Disorders “down below” may not be the easiest topic to bring up with your healthcare provider, but problems like incontinence or dropped pelvic organs are more common than you may think. In fact, up to 40 percent of women between ages 50 and 70 suffer from pelvic organ prolapse and one in three women have stress urinary incontinence.
The following describes the four most common problems.
1. Pelvic organ prolapse occurs when the pelvic floor muscles weaken and the ligaments that hold the organs in place become damaged. The uterus, bladder or rectum then can bulge into the vagina. Moderate to severe bulging may cause a pulling or a heavy feeling in the pelvis, trouble urinating or moving your bowels and low back pain.
- Nonsurgical options include a pessary—a ring or cup device worn in the vagina to support pelvic organs.
- Minimally invasive surgical options include placing a patch of muscle tissue to the pelvic floor to repair the muscles or using a synthetic mesh to hold pelvic organs in place.
2. Stress urinary incontinence is involuntary urine loss when you cough, sneeze, laugh or lift something heavy.
- Nonsurgical options include a pessary device to put pressure on the urethra or medicines such as estrogen and certain antidepressants to help you hold your urine.
- Minimally invasive surgical options include collagen injections to help the urethra stay closed; a procedure in which a synthetic sling is placed under the urethra; and colposuspension, a procedure that raises the bladder or its neck.
3. Heavy menstrual bleeding, or menorrhagia, can include soaking through a sanitary pad or tampon every hour for two or three consecutive hours, passing large clots and having a period that lasts longer than seven days.
- Nonsurgical options may include medications such as hormones for controlling ovulation, which slow the growth of uterine lining or block estrogen’s effects, and intrauterine devices (IUD) that release hormones.
- Minimally invasive surgical options include endometrial ablation, in which laser, radio frequency energy or heat destroys the uterine lining.
4. Uterine fibroids, noncancerous tumors, can be less than an inch or more than eight inches and can grow in clusters or alone. Common symptoms include heavy periods, bleeding between periods, pelvic pain and pressure.
- Nonsurgical options include estrogen-blocking hormones or a focused ultrasound that destroys the tumor with sound waves.
- Minimally invasive surgical options include uterine artery embolization, which shrinks fibroids; myolysis, which destroys the tumor with laser, radio frequency energy or freezing; and myomectomy, surgical removal of the tumors, leaving the uterus intact.