www.mariefellthepilatesphysio.comProlapse & Periods, lets talk about it…

It is not fully understood why you may feel your prolapse symptoms at certain times of your monthly cycle but here are a few theories;

1. Your uterus will change size during your menstrual cycle as the lining thickens after ovulation in preparation for a potential fertilised egg (or not) and then sheds it’s lining if no egg is fertilised or there like in an anovulatory period. (See period page for more info on this). It is likely before your period your uterus is heavier in bulk therefore prolapse symptoms may be felt more.

2. The pelvic organs are dynamic structures that change in their size according to when they are full or empty (think full bladder, needing to poo, or when you are on your period). They are not held in rigid positions inside our pelvis which could contribute to bothersome symptoms.⠀

3. During your menstrual cycle huge hormonal changes occur which are likely to alter your symptoms.

So please keep in mind:

  • You are not doing anything wrong and with time and rehab to your pelvic floor muscles your symptoms may even go away.
  • Strengthen your pelvic floor muscles holistically. Use them in different functional positions and not just sitting down/standing up. Gradually increase the load and impact to see big changes and preferably under guidance of a pelvic health physio.
  • If you notice you don’t have any bothersome symptoms for the majority of your cycle then rejoice and plan your calendar for extra self care before/during/after menstruation.
  • You’re not doing anything wrong. Your body’s natural rhythm of it’s monthly cycle is doing it’s thing.
  • Acceptance (and knowledge of the why) helps massively with healing.

Have you noticed a pattern? Track your cycle to find out. Write down each day if you notice any prolapse symptoms or not.

A simple ✅ = yes, and a ❌ = no. You might even want to write one word with it like mild, mod, severe, heavy, dragging, to help you then see a pattern.

Looking for patterns can reassure you and empower you to make decisions about exercise commitments or social engagements. You can plan to avoiding heavy lifting workouts or having a drinking catch up with friends at that time of your cycle which can help calm any anxiety you have and help you to feel in control.

The magic is in writing it down every day or using an app to capture your body’s info.

It’s highly empowering and I encourage all people with a uterus to do this!

Let’s talk about period products and prolapse as you may find these need to alter slightly.

This can be one of the first signs of a prolapse when your tampon will no longer stay in. Perhaps its due to reduced pelvic floor strength or tone which can be improved over time with pelvic floor reeducation exercises.
There are many options now to try in terms of size, brand and style. Many prolapse people prefer a shorter, wider tampon, but we are all different and trial and error here is key.

There has been news suggesting menstrual cups can cause prolapse and are not advised to use, but this isn’t 100% true. A menstrual cup can act as a sort of pessary in that it provides mechanical support to your vaginal walls as suction occurs to keep it in place. As long as you break the seal before you remove it to empty, then they are safe to use. Many prolapse people prefer a wider, shorter cup with a shortened stem. Again, there are many different ones out there for you to try if menstrual cups are your preferred period device.

Can you use a pessary on your period? If it’s comfortable then yes you can.
A support pessary (like a ring) can be used with a tampon, always ask your provider if you are unsure about this. Ideally you need to be able to remove the pessary daily to wash it during your period for hygiene reasons. Many people find the correct sized tampon on it’s own does provide adequate support.

Also, it is important to mention that some people feel fine when on their periods with a prolapse but others struggle and you are not alone if that is you. Ask your healthcare provider for options (GP/ gynaecology cons/pelvic health physio).

Help is out there, please do reach out and ask.

For more information about prolapse, visit my prolapse educational website page.