After about 15 years of living with female urethral spasms (or bladder spasm) we did some big time internet searching and reading about all sorts of things. Lots and lots of different things. Some useful and some well..not so much. And some just down right terrifying. I forget how but somehow my husband ran across information on uterine prolapse and we started wondering if this might be part of what was causing my urethral spasms. I didn't have an obvious, extreme prolapse-- although recently I had a few days when my tampon felt like it was mysteriously trying to push itself out. The only things I knew about prolapse were that it happened after births and that lots of women couldn't hold their pee because of it. I had never had any issue holding in my urine, so I had never considered it an issue for me, and I'd certainly never had a doctor even suggest it as a possibility-- even though I'd had two very large babies. More on my personal experience.
All the things we didn't know about the female body:
As we started to learn more, we found there were so many things we had never read or been told about female anatomy. Maybe you already know this stuff and we're just clueless, but I had no idea that the uterus moves around during the monthly cycle. I'd always thought of my internal organs as fixed points but its more a jumble of stuff shoved in together.
As the following diagram shows, the uterus changes orientation throughout the monthly cycle. It's density and texture also changes. This seems to be typically discussed in relation to pregnancy and ovulation. But this movement will have an effect on what and how much a prolapsed uterus is pushing on. Seems this is useful information that should be mentioned more.
Complete page
Looking at these diagrams, it made it clear how intimately related the female bladder and uterus really are. And it made sense that at certain times of month (when I would have urethral spasms) the orientation could cause the uterus to push on the bladder if the uterus shifted downward because the muscle walls were not strong enough to support things.
Physical therapy is available instead of surgery
We learned that there are actual physical therapists out there who specialize in pelvic therapy. We would have visited one, but we live in the middle of nowhere where such things are not available, so we decided to learn and try it ourselves. We found descriptions of how to measure the amount of uterine prolapse and tried to measure how low my uterus was. We found that it would slip downward at certain times of the month. And would, as described above, change orientation during the cycle.
As my husband got more experience with feeling inside me and how it would change, we learned that as the uterus would tip various ways it would cause bladder discomfort or alternately constipation, depending on it's orientation. On the days I was having pain or discomfort, we learned that through a combination of external massage and internal pressure he could press gently up on the uterus to coax it back into a higher and more normal proper position. There were times when I was in extreme discomfort and he would shift it and I could feel this huge release of pressure from my bladder and urethra. It was the first thing I've ever found that actually relieved the pain! Anyone who has experienced chronic pain will understand how exciting that was. On days when my husband/DIY therapist was not handy, laying in different orientations to help the uterus slide away from the bladder also was helpful in reducing discomfort.
While the pelvic adjustments had helped relieve the acute symptoms, our goal was to eliminate them starting in the first place. In researching ways to combat or cure prolapse the options seemed grim. Most were surgical options and honestly their success rate was VERY low. One day in reading about Dr. Kegel he suggested that increasing vaginal muscle tone could have positive effects. And that some surgeries he had tried without exercise were only temporarily successful. I have done Kegel exercises at various times, but like many people, I think I'd mostly done them wrong. The instructions typically given are not very helpful. "Activate your muscles while urinating to stop the flow. Remember that feeling and then practice doing it later." I had activated and strengthened the muscles at the exit (which had probably saved me from incontinence)-- but that had done nothing for the muscles that make up the side walls of the vagina. They were completely weak. The exercise described by Dr. Kegel specifically targeted strengthening the "pubococcygeus". Muscles "of the proximal urethra, middle third of the vagina and rectum". The "pubococcygeus" is not merely muscles around the orifices. Something that somehow didn't get passed on clearly to the rest of us.
My summary of Dr. Kegels article
How does one strengthen their vaginal walls?
Ever hear of "Vagina Weightlifting"? Neither had did I. But check out this lady.
Complete article
Some medical folks (probably surgeons) argue that the muscles of the vagina can't hold up a uterus, even if they are in good condition. I have a hard time believing that since the average uterus only weighs between 0.06 and 0.22 pounds. Check out this video of some average young women, with no strength training, and how much they can hold. A typical bottle of water is 1 lb for reference. They are lifting 5 times the weight of a uterus. Still think a vagina couldn't hold up a uterus?
Sounded like it was worth a try. Really didn't have anything to lose by trying. After looking into different contraptions for pelvic strengthening, I bought a simple set of weights. There are tons of sizes and shapes available. I bought this set because I liked that I'd be able to easily increase the amount of weight.
Honestly, since I'd never had the urinary incontinence, that a lot of reviewers were fighting, I figured I'd be able to hold the heavier weights without too much trouble. First day I tried and was shocked to find that I could only hold the very lightest weight, only .05 lbs for a few seconds before it would slip out. Those girls were holding 20 (twenty) times the weight I could. Despite having typical pelvic exams over the years, no medical professional ever suggested my vaginal muscles were sub par and could use some strengthening. But here was proof as I couldn't even do the lightest weight.
I started practicing twice a day-- working with a weight until I could easily hold it for 15 minutes and then moving up to the next weight. The progression happened fairly quickly, within a few weeks, I had worked my way up to the heaviest weight. Then I started holding it for longer periods of time-- 30-60 minutes and adding additional weight onto it.
And it has made a big difference! The muscles are obviously stronger than they were, and I've had fewer and fewer bad days. I rarely need my husband to do adjustments for me anymore because the uterus seems to be staying up higher where it belongs. It is so nice to finally, after years and years of discomfort, we have found a solution. And much to our elation it didn't involve cutting on my body. It frustrates me that no one-- not my primary care physician, not my gynecologist, not my urologist ever suggested anything like this. It makes me wonder how many other people are suffering needlessly. This blog is my attempt to help those others out there.
