Herbs and Prolapse
Prolapse literally means "To fall out of place." In medicine, prolapse is a condition where organs, such as the uterus, fall down or slip out of place. It is generally reserved for organs protruding through the vagina, or for the misalignment of the valves of the heart.
Prolapse may also be called uterine prolapse, genital prolapse, uterovaginal prolapse, pelvic relaxation, pelvic floor dysfunction, urogenital prolapse or vaginal wall prolapse.
Pelvic organ prolapse occurs when the pelvic floor muscles become weak or damaged and can no longer support the pelvic organs. The womb (uterus) is the only organ that actually falls into the vagina. When the bladder and bowel slip out of place, they push up against the walls of the vagina. While prolapse is not considered a life threatening condition it may cause a great deal of discomfort and distress.
Cystocele (bladder prolapse)
When the bladder prolapses, it falls towards the vagina and creates a large bulge in the front vaginal wall. It's common for both the bladder and the urethra (see below) to prolapse together. This is called a cystourethrocele and is the most common type of prolapse in women.
Urethrocele (prolapse of the urethra)
When the urethra (the tube that carries urine from the bladder) slips out of place, it also pushes against the front of the vaginal wall, but lower down, near the opening of the vagina. This usually happens together with a cystocele (see above).
Enterocele (prolapse of the small bowel)
Part of the small intestine that lies just behind the uterus (in a space called the pouch of Douglas) may slip down between the rectum and the back wall of the vagina. This often occurs at the same time as a rectocele or uterine prolapse (see below).
Rectocele (prolapse of the rectum or large bowel)
This occurs when the end of the large bowel (rectum) loses support and bulges into the back wall of the vagina. It is different from a rectal prolapse (when the rectum falls out of the anus).
diagram of uterine prolapseUterine prolapse is when the womb drops down into the vagina. It is the second most common type of prolapse and is classified into three grades depending on how far the womb has fallen.
Grade 1: the uterus has dropped slightly. At this stage many women may not be aware they have a prolapse. It may not cause any symptoms and is usually diagnosed as a result of an examination for a separate health issue.
Grade 2: the uterus has dropped further into the vagina and the cervix (neck or tip of the womb) can be seen outside the vaginal opening.
Grade 3: most of the uterus has fallen through the vaginal opening. This is the most severe form of uterine prolapse and is also called procidentia.
Vaginal vault prolapse
The vaginal vault is the top of the vagina. It can only fall in on itself after a woman's womb has been removed (hysterectomy). Vault prolapse occurs in about 15% of women who have had a hysterectomy for uterine prolapse, and in about 1% of women who have had a hysterectomy for other reasons.
There are a number of different types of prolapse that can occur in a woman's pelvic area and these are divided into three categories according to the part of the vagina they affect: front wall, back wall or top of the vagina. It is not uncommon to have more than one type of prolapse.
There are a number of things you can do to reduce your risk of prolapse or help prevent a mild prolapse form getting worse:
* One of the most effective things you can do to reduce your risk of prolapse is to exercise your pelvic floor muscles. Doing regular pelvic floor exercises (also called Kegel exercises) throughout your adult life helps keep the muscles toned and strong. Most women do Kegel exercises when they are pregnant and for a few months after birth, but by making pelvic exercises part of your daily routine you can further reduce your risk of both prolapse and incontinence in later life.
* If you are significantly overweight, try to lose weight. This will remove some of the pressure from your pelvic area.
* If you smoke, try to cut down or stop, as this will help reduce strain from coughing.
* Don't lift heavy objects. This can damage your pelvic muscles.
* Eat a high fibre diet (fresh fruits, vegetables, bran) to help prevent constipation and reduce straining.
* If you are menopausal or post-menopausal, some doctors may suggest you use hormone replacement therapy to protect against prolapse or prevent an existing prolapse from getting worse, but there is little scientific evidence to support the claim that HRT prevents prolapse. Before you make a decision about whether or not to use HRT, discuss the risks and benefits with your doctor.
