Pelvic Organ Prolapse (POP)
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Pelvic Organ Prolapse (POP) Yoga Nashit – Women's Yoga Teachers' Course 2018-2019 Submitted to: Mira Artzi Padan Submitted by: Lori Erlich [email protected] Mobile phone: +972-54-5572891 Table of Contents: I: About Yoga Nashit Page 1