Rarely talked about despite its overwhelming occurrence, pelvic organ prolapse (POP) occurs when an organ in the pelvis drops down from its normal position and pushes against the vaginal wall. While the exact prevalence of pelvic organ prolapse is unknown, experts estimate that nearly 50 percent of women between the ages of 50 and 79 have some form of POP. Besides resorting to surgery, there are just a few treatments available to help affected women. Fortunately, bodyworkers who understand the tenets of Traditional Chinese Medicine (TCM) and practice shiatsu have access to a powerful therapeutic tool to mitigate organ prolapse.
About Pelvic Organ Prolapse
Pelvic organ prolapse is a medical condition that occurs when the normal support of the vagina is lost, resulting in sagging or dropping of nearby structures. As the prolapse of the vagina and uterus progresses, women may feel bulging tissue protruding through the opening of their vagina.
Once rarely discussed or recognized, POP has become a priority women’s health issue today. Many primary care physicians and gynecologists routinely screen patients for its symptoms, and the new surgical specialty of urogynecology has arisen to correct pelvic organ prolapse and the urinary incontinence that often results. By age 80, more than 10 percent of women will have undergone surgery for prolapse.
Affecting various walls of the vagina, different pelvic organs can prolapse:
- Cystocele – A cystocele occurs when the bladder protrudes into the front wall of the vagina.
- Urethrocele – An urethrocele develops when the urethra presses into the front vaginal wall.
- Rectocele – A rectocele occurs when part of the rectum bulges into the back wall of the vagina, sometimes causing difficulty with bowel movements.
- Uterine Prolapse – The uterus drops down into the vagina.
- Vaginal Vault Prolapse – In women who have undergone a hysterectomy, the top of the vagina can drop and protrude into the lower vagina.
Unfortunately, many cases of POP go undiagnosed because many women are reluctant to discuss symptoms, which may include:
- A feeling of pelvic pressure, or a bearing down sensation
- Leg fatigue and low back pain
- Stress incontinence and difficulty starting to urinate
- Problems with bowel movements, such as pain, pressure and constipation
- Irritated vaginal tissue or pain during intercourse
- Feeling very full in the lower belly
- Feeling as if something is falling out of the vagina
- Inability to keep a tampon in
Pelvic support comes from pelvic floor muscles, fascia and ligaments. If the pelvic floor muscles weaken, the fascia and ligaments have to bear the brunt of a woman’s weight. Eventually, these structures may stretch and fail, allowing pelvic organs to drop and press into the vaginal wall. The following women are at higher risk for a pelvic organ prolapse:
- Those who have had multiple vaginal births
- Women who have had injury or surgery to the pelvic floor – especially a hysterectomy
- Having a connective tissue disorder
- Being post-menopausal
In addition, the following increase the chance of suffering a pelvic organ prolapse:
- Constipation and chronic bowel straining
- Chronic coughing
- Heavy lifting
Women without symptoms or symptoms that are mild typically don’t need treatment. However, there are some things that will help prevent the worsening of a prolapse:
- Weight loss (if applicable)
- Avoid lifting anything heavy
- Quit smoking
Besides these precautions, there are several solutions for a pelvic organ prolapse:
- Kegels – Kegel exercises are a series of contractions that strengthen the pelvic floor. The pelvic muscles used to stop a stream of urine and prevent passing gas are squeezed – without contracting the stomach muscles.
- Pessary – Similar to a diaphragm or cervical cap, a vaginal pessary is a device that’s inserted into the vagina to help support sagging pelvic structures. Those with a severe POP can’t keep a pessary in.
- Surgery – For women who have significant pain or problems from their prolapse, surgery is an option. Pelvic reconstructive surgery can be performed through the vagina or abdominally, where the prolapsed organ is repositioned and secured.
Shiatsu for POP
Since the pelvic organs and their surrounding fascia and ligaments are generally not accessible to a bodyworker, some massage therapists might assume that there is little they can do. However, that is not the case for therapists with an understanding of TCM and meridian theory.
Understood to be a real medical issue for centuries, organ prolapses are nothing new. According to Chinese medical theory, a prolapsed internal organ is usually due to a weakness of the Spleen energy. The normal direction of the Spleen’s energy is upwards; hence, a weakness can manifest as a feeling of bearing down, fatigue, diarrhea or an organ prolapse. One of the ways practitioners of TCM address this weakness is by stimulating points that raise the energy.
As long as a prolapse is not to the point where it needs to be repaired surgically, shiatsu can play a supportive role in a woman’s recovery.
- Located at the apex of the head, Governing Vessel 20 is the most well-known point for addressing a prolapse. As this meridian begins between the vagina and rectum, this point is particularly useful for raising the energy at the uterus, vagina and rectum.
- Stimulating energy along the liver meridian (especially on the lower leg) is advised, because of the liver energy’s special tie to the pelvic region. According to TCM, the liver meridian encircles the external genitalia, connects to the uterus and dominates the tendons, muscles, ligaments and nerves.
- Also on the lower leg, the spleen meridian lies adjacent to the liver meridian. Because a spleen energy weakness is almost always responsible for an organ prolapse, tonification methods on the spleen meridian can raise the energy – a big help to a woman with a pelvic organ prolapse.
As the understanding of its prevalence and normalcy grows, more women will speak up about their discomfort and get help for a pelvic organ prolapse. Especially since there are just a few treatment options for POP, bodyworkers who practice shiatsu have a unique skill that can aid in the recovery from a pelvic organ prolapse.