HOW TO TREAT COMPLETE UTERINE PROLAPSE

First of all, we need to consider what true procidentia is and how often it occurs. We have never heard of a case of it here at WW. Personally, on many occasions I have been able to push almost my entire uterus out of my vagina and hold it in my hand. I could never get the front edge of the fundus to come all the way down the vaginal canal, however, and the entire pushed-out prolapse protruded about three to four inches.

True procidentia means the vagina is turned inside out and in its sack is carried the uterus plus a good portion of the bladder and rectum. My condition is different in that my front vaginal wall is sutured to my abdominal wall, so I think that sort of procidentia is probably impossible in my case. Bladder neck suspension surgery created the conditions for my immediate and profound uterine prolapse, however.

We need to take into consideration that many of the pictures/videos of women lying on gurneys and being prepped for hysterectomy have had their cervix/vagina pulled all the way down by the surgeon. This is the first step of vaginal hysterectomy after which many of these photos are taken. It is a dramatic and gruesome sight that scares many women into thinking this is end-stage prolapse.

I cannot speak about the true conditions of the women in 3rd world countries such as Nepal, a huge number of whom are said to be severely prolapsed, because I am not a clinician and have not witnessed their procidentia personally. I do take into consideration the testimonies of the surgeons who say “procidentia” is very common there. Logic tells me, however, that many of these cases are probably 3rd degree uterine prolapse, where the uterus is poking well out of the vagina. Let’s be very clear that when a gynecologist sees this, he/she is heavily programmed to view it as a serious, almost emergency situation for which hysterectomy is the ONLY response.

My own experience of living with a severe uterine prolapse for almost twenty years has taught me that the female body keeps trying to re-position the uterus, even at this late stage. We have lots of data that when complete uterine evulsion happens during vaginal birth, the uterus can be manually replaced and stay in its anatomic position thereafter. Those dynamics still exist for older women, but are reduced due to physiologic aging of tissues and bone structure. In my own case, I believe part of my small bowel has positioned itself where my uterine fundus used to be.

Gynecology has defined the internal structures of pelvic organ support (by lots of experience pulling down the soon-to-be-amputated cervix) and it is clearly stated in their literature that while the upper supports of the vagina are rather loose, the supports near the vaginal opening are so strong that the vagina is prevented from turning all the way inside out. I have wondered if all the cases of complete procidentia actually have an iatrogenic foundation. We really have no way of knowing that at this time. One thing is certain, though, that 3rd/4th degree prolapse is considered by doctors and women alike to be irreversible.

We now know this to be a misconception. This is how I help women with severe uterine prolapse understand and treat their condition:

1. Your uterus is very mobile and you can easily push it forward.

2. A 4th degree uterine prolapse is different from a 2nd degree prolapse by only a very few centimeters. However, the fact that it is out of your body is a problem that must be addressed.

3. Your pelvic organ support system is very strong and these dynamics continue to try to pin your uterus into position at the lower abdominal wall with every breath you take.

4. You must understand how your posture works to keep your uterus pushed forward.

5. Sitting for long hours with a C-shaped spine may be the most aggravating factor in uterine prolapse.

6. Walking is extremely supportive.

7. Uterine prolapse requires care and it is important that you have access to clean water and the basics of a health-supporting lifestyle. Carrying 80 lbs. of bricks on your back is not conducive to prolapse stabilization and reversal. Carrying thirty pounds of water on your head is.

8. Every morning manually push your uterus all the way forward. Understand that it is not moving UP, but that it is moving FORWARD toward your abdominal wall.

9. Learn WW firebreathing and nauli and practice these exercises either as you push your uterus forward or immediately after. Practice them throughout the day as needed.

10. Keeping your spine in its proper shape throughout the day will slowly help pull your uterus forward.

11. You can increase these dynamics by leaning your torso back while keeping your hips stationary. The pelvic organ support system is developed as we go from crawling in infancy to walking. When a baby girl stands up, her round ligaments pull her uterus forward, until finally it is permanently bent all the way horizontal. She stood up 90 degrees from horizontal and set this process in motion. You can lean back 120 degrees and continue to work these same dynamics.

12. Making large movements with your arms while walking works large sheets of fascia underneath your back and buttocks muscles helping to both increase your lumbar curvature and pull your organs forward.

13. It is important to know that gynecology believes uterine prolapse is not reversible only because the practice has neither recognized the female pelvic organ support system, nor understood how it works.

14. Fourth degree prolapse most certainly is reversible - at least to the point that it is pulled inside the labia.

15. If you have a long-standing uterine prolapse, it is likely you will not experience 100% reversal. However, it is very likely that you will experience increasing episodes where you cannot feel your cervix at all.

16. It is also the case that your prolapse will wax and wane. You will always have good times and difficult times.

17. Keep in mind that a hysterectomized woman will always experience bulges - often so severe as to compel her back into the operating room. She will never experience the deeply satisfying feeling of having her profoundly prolapsed uterus tucked up well inside (on a good day) while the rest of her body is in top health. She will not have the benefit of the heart-protecting substance her uterus secretes, nor fully functioning ovarian hormonal support for the rest of her life. She will be forever at risk of post-hysterectomy procidentia, a condition requiring emergency surgery; brittle bones; and inflammatory disease.

