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Speaker 1: Brought to you by the reinvented two thousand twelve Camray.

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Speaker 1: It's ready. Are you welcome to stuff mom never told you?

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Speaker 1: From housetop works dot com. Hello, and welcome to the podcast.

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Speaker 1: I'm Caroline and I'm Kristin Kristen. Um. So, my friend

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Speaker 1: Tom used to do stand up comedy. He's a very

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Speaker 1: funny guy. He used to have radio shows and stuff

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Speaker 1: like that. And the source of a lot of his

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Speaker 1: comedy was his family, Um, very kookie bunch, very funny ladies.

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Speaker 1: And one of his bits was imitating his aunt Martha,

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Speaker 1: who has a very, very thick Northern accent, and he

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Speaker 1: would tell this whole story about how Aunt Martha's uterus

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Speaker 1: fell out, and it was really funny. And I never

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Speaker 1: really knew it was a thing, or that it had

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Speaker 1: a name, or that it was common. But apparently Aunt

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Speaker 1: Martha is not alone and a uterus fallen out. No,

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Speaker 1: and it's called uterine pro lapse. Yeah, today on the

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Speaker 1: podcast we are talking about what happens when your uterus

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Speaker 1: falls out. It can also happen in other areas, and

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Speaker 1: sometimes it can bring other inside parts outside with it.

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Speaker 1: And yeah, prolapse is not the most pleasant topic of conversation.

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Speaker 1: Also not the most pleasant Google image search. Don't don't.

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Speaker 1: I recommend you not do that. But it is something

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Speaker 1: that happens. This was coming from a listener requests. A

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Speaker 1: younger listener actually wrote in because she had a medical

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Speaker 1: scare and thought that she had pro laps. But it

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Speaker 1: turned out, thankfully to be something else. But when we

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Speaker 1: started doing some more research, come to find out prolapse

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Speaker 1: is something that does happen to a lot of older

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Speaker 1: women in particular. But let's back up a little bit. Yeah,

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Speaker 1: what is it? What is it? Well, it's when your

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Speaker 1: pelvic floor muscles and ligaments stretch and weekend, providing inadequate

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Speaker 1: support for the uterus if we're talking specifically obviously about

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Speaker 1: uterine pro lapse, and the uterus will then slip down

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Speaker 1: into or protrude out of the vagina. Yes, there you go. Yes,

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Speaker 1: there are several risk factors, most of them have to

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Speaker 1: do with age, menopause, whether you have had children, and

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Speaker 1: whether you do a lot of heavy lifting. If all

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Speaker 1: of those applied to you, watch out for the following symptoms. Um,

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Speaker 1: there's a sensation of heaviness and pulling in your pelvis tissue,

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Speaker 1: actually protruding from your vagina. Often urinary problems accompany this condition,

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Speaker 1: so you might have leakage or urine retention. There's also

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Speaker 1: low back pain and trouble having bowel movements because the

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Speaker 1: bowel movements kind of come into play if if your

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Speaker 1: rectum is involved in the dropping into the vagina. Yeah,

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Speaker 1: incontinence is one of the first and most common signs

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Speaker 1: of pro lapse. And then you might also have concerns

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Speaker 1: such as sensing looseness in the tone of your vaginal

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Speaker 1: tissue if you are having intercourse um and sometimes symptoms

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Speaker 1: that are less bothersome in the morning and worse than

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Speaker 1: as the day goes on. And that's because gravity will

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Speaker 1: also aggravate these symptoms because it pulls that tissue downward.

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Speaker 1: So okay, so what is what is the deal with

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Speaker 1: with this happening to women who have had babies? Like,

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Speaker 1: why why does this happen? What's going on up in there?

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Speaker 1: Pregnancy and trauma incurred during childbirth, particularly if you've had

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Speaker 1: a large baby or a difficult labor and delivery, can

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Speaker 1: really cause a lot of that muscle weakness and stretching

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Speaker 1: a the supporting tissues. So that's just another thing that

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Speaker 1: would have to go through when they're having babies. Yeah,

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Speaker 1: and a vaginal births in particular are implicated with this.

