Q.1 What age-group females come more for this complaint?
Answer:-
I have seen females between 20 – 65 years of age coming for uterine prolapse in my OPD. The reasons vary for different age groups. For instance, females between 20 – 30 years get uterine prolapse majorly due to childbirth. For the age-group of 35 – 40 years, the common reason is any pelvic surgery or pregnancy. After a pelvic surgery, if the woman doesn’t rest, it puts pressure on the pelvic organs. During delivery, the trauma and pressure created throughout the childbirth may weaken the surrounding areas. For women between the age of 45-65 years, the common cause is hormonal imbalance. As estrogen, a hormone, supports the uterus, deficiency of estrogen during old age causes uterine prolapse.
Q.2 Do they come at an initial stage or later? How do you handle the shyness and taboo regarding such a disease?
Answer:-
As most of the women are unaware of their problems during the initial phase, they mostly come during the later stage. Most of them also avoid talking to a healthcare professional as they feel shy about it. We have to create awareness about why uterine prolapse occurs in the first place and measures to prevent them. Preventive measures like kegel exercise can be done anywhere and thus should be practiced by all females. We should also create awareness about the symptoms. Some of the common symptoms of uterine prolapse are:
1) Pelvic heaviness or pulling
2) Increase in vaginal discharge
3) Difficulties with sexual intercourse
4) Urinary leakage, retention or bladder infections
5) Bowel movement difficulties, such as constipation
6) Lower back pain
7) Uterine protrusion from the vaginal opening
8) The feeling of something coming out of the vagina
9) Weak vaginal tissue
Most common causes for weak pelvic floor muscles
1) Multiple pregnancies
2) Vaginal delivery: Including trauma, delivering a large baby
3) Menopause: Due to decrease of the hormone estrogen
4) Immediate heavy lifting after delivery
5) Straining during bowel movements
6) Smokers: chronic cough
7) Genetical factors
We can only achieve this by educating through media platforms such as newspapers, radio, and television. Moreover, it is important for them to understand that it is not to feel embarrassed about and thus they shouldn’t hesitate in discussing their problem.
Some precautionary measures include:
1) Kegel exercise: To perform a proper kegel:
Tighten the pelvic floor muscles, at the time of urination stop and hold for 5 seconds
take a 5-second break and repeat for three sets,10 times per day.
2) We can use vaginal pessary in the 2nd or 3rd stage, it supports and keeps uterus in its position.
3) Estrogen therapy during menopause
4) Maintain a healthy weight through diet and exercise.
5) Managing chronic cough and quit smoking
6) Avoid heavy lifting works
7) Prevent and treat constipation
Q.3 Is there advice you would like to give to prevent this problem?
Answer:-
I would like to give them the advice to consult with a doctor on time. Don’t hesitate in talking about this problem with your family or friends. I am sharing you one case. There is one patient of age 40 years who came to my OPD with the complaint of something coming out of her vagina for 4 years and it goes inside after pushing. Other complaints include:
- Foul-smelling vaginal discharge
- Difficulty in completely evacuating her bladder
- Abdominal pain while heavy work
- Irregular menstruation since one year
This woman has 5 kids and undergone 4 abortions. All this made her pelvic muscle floor really weak. After a lot of counselling, I convinced her to undergo physical check-up. While examining her, I found a 4th degree prolapse which would require surgery. She was asthmatic and a smoker. To control asthma, she was advised to quit smoking. During that time, she used pessary for symptomatic relief. Once her asthma settled, we could do her surgery. If she had come in initial stages, surgery could have been avoided.
My message to all women “There is nothing to be ashamed of in discussing your problems. Your health comes first. Treatment in initial stages is easy. So, consult a doctor before its too late.
