When Helen Ledwick typed “why do my organs feel like they’re going to fall out” into Google nearly 10 years ago, she never imagined that search would signal the beginning of a profound change in her life.
The former BBC journalist and podcaster discovered that pelvic organ prolapse (POP) affects around one in 12 women after giving birth, but many have never heard of it.
Prolapse occurs when one or more organs in the pelvis, such as the bladder, intestines, or uterus, move from their normal position and press against the walls of the vagina, causing a bulge that can be felt inside or outside of the vagina.
Although the disease is not life-threatening, it can affect daily life, relationships, and mental health.
Symptoms include a strong feeling of heaviness or the sensation of something moving inside your vagina. Some people describe this as “like sitting on a tennis ball.”
For Ledwick, the shock came two weeks after the difficult birth of her second child.
“I got up from the couch and suddenly felt everything move,” he recalls. “It felt like when a tampon slips out. Something wasn’t right.”
Feeling confused and scared, she grabbed a mirror and her phone to figure out what was going on.
“I had never heard the word escape before,” he says. And once I started talking about this subject, I realized that despite it being common, it is still a taboo.
Redwick believes the shame and stigma surrounding the issue contributes to a lack of information among women and medical professionals, and she’s trying to change that.
Helen Ledwick said her diagnosis, confirmed by doctors, had caused confusion and fear. “I was expecting an explanation, treatment and some level of urgency. But what I received was a lack of certainty.”
The initial guidelines were to avoid activities that could worsen symptoms, such as running, jumping, and weight-lifting.
“It was like the advice was not to live your life,” he says.
The isolation was more difficult than the physical symptoms.
“People live with shame, silence and loneliness,” he explains. “I feel like I’m the only person in the world going through something like this because it’s not talked about.”
Ms Ledwick posted on Instagram asking for support. She found other anxious and confused women (some of whom were too embarrassed to ask for help), which motivated her to create a podcast and write a book called “Why Moms Won’t Jump.”
The goal was to provide a platform for women to share their stories and break the silence around pelvic health.
“I was angry because no one was talking about it, so I decided to talk about it,” he says. “I wanted to give women the knowledge that took a long time to find and the reassurance that they are not alone.”
Women’s health expert Dr Nighat Arif says Helen’s case is common and the symptoms are not always visible.
“Sometimes there is no visible lump, just a feeling of pressure, and it can occur in the lower, front, or upper back, near the belly button,” he explains. “Symptoms can sometimes worsen during sex, which is still considered taboo.”
Prolapse can have many causes, including childbirth, physical exertion, being overweight, constipation, and even a hysterectomy. In rare cases, it can also occur in men.
During pregnancy and natural childbirth, the risk of prolapse increases, especially after a difficult birth.
As women age, they are more likely to develop uterine prolapse, especially after menopause.
Pelvic floor muscle exercises and lifestyle changes can help relieve symptoms, but in some cases medical treatment, such as the use of a vaginal pessary (a removable device used to support the vaginal wall or prolapsed uterus) or surgery, may be necessary.
Gynecologist Christine Ekechi explains that women with prolapse may notice swelling or protrusion inside the vagina “because the pelvic floor ligaments are weakened and can shift things like the bladder.”
Ledwick says what started as a lonely Google search 15 years ago has turned into something much bigger: a movement to help other women recognize their problems and seek help.
In his case, recovery was slow but made a big difference. “It was a long process of gradual strengthening, with postpartum exercises and strength training,” he says.
She then saw a physical therapist who helped her get back to running. Ledwick says it was a “defining moment because I really thought I would never be able to do it again.”
Helen Ledwick has now achieved more than she ever thought possible and has signed up for a 10km race.
“I feel good and have learned how to deal with the symptoms. I still have prolapse, but I no longer let prolapse control my life like it used to. I feel like I’ve won the battle.”
Diagnosis and possible treatments
According to the Brazilian Federation of Obstetrics, Gynecology and Obstetrics (Febrasgo), the diagnosis is usually confirmed through a physical exam in which the woman is placed in a gynecological position and performs the Valsalva maneuver (a breathing technique in which the patient exhales forcefully while covering the lips and nose to increase pressure).
According to Febrasgo, prolapse treatment is also recommended for women who are symptomatic or have complications such as kidney problems, urinary tract obstruction, or intestinal obstruction.
“For example, if the supporting compartment of the bladder is damaged, women experience symptoms such as difficulty urinating, complete emptying of the bladder, sometimes urge incontinence, and recurrent urine infections,” explains Marcelo Lemos dos Reis, vice president of the Regional Medical Council of Santa Catarina (CRM-SC), in the organization’s video on the subject.
According to Febrasgo, treatment for genital prolapse includes conservative and surgical treatments. Among the conservative options are the vaginal pessaries mentioned earlier in the text, sometimes involving the use of estrogen creams before and after insertion of these pessaries.
Pelvic floor muscle training is also indicated for mild prolapse and can reduce symptoms and improve muscle function, but cannot correct advanced prolapse.
If surgery is required, the surgical method will depend on the diagnosis and the area affected, at the discretion of a specialist doctor.
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