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Speaker 1: Doctors and pregnant women have been looking into whether or

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Speaker 1: not C sections. Elective c sections are the way to

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Speaker 1: go because it is associated with a lowered risk of

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Speaker 1: pelvic organ pro laps. That's not to say that it's

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Speaker 1: completely preventative, UM, but some women are now opting for

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Speaker 1: they're called maternal choice c sections partially because of the

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Speaker 1: risk of pro lapse. UM. And just to give you

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Speaker 1: an idea of how many women experience this, uh, this

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Speaker 1: is from the Honor Society of Nursing. Approximately nine percent

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Speaker 1: of US women require surgery for pelvic pro lapse, which

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Speaker 1: is part of a series of conditions which are referred

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Speaker 1: to as pelvic floor disorders, and almost twenty four percent

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Speaker 1: of American women will look experience at least one pelvic

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Speaker 1: floor disorders such as pro laps in their lifetime. Yeah,

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Speaker 1: there are a lot of risk factors for this. UM.

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Speaker 1: We we touched on a few already, but c o

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Speaker 1: p D even plays apart, which is chronic obstructive pulmonary

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Speaker 1: disease which ties into the chronic coughing thing. So if

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Speaker 1: there's a lot of if you've done a lot of

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Speaker 1: coughing in your lifetime, you could have uterine pro laps. UM.

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Speaker 1: Also chronic constipation if you've had a lifetime history of

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Speaker 1: straining on the toilets, this could also affect rectal pro laps.

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Speaker 1: And obesity is another big factor that doctors are looking

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Speaker 1: more closely at, and especially for again UH women who

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Speaker 1: are pregnant and overweight or obese UH doctors might advise

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Speaker 1: for a c section because of those combined risk factors

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Speaker 1: for pro laps down the road. UM, and there are

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Speaker 1: other types of pro lapse aside from uterine pro lapse.

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Speaker 1: We have rectal pro lapse where it's the lower end

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Speaker 1: of the colon above the anus gets stretched out and

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Speaker 1: protrudes out of the anus um. And it is more

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Speaker 1: common in women. It seems like all of all the

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Speaker 1: all the varieties of prolapse, the colorful bouquet of prolapse

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Speaker 1: types that can happen more common in women. Yeah, there's

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Speaker 1: also bladder pro lapse because in women, the front wall

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Speaker 1: of the vagina supports the bladder and so that wall

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Speaker 1: can weaken due to age or bodily stress, and if

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Speaker 1: it deteriorates enough, the bladder can actually descend into the vagina,

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Speaker 1: and this type of pro lapse is commonly associated with menopause. Now.

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Speaker 1: The listener who wrote in requesting an episode on prolapse

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Speaker 1: was especially concerned because she was outside of the typical

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Speaker 1: age range where you see this happening, because she was younger.

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Speaker 1: I think she was in her mid twenties, maybe her

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Speaker 1: early thirties. But a lot of times, Uh, it affects

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Speaker 1: post menopausal women who have had more than one vaginal delivery. Uh,

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Speaker 1: even though it can't affect still women of any age. Yeah.

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Speaker 1: Part of this might have to do with hormones and

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Speaker 1: loss of muscle tone associated with aging. And a two

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Speaker 1: thousand eight Harvard study looked at pelvic organ pro lapse

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Speaker 1: and wanted to find out over the course of the

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Speaker 1: reproductive life cycle, who's getting surgery for this, So women

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Speaker 1: of reproductive age, there's seven per ten thousand women getting it. Uh,

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Speaker 1: twenty eight point eight percent of those women experienced surgical

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Speaker 1: complications perrymenopausal women twenty four per ten thousand, post menopausal

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Speaker 1: thirty one per ten thousand, and in elderly women it's

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Speaker 1: seventeen per ten thousands, so definitely post menopausal. It's most common,

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Speaker 1: followed by perrymenopausal and then elderly, but again it can

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Speaker 1: still happen in ung the younger cohorts as well. Uh.

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Speaker 1: There's also been research into whether or not there is

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Speaker 1: a genetic factor to pro lapse. There's an article from

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Speaker 1: two thousand and ten published in Urology Times Real page

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Speaker 1: turner talking about how recent studies haven't covered a genetic

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Speaker 1: component component of both pelvic organ pro laps and stress

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Speaker 1: urinary in continents, though not from the same chromosome, and

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Speaker 1: so they're trying to figure out whether or not doctors

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Speaker 1: could target patients who might have those genetic components for

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Speaker 1: early prevention, right because they are. They are pretty related.