Pelvic floor exercises help prevent prolapse by strengthening the muscles that support the pelvic organs. The exercises are easy and quick to do, but it's important to do them correctly, and many women benefit from guidance from a physiotherapist.
Start by locating the muscles you need to exercise. There are a few different ways to do this:
1. Place one or two fingers in your vagina and squeeze your muscles until you can feel your vagina tighten around your fingers. These are your pelvic muscles. Imagine you're trying to stop the flow of urine mid-stream. The muscles you tighten (contract) are your pelvic floor muscles.
2. The other way to identify the correct muscles is to imagine you are trying to stop yourself from passing gas. The muscles you squeeze to do this are your pelvic muscles.
3. Once you've identified the correct muscles you're ready to begin. The exercises can be done while lying down, sitting or standing, with your knees together or slightly apart.
Set 1 —lowly tighten your pelvic floor muscles and count to four, then let the muscles relax for a count of four. As your muscles get stronger gradually increase the count to 10. Try to repeat this 10 to 15 times.
Check that you're not tightening the muscles in your legs, abdomen or buttocks, as it's important to use only your pelvic muscles. Remember to keep breathing.
Set 2 — Now tighten and relax your pelvic muscles as quickly as you can, again 10 to 15 times.
As a preventive measure, try to do the exercises two or three times a day. If you have a prolapse, you may be advised to increase the number of times you do the exercises, but don't overdo it. Excessive exercising of the pelvic muscles can cause muscle fatigue and make the exercises less effective.
You can do the exercises anywhere, anytime, but studies show that when women do them at home, they are more likely to do them correctly. Some women find it helps to set aside specific times to do the exercises, such as before getting out of bed in the morning and before going to sleep at night.
If you think you're doing the exercises incorrectly or need help locating your pelvic floor muscles, a physiotherapist will be able to help you. Ask your doctor for a referral.
with thanks to /www.womenshealthlondon.org.uk
Action of the Herbs in Modern Prolapse Tonics
The herbs in modern herbal medicines for prolapse are muscular spasmolytics that help strengthen the tension of organ tissues so helping to reduce the pressure resulting from prolapsed organs so reducing the symptoms resulting from prolapse.
Our herbal tonic medicines are carefully prepared on a personal and individual basis for your healing by medical herbalist Alan Hopking MA MNIMH FINEH.
Only whole herbs are used in our herbal medicines. Nothing else is added. If you have symptoms which you consider might be helped with herbal medicine please contact herbal practitioner Alan Hopking for a friendly confidential professional consultation. See terms and fees.
Once you have received your herbal prescription you can contact Alan Hopking at any time for more free advice (preferably by email). When you have completed your bottle of herbal medicine and if you want a repeat prescription you are requested to phone or email so that your progress can be assessed and adjustments made if necessary so that there is no break in your treatment. To order or re-order, click here.
HERBACTIVE Centre of Herbal Medicine, England, UK. Freephone 0800 0834436
General advice to consumers on the use of herbal remedies from the Medicines Healthcare products Regulatory Agency
From the website of the Medicines Healthcare products Regulatory Agency (www.mhra.gov.uk) Department of Health, UK
• Remember that herbal remedies are medicines. As with any other medicine they are likely to have an effect on the body and should be used with care. • Herbal remedies may sometimes interact with other medicines. This makes it particularly important to tell your doctor or pharmacist if you are taking a herbal remedy with other medicines such as prescribed medicines (those provided through your doctor or dentist). • Treat with caution any suggestion that a herbal remedy is '100% safe' or is 'safe because it is natural'. Many plants, trees, fungi and algae can be poisonous to humans. It is worth remembering that many pharmaceuticals have been developed or derived from these sources because of the powerful compounds they contain. Any medicine, including herbal remedies, which have an effect on the body should be used with care. • Treat with caution any herbalist or other person who supplies herbal remedies if they are unwilling or unable to provide written information, in English, listing the ingredients of the herbal remedy they are providing. • If you are due to have a surgical operation you should always remember to tell your doctor about any herbal remedy that you are taking. • Anyone who has previously experienced any liver complaint, or any other serious health complaint is advised not to take any herbal remedy without speaking to their doctor first.
