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“My Insides Are Falling Down!”

woman with pelvic pain

by Peahen Gandhi, MD, FACOG, FPMRS

“My insides are falling down,” explained my patient Mandy, who came to see me for her annual GYN exam. A young mother with three children, she’s not one to complain, so when I first asked her how she was doing, she politely said, “Fine!”

But as she answered questions during her exam, her real story came out.

Three Babies and a Leaky Bladder

Ever since delivering her third child, Mandy’s bladder has been leaky. She used to love tennis, but can’t play anymore because of the stress it puts on her bladder. She also admitted that she constantly has the uncomfortable feeling that her “insides are falling down.”

Mandy has pelvic health issues.

Like many women, she has accepted the changes in her body and has given up on activities that used to bring her happiness, like tennis and aerobics.

The fact is, one-quarter of women face poor pelvic health issues.

Pelvic Health Risk Factors

Pregnancy/childbirth – Childbirth puts strain on the pelvic area during delivery.

Menopause – Pelvic floor muscles weaken in menopause, leading to pelvic organ prolapse (POP).

Heredity – Having a mother or sister with PFD (Pelvic Floor Disorder) puts a woman at higher risk.

Obesity – Overweight or obese women have increased pressure on the bladder and frequently lack strength in their bladder muscles.

Other risk factors for poor pelvic health include:

  • Constipation/chronic straining
  • Diet
  • Smoking
  • Heavy lifting/exertion
  • Lung conditions/chronic coughing
  • Nerve injuries
  • Other health conditions.

Signs of a Healthy Pelvic Floor

The key foundation for pelvic health is the “pelvic floor” — a versatile set of muscles that works 24/7 — supporting the uterus, cervix, vagina, bladder and rectum. Pelvic health encompasses four broad categories:

1. Normal functioning of the bladder, and the portion of the digestive system that includes the bowel and rectum.

2. Well supported reproductive organs. A woman with good pelvic health will have no uncomfortable feeling of sagging, pressure or “falling.”

3. No significant pain or dysfunction in the pelvic area, whether from aging, childbirth or past injuries due to surgeries or accidents.

4. Good sexual function and sensation.

Pelvic Health Treatment

Pelvic health treatments can include:

  • Medications
  • Lifestyle changes
  • Physical therapy
  • Noninvasive procedures
  • Pelvic reconstructive surgery.

Enjoy Life Again

Complete pelvic health diagnosis and treatment can best be addressed by a specialist known as a urogynecologist: an OB/GYN who is board-certified in the subspecialty of Female Pelvic Medicine and Reproductive Medicine (FPMRS).

With treatment, Mandy was able to enjoy life again. You can too. If you experience problems with bladder or fecal leakage, pelvic pain, the sensation of your insides “falling down” or impaired sexual function, call us to make an appointment with one of our FPMRS physicians.