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Speaker 1: People who have prolapse issues tend to have in continents

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Speaker 1: issues also. Now, Kristen mentioned obesity earlier, and it's kind

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Speaker 1: of touchy is to whether it's a cause or a

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Speaker 1: related factor. Um. A two thousand four Swedish study found

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Speaker 1: that obesity is an associated factor for pelvic floor dysfunction,

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Speaker 1: particularly obesity, not just being overweight, and a January study

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Speaker 1: from Brown University found that a higher proportion of obese

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Speaker 1: women reported feeling vaginal bulging compared with women who were

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Speaker 1: simply overweight. I'm going to go ahead on a side

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Speaker 1: note and say, I hope this is maybe the only

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Speaker 1: time in the podcast we have the opportunity to use

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Speaker 1: the phrase vaginal bulging. Yes, and now back to our

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Speaker 1: regularly scheduled pro Laps podcast. Um, Yes, six months. This

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Speaker 1: is still with a Brown University studies six months after

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Speaker 1: going on a weight loss program. Uh, these participants didn't

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Speaker 1: find any significant differences in self reported bothersome pro laps symptoms.

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Speaker 1: So that's why they're not exactly sure whether like what

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Speaker 1: roles specifically being overweight or a beast might play with us,

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Speaker 1: because even after they lost the weight, the symptoms didn't

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Speaker 1: go away. Right. And this ties and closely with the

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Speaker 1: two thousand nine study published in Obstetrics and Gynecology, which

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Speaker 1: found that yes, again, being overweight or abuses associated with

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Speaker 1: progression of pelvic organ pro lapse, but weight loss. Just

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Speaker 1: like in this other study, this more recent study, weight

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Speaker 1: lass didn't really seem to be significantly associated with the

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Speaker 1: regression of it. So that suggests that damage to the

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Speaker 1: pelvic floor related to weight gain could be irreversible if

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Speaker 1: if they are indeed as closely connected as people suspect well.

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Speaker 1: And there's also another irreversible kind of contributing factor possibly

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Speaker 1: to your risk of pro lapse, and that is ethnicity

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Speaker 1: and race. There have been a number of studies looking

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Speaker 1: at the prevalence rates among different ethnic groups and they've

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Speaker 1: found that overall, Hispanic women are at the highest risk

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Speaker 1: of pro laps and white women pretty much in the middle.

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Speaker 1: Black women demonstrate the lowest risk for pro lapse. Now,

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Speaker 1: we mentioned an earlier study about pelvic oregan prolapse surgery

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Speaker 1: and the age groups. You know that it's more common

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Speaker 1: in post menopausal women. A Harvard study from two thousand

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Speaker 1: six looked at two thousand three rates of surgery according

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Speaker 1: to ethnic groups. They found that between white women, black women,

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Speaker 1: and women of other races, white women had the most

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Speaker 1: surgeries for this condition fourteen point eight per ten thousand.

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Speaker 1: Black women came in second at five point six per

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Speaker 1: ten thousand, and women of other races and ethnic groups

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Speaker 1: came in at eight point seven per ten thousand. And

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Speaker 1: it looks like according to this study, black women, although

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Speaker 1: they had far fewer surgeries for this condition than white women, did,

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Speaker 1: they had higher complications. Thirty four point one percent of

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Speaker 1: Black women who had the surgery had surgical complications versus

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Speaker 1: nineteen point four percent of white women and twenty seven

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Speaker 1: point four percent of women of other races, And so

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Speaker 1: they came to the conclusion that this could be an

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Speaker 1: issue of race. Racial disparity is access to surgery, whether

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Speaker 1: you're on public assistance, et cetera. So, speaking of surgery,

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Speaker 1: what can be done if you know you end up

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Speaker 1: in this situation where you have these unpleasant things going

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Speaker 1: on with your pelvic floor muscles. There are self care treatments.

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Speaker 1: We've talked about kegle exercises before on the podcast, and

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Speaker 1: those have been shown to strengthen pelvic muscles, maintaining a

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Speaker 1: healthy weight and avoiding heavy lifting, or a couple of

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Speaker 1: other things. There's also something called a vaginal pessary, which

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Speaker 1: is a device that can be either temporary or permanent,

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Speaker 1: that fits inside the vagina and literally holds the uterus

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Speaker 1: in place that I don't I don't know what that

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Speaker 1: looks like, but it sounds uncomfortable, looks like a little

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Speaker 1: a little ring. It reminded me almost of the neubring

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Speaker 1: birth control I hope it stays in place. If you

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Speaker 1: have a temporary one um and like we said, like

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Speaker 1: we've been talking about this whole time, their surgery is available.

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Speaker 1: You can have vaginal or abdominal surgery. Your doctor might

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Speaker 1: recommend a hysterectomy or the use of a tissue graphed,

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Speaker 1: which doesn't sound comfortable either. And if this kind of

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Speaker 1: self care is going on, one question that I had

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Speaker 1: when we were looking into this was what about sex.

