pressure was gone. Poof. I was cautiously excited — surely it would return any second. But hours passed and no pressure. I was beyond ecstatic. I’m sure this is not the response most women have when they experience prolapse, but I felt free for the first time in a long time.
My pressure-free high was taken down a few notches after I got in to see the urogynecologist. He said the only solution was surgery with a chance that the frequent urination would come back and the prolapse could happen again.
I wanted to avoid the pressure and constant peeing at all costs. I asked him about seeing a pelvic physical therapist, which I had read about online. He said the same thing that all my other healthcare providers would say: You can try pelvic floor therapy, but we will be here when it doesn’t help.
Thankfully, I didn’t let them discourage me. I had rehabbed major back, neck and shoulder issues with movement therapy years before, so I knew the power of the body to heal and regenerate. What did I have to lose?
I had to wait more than a month to get an appointment, so I binge-watched pelvic floor workouts and tutorials on prolapse. I learned that prolapse can be caused by a hypertonic pelvic floor, which means it’s in a constant state of contraction and stops the muscles from relaxing. Then I learned one of the symptoms of a hypertonic pelvic floor is frequent urination. I realized this was probably the reason for my prolapse. My muscles had been so tight for weeks — they just gave out. Just like a pressure cooker that burst.
With the help of my pelvic physical therapist and a lot of online resources, I slowly educated myself on how to rewire my body and nervous system to relax my pelvic floor. I learned how to breathe fully and I worked on softening and relaxing my entire body — letting it melt into the floor. Then I built up my strength and learned how to really listen to my body.
But the body work only got me so far. My mind was the real driver of my symptoms, so I had to work on calming down my inner critic. I learned to shed layers of protection and shame and allow myself to gain strength from within. I learned how to regulate my nervous system so that it felt safe. I began to believe in myself and trust my body, soul and mind.
Turns out, stress can have a negative impact on the pelvic floor and urinary frequency, although none of my healthcare providers made that connection. No one asked me how I was sleeping or if I was dealing with any life changes. They looked at my chart, saw my age and wrote me off. Yes, two vaginal births and entering menopause probably contributed to my prolapse, but it was so much more than that.
I’m not sure what my next season of life will look like, but I’m approaching it with curiosity and confidence instead of fear. I now know my pelvic floor is where I store my stress, frustration and deepest feelings. I do my best every day to honor my body, mind and my spirit.
I haven’t had any prolapse symptoms in several months and I’m back to doing my regular activities. Urinary frequency is still a problem when I’m stressed and tense, but I’m OK with that. It’s my barometer telling me to relax, take a deep breath and remind myself, “You’re good, Lisa.”
*Last name withheld for privacy.
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