Few conventional medicines have been established as safe to take during pregnancy and it is generally recognised that no medicine should be taken unless the benefit to the mother outweighs any possible risk to the foetus. This rule should also be applied to herbal medicinal products. However, herbal products are often promoted to the public as being “natural” and completely “safe” alternatives to conventional medicines. Some herbal ingredients that specifically should be avoided or used with caution during pregnancy. As with conventional medicines, no herbal products should be taken during pregnancy unless the benefit outweighs the potential risk.
Many herbs are traditionally reputed to be abortifacient and for some this reputation can be attributed to their volatile oil component.(6) A number of volatile oils are irritant to the genito-urinary tract if ingested and may induce uterine contractions. Herbs that contain irritant volatile oils include ground ivy, juniper, parsley, pennyroyal, sage, tansy and yarrow. Some of these oils contain the terpenoid constituent, thujone, which is known to be abortifacient. Pennyroyal oil also contains the hepatotoxic terpenoid constituent, pulegone. A case of liver failure in a woman who ingested pennyroyal oil as an abortifacient has been documented.
A stimulant or spasmolytic action on uterine muscle has been documented for some herbal ingredients including blue cohosh, burdock, fenugreek, golden seal, hawthorn, jamaica dogwood, motherwort, nettle, raspberry, and vervain. Herbal Teas Increased awareness of the harmful effects associated with excessive tea and coffee consumption has prompted many individuals to switch to herbal teas. Whilst some herbal teas may offer pleasant alternatives to tea and coffee, some contain pharmacologically active herbal ingredients, which may have unpredictable effects depending on the quantity of tea consumed and strength of the brew. Some herbal teas contain laxative herbal ingredients such as senna, frangula, and cascara. In general stimulant laxative preparations are not recommended during pregnancy and the use of unstandardised laxative preparations is particularly unsuitable. A case of hepatotoxicity in a newborn baby has been documented in which the mother consumed a herbal tea during pregnancy as an expectorant. Following analysis the herbal tea was reported to contain pyrrolizidine alkaloids which are known to be hepatotoxic.
A drug substance taken by a breast-feeding mother presents a hazard if it is transferred to the breast milk in pharmacologically or toxicologically significant amounts. Limited information is available regarding the safety of conventional medicines taken during breast-feeding. Much less information exists for herbal ingredients, and generally the use of herbal remedies is not recommended during lactation.
Herbal remedies have traditionally been used to treat both adults and children. Herbal remedies may offer a milder alternative to some conventional medicines, although the suitability of a herbal remedy needs to be considered with respect to quality, safety and efficacy. Herbal remedies should be used with caution in children and medical advice should be sought if in doubt. Chamomile is a popular remedy used to treat teething pains in babies. However, chamomile is known to contain allergenic sesquiterpene lactones and should therefore be used with caution. The administration of herbal teas to children needs to be considered carefully and professional advice may be needed.
The need for patients to discontinue herbal medicinal products prior to surgery has recently been proposed. The authors considered eight commonly used herbal medicinal products (echinacea, ephedra, garlic, ginkgo, ginseng, kava, St John’s Wort, valerian). On the evidence available they concluded that the potential existed for direct pharmacological effects, pharmacodynamic interactions and pharmacokinetic interactions. The need for physicians to have a clear understanding of the herbal medicinal products being used by patients and to take a detailed history was highlighted. The American Society of Anaesthesiologists (ASA) has advised patients to tell their doctor if they are taking herbal products before surgery and has reported that a number of anaesthesiologists have reported significant changes in heart rate or blood pressure in some patients who have been taking herbal medicinal products including St John’s Wort, ginkgo and ginseng. MCA is currently investigating a serious adverse reaction associated with the use of ginkgo prior to surgery. In this case, the patient who was undergoing hip replacement experienced uncontrolled bleeding thought to be related to the use of ginkgo.
From the website of the Medicines Healthcare products Regulatory Agency (www.mhra.gov.uk) Department of Health, UK
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