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Speaker 1: I mean, if if all of this stuff is going

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Speaker 1: on on your insides, it seems like that would totally

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Speaker 1: make sex out of the question. But in fact, you

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Speaker 1: can and it is okay to have sex with pro lapse.

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Speaker 1: This was coming from Dr Oz's website share Care, and

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Speaker 1: he says it's safe to have sex if you have

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Speaker 1: pelvic pro lapse, although it may be uncomfortable. And the

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Speaker 1: reason why the doctor's explained that it was okay was

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Speaker 1: again going back to this issue of gravity and not

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Speaker 1: to be too graphic, but when you are standing up,

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Speaker 1: it pulls that to you down, but when you were

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Speaker 1: lying back, it will, in the words of one doctor,

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Speaker 1: go back inside, making it okay to have sex. But

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Speaker 1: again it might be especially depending on the degree of

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Speaker 1: the prolaps, it might be a little uncomfortable. Okay, so

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Speaker 1: it's been deemed safe to have sex, you know when

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Speaker 1: you have this condition. But if you are one of

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Speaker 1: the people who had a surgical treatment then involved inserting

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Speaker 1: mesh into your vagina to hold your uterus in place,

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Speaker 1: there could be issues. UM. In July, the FDA found

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Speaker 1: that risks of placing mesh through the vagina to repair

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Speaker 1: pelvic organ prolapse may outweigh its benefits, and they found

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Speaker 1: that the most frequently reported complications, in addition to pain

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Speaker 1: during intercourse and bleeding, where that the mesh can become

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Speaker 1: exposed or protruded from the vaginal tissue. There's a lot

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Speaker 1: of pain involved, um, and you might have to have surgeries.

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Speaker 1: So they suggested that healthcare providers should recognize that prolapse

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Speaker 1: can be treated without mesh because the whole mesh thing

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Speaker 1: is a permanent solution, and so that could if you

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Speaker 1: do want to have sex with this condition, that could

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Speaker 1: make it more difficult. Now we're talking about options for

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Speaker 1: prolaps treatment, there's the you know, temporary kinds of things

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Speaker 1: you can do self care of surgeries. For more permanent options,

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Speaker 1: but in developing nations, this issue of pro lapse can

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Speaker 1: actually lead lead women not to the doctor necessarily, but

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Speaker 1: to being cast out of their house and even out

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Speaker 1: of their society. Yeah. The United Nations Population Fund has

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Speaker 1: a section on this. Actually, they say that many women

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Speaker 1: are abandoned by their husbands and end up with social

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Speaker 1: outcouts in their community. Like Kristen said, because when these

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Speaker 1: women experienced this, their mobility is limited and therefore that

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Speaker 1: makes work, chores and sex nearly impossible, and they end

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Speaker 1: up having chronic back pain, urinary and continence, things that

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Speaker 1: might not sidelines someone in the US who has access

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Speaker 1: to surgery, you know, when surgery is more readily available. Um.

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Speaker 1: They looked in particular at Nepal, where fertility is very

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Speaker 1: high and women carry heavy loads on their backs, which

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Speaker 1: is a bad combination to be honest. They said that

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Speaker 1: one out of ten women are estimated to suffer from

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Speaker 1: uterine pro lapse in Nepal. Yeah, and as a result

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Speaker 1: of an organization called Safe Motherhood and Nepal Federation launched

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Speaker 1: a Uterine Prolapse Alliance in two thousand seven to raise

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Speaker 1: understanding about the causes and preventions, and they're working with

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Speaker 1: the government to provide health programming to address these issues

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Speaker 1: surrounding UH prolaps. So while this might not have been

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Speaker 1: the sunniest topic we have ever covered on the podcast,

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Speaker 1: and frankly not the easiest one to discuss either, again,

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Speaker 1: I think it's important to address health issues like these

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Speaker 1: that are not talked about but do affect a lot

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Speaker 1: of us, not just at home, but a round the world.