18. The female body had to strike a very delicate balance with nature. Only after women stood up and developed wide-enough hips to birth large-headed offspring could the human race be born. The human female had no choice but to keep the primeval, forward-facing pelvic position that exists in reptiles and mammals alike. All she could do was to curve her spine and belly enough to keep intraabdominal pressure focused on her lower abdominal wall. The pelvic organs followed suit until they created right angles with their respective channels, and therefore passive sphincters developed like kinks in garden hoses. This resulted in the most advantageous pelvic organ support system in the animal kingdom. In the process, the beautiful shape of the female body emerged.

19. The notion of “Kegels” is misconceived. Kegels for a diastasis in the pelvic musculature makes as little sense as crunches for a diastasis in the abdominal muscles. Kegels aggravate prolapse.

20. The uterus and ovaries shrink at menopause, a fact that should be considered in the long view of prolapse.

21. Taking care of a severely prolapsed uterus can be seen as an opportunity to honor and protect the miraculous and necessary link in the birth of humankind. Each woman must do this for herself, as there is no physical therapy that can create the dynamics of pelvic organ support. Prolapse is a structural and postural problem and only we can create our own posture. Only we can push our own uterus forward, and only we can sense what factors improve or aggravate our condition.

Only a certain percentage of women are emotionally and physically able to perform this level of self-care. There is no judgment of those who choose hysterectomy. There is an urgent need, however, to inform all women of the true nature of severe prolapse and the very real issues with hysterectomy. Any woman agreeing to hysterectomy without being completely informed of the dynamics of pelvic organ support as well as the risks of hysterectomy is submitting to radical surgery without full consent. We are still a long way from gynecology providing this information, so it is really up to women to inform other women.

Christine

Comments

I would like to just encourage those who are considering hysterectomy for fixing a prolapsed uterus to go to the Hers Foundation, www.hersfoundation.org, where there are some great illustrations to help women understand the importance of keeping their uterus, and understanding the anatomy of hysterectomy. There is also a very comprehensive list of questions you should ask your gynaecologist before making your final decision.

BTW Christine, what is the technique you would use to push your uterus forward?

Cheers

Louise

Thanks for taking the time to write this blog.
You wrote: "only a certain percentage of women are emotionally and physically able to perform this level of self-care"
who knows what that percentage is. But I agree totally that it is exactly that SELF CARE that many many humans have a very hard time doing. I hope that with your encouragement more and more women will choose this option.
point 15- I am not sure about.....I really do trust that the body can heal! It may just take much much longer and much more diligence.
point 7- brings up a question....I wonder if we could include 30lb head carrying as therapy and see how we go :)

Thanks for including HERS, Louise. Nora Coffey has done a stellar job of making women more safe from hysterectomy than they've been in 100 years. We just need to convince her to take uterine suspension off her list of “alternative” treatments!

Pushing the uterus forward is exactly the same maneuver as inserting a tampon. Gentle pressure, push all the way forward as far as you can reach.

Thanks so much, Alemama, and you are right-on about self-care. The reality is, prolapsed women are going to be dealing with *something* down there in any case. Who wouldn’t choose to take care of a bump of a cervix over ungodly back pain, laxative dependence, and much, much worse?

Point 15 - I love your optimism! I think that too, and then I get into a slump of convalescence due to overwork or overindulgence and everything backslides. It’s really up and down for me, as I know it is for many. But I never stop trying! C.

Point 7 - I know *someplace* must make large head-baskets with a concave bottom for placing padding for the scalp. If anyone can find them, I’ll import them! :)

Point 6 -- yes!!!

I am also intrigued by the possible benefits of bearing weight on one's head. Weight bearing exercise is so beneficial for women anyway . . . and maybe shifting that weight from the arms to the head is doubly so . . . can we come up with something more socially acceptable than a head basket, lol? Maybe a cap with pockets to hold small weights and is thus adjustable? Maybe we can bring a Lincoln-esque stovepipe hat back into vogue . . . with a secret compartment to hold a gallon of milk? :-)

Hey Wholewomen, check this out. This is a Phillipines Folkloric dance group dancing with baskets on their heads! http://www.youtube.com/watch?v=uV8pbBYES8s

Louise

Somebody like World Vision might be able to come up with a product like that, sourced from somewhere in Africa(?) or Asia(?), Middle East(?), where women would still have the skill of weaving baskets for carrying loads on their heads. It might even have a built in, or accessory padding ring. There are numerous poverty aid charities which circulate gift catalogs containing products made by craft groups/cooperatives in third world countries for sale in first world countries.

This might be a way of taking Wholewoman knowledge to third world countries, and enabling third world women to produce an income for themselves, in partnership with a charity that supports enterprises in countries where it operates.

All we would need is first hand knowledge of parts of the world where women still carry loads in locally made baskets on their heads and find a reputable charity which operates in that country to work with Wholewoman in a design and marketing arrangement, and coordinate a manufacturing group with microloan finance.

Any leads, anyone?

Louise

Check out their posture...as I demonstrated in my first dvd (the one Aza has), you can’t balance something heavy on your head without forcing the body into natural posture. And this fact has a logical basis. The head is heavy...given gravity and all, it must determine spinal curvature more than anything else. Adding even more weight to the head just intensifies those dynamics: the lumbar curve increases, the upper back flattens, the neck lengthens, and the chin slightly tucks. Thanks for sharing that!

Maybe I can carry my laundry basket on my head! I hadn't thought of doing that.