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.