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Speaker 1: Yeah so, and then I mean I didn't Yeah, I

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Speaker 1: didn't realize how common it was in anyone besides Tom's

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Speaker 1: aunt Martha. Right, Yeah, I I really I wasn't very

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Speaker 1: aware of u of much about it until now. And

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Speaker 1: for the listeners who have made it through this entire

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Speaker 1: prolapse episode, I applaud you and for that you will

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Speaker 1: receive listener mail about homeschooling as a palate cleanser. So

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Speaker 1: if you have any letters so to share with us

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Speaker 1: mom stuff at Discovery dot com is where you can

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Speaker 1: send them. And like I said, we've got a couple

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Speaker 1: of letters here about homeschool I met one here from

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Speaker 1: Jess and she says she was homeschooled up until the

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Speaker 1: eighth grade. She says, we my parents moved around a

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Speaker 1: lot so it's easier to teach us at home rather

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Speaker 1: than enroll us in a new school every year. We

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Speaker 1: ordered our school books from the Stay Eights and had

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Speaker 1: regular school time. Socialization was not a problem since I

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Speaker 1: have a very large family and we often lived with

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Speaker 1: other families. My parents are German, and in Germany, homeschooling

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Speaker 1: is against the law. Parents who wanted to homeschool their

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Speaker 1: children can count on jail time and or find the

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Speaker 1: law came into effect to hinder child labor. In Austria,

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Speaker 1: where my parents settled down after traveling the world, there

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Speaker 1: is an Austrian word that means compulsory education, which means

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Speaker 1: children have to be educated, and we had to go

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Speaker 1: to state school every year and do tests to prove

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Speaker 1: that we were up to par. After a couple of years,

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Speaker 1: my parents decided to send my younger siblings to school.

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Speaker 1: Most didn't have a problem adjusting since they were very young,

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Speaker 1: and I've also gone to school, but I have to

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Speaker 1: say I found and still find it very tiring. I'm

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Speaker 1: used to learning and researching on my own, and in

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Speaker 1: school everything takes longer. I worked through the material for

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Speaker 1: a whole school year in three months. This is something

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Speaker 1: you can't do in a school. Ironically enough, I now

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Speaker 1: work as a school secretary and get to see the

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Speaker 1: school system from the other side. So thanks for the

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Speaker 1: international insight from Jess Okay. Here's a different perspective on

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Speaker 1: homeschooling from Amelia. She says that she wanted to mention

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Speaker 1: the fact that some parents choose to homeschool their children

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Speaker 1: for safety reasons. I'm from l A and it's pretty

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Speaker 1: well known that public schools and cities this large tend

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Speaker 1: to be quite violent and potentially unsafe places. So my

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Speaker 1: brother and I were homeschooled for the first handful of

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Speaker 1: years of our educations until my mom got a job

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Speaker 1: teaching at a small local private school, working in exchange

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Speaker 1: for our tuition. However, even the small private school, though wonderful,

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Speaker 1: was lacking in a few areas. At what point my

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Speaker 1: older brother begged to be allowed to attend public school

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Speaker 1: and my mom finally caved. It only took one day

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Speaker 1: there for my brother to realize he wasn't going to

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Speaker 1: be comfortable walking through a metal detector every morning at

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Speaker 1: eight am and being searched for weapons alongside his classmates

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Speaker 1: in a place with fourteen foot fences. That resembled a prison.

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Speaker 1: It's a parent's job to ensure their children are safe

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Speaker 1: and to keep them from potentially dangerous environments, so it's

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Speaker 1: not surprising to see more parents choosing to in school

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Speaker 1: their kids when the local schooling options are so scary,

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Speaker 1: unless they happen to be well off enough financially to

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Speaker 1: afford very expensive private schools. All in all, I had

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Speaker 1: a wonderful childhood, and looking back, I would not trade

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Speaker 1: my education for any other. I had a small group

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Speaker 1: of adults who were dedicated to giving me the best

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Speaker 1: education possible, and while they weren't perfect and I missed

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Speaker 1: out on a few things, the extra attention that I

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Speaker 1: received compared to public school friends stuck in classrooms of

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Speaker 1: thirty plus kids, meant that I got a better grasp

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Speaker 1: on subjects that were difficult for me, and the overall

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Speaker 1: success of my education shows every day in my work.

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Speaker 1: So thank you Amelia for the perspective, and thanks to

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Speaker 1: everyone who's written in Mom's Stuff at Discovery dot Com

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Speaker 1: is where you can send your letters, and you can

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Speaker 1: also find us on Facebook. Like us there and follow

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Speaker 1: us on Twitter at Mom's Stuff podcast, and you can

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Speaker 1: also now find us on Tumbler as well, stuff Mom

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Speaker 1: never told you dot tumbler dot com. And as always,

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Speaker 1: you can make yourself a little bit smarter during the

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Speaker 1: week by heading over to our website, It's how stuff

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Speaker 1: works dot com for more on this and thousands of

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Speaker 1: other topics. Is it how stuff works dot com brought

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