And guess what, I can even lift a water bottle now. Only for about 10 seconds, but that is still exciting. And no, I won't be posting a video of that. :-)
Some additional links:
A woman's experience strengthening her insides to relieve incontinence. Great descriptions of how to find the correct muscles and some good humor Link
A physical therapist commenting on vaginal weight lifting. Link
UPDATE 9/2017 If you're interested in how well this has worked for me
All the things we didn't know about the female body:
As we started to learn more, we found there were so many things we had never read or been told about female anatomy. Maybe you already know this stuff and we're just clueless, but I had no idea that the uterus moves around during the monthly cycle. I'd always thought of my internal organs as fixed points but its more a jumble of stuff shoved in together.
As the following diagram shows, the uterus changes orientation throughout the monthly cycle. It's density and texture also changes. This seems to be typically discussed in relation to pregnancy and ovulation. But this movement will have an effect on what and how much a prolapsed uterus is pushing on. Seems this is useful information that should be mentioned more.
Complete page
Looking at these diagrams, it made it clear how intimately related the female bladder and uterus really are. And it made sense that at certain times of month (when I would have urethral spasms) the orientation could cause the uterus to push on the bladder if the uterus shifted downward because the muscle walls were not strong enough to support things.
Physical therapy is available instead of surgery
We learned that there are actual physical therapists out there who specialize in pelvic therapy. We would have visited one, but we live in the middle of nowhere where such things are not available, so we decided to learn and try it ourselves. We found descriptions of how to measure the amount of uterine prolapse and tried to measure how low my uterus was. We found that it would slip downward at certain times of the month. And would, as described above, change orientation during the cycle.
As my husband got more experience with feeling inside me and how it would change, we learned that as the uterus would tip various ways it would cause bladder discomfort or alternately constipation, depending on it's orientation. On the days I was having pain or discomfort, we learned that through a combination of external massage and internal pressure he could press gently up on the uterus to coax it back into a higher and more normal proper position. There were times when I was in extreme discomfort and he would shift it and I could feel this huge release of pressure from my bladder and urethra. It was the first thing I've ever found that actually relieved the pain! Anyone who has experienced chronic pain will understand how exciting that was. On days when my husband/DIY therapist was not handy, laying in different orientations to help the uterus slide away from the bladder also was helpful in reducing discomfort.
While the pelvic adjustments had helped relieve the acute symptoms, our goal was to eliminate them starting in the first place. In researching ways to combat or cure prolapse the options seemed grim. Most were surgical options and honestly their success rate was VERY low. One day in reading about Dr. Kegel he suggested that increasing vaginal muscle tone could have positive effects. And that some surgeries he had tried without exercise were only temporarily successful. I have done Kegel exercises at various times, but like many people, I think I'd mostly done them wrong. The instructions typically given are not very helpful. "Activate your muscles while urinating to stop the flow. Remember that feeling and then practice doing it later." I had activated and strengthened the muscles at the exit (which had probably saved me from incontinence)-- but that had done nothing for the muscles that make up the side walls of the vagina. They were completely weak. The exercise described by Dr. Kegel specifically targeted strengthening the "pubococcygeus". Muscles "of the proximal urethra, middle third of the vagina and rectum". The "pubococcygeus" is not merely muscles around the orifices. Something that somehow didn't get passed on clearly to the rest of us.
My summary of Dr. Kegels article
How does one strengthen their vaginal walls?
Ever hear of "Vagina Weightlifting"? Neither had did I. But check out this lady.
Some medical folks (probably surgeons) argue that the muscles of the vagina can't hold up a uterus, even if they are in good condition. I have a hard time believing that since the average uterus only weighs between 0.06 and 0.22 pounds. Check out this video of some average young women, with no strength training, and how much they can hold. A typical bottle of water is 1 lb for reference. They are lifting 5 times the weight of a uterus. Still think a vagina couldn't hold up a uterus?
Sounded like it was worth a try. Really didn't have anything to lose by trying. After looking into different contraptions for pelvic strengthening, I bought a simple set of weights. There are tons of sizes and shapes available. I bought this set because I liked that I'd be able to easily increase the amount of weight.
Honestly, since I'd never had the urinary incontinence, that a lot of reviewers were fighting, I figured I'd be able to hold the heavier weights without too much trouble. First day I tried and was shocked to find that I could only hold the very lightest weight, only .05 lbs for a few seconds before it would slip out. Those girls were holding 20 (twenty) times the weight I could. Despite having typical pelvic exams over the years, no medical professional ever suggested my vaginal muscles were sub par and could use some strengthening. But here was proof as I couldn't even do the lightest weight.
I started practicing twice a day-- working with a weight until I could easily hold it for 15 minutes and then moving up to the next weight. The progression happened fairly quickly, within a few weeks, I had worked my way up to the heaviest weight. Then I started holding it for longer periods of time-- 30-60 minutes and adding additional weight onto it.
And it has made a big difference! The muscles are obviously stronger than they were, and I've had fewer and fewer bad days. I rarely need my husband to do adjustments for me anymore because the uterus seems to be staying up higher where it belongs. It is so nice to finally, after years and years of discomfort, we have found a solution. And much to our elation it didn't involve cutting on my body. It frustrates me that no one-- not my primary care physician, not my gynecologist, not my urologist ever suggested anything like this. It makes me wonder how many other people are suffering needlessly. This blog is my attempt to help those others out there.
And guess what, I can even lift a water bottle now. Only for about 10 seconds, but that is still exciting. And no, I won't be posting a video of that. :-)
Some additional links:
A woman's experience strengthening her insides to relieve incontinence. Great descriptions of how to find the correct muscles and some good humor Link
A physical therapist commenting on vaginal weight lifting. Link
UPDATE 9/2017 If you're interested in how well this has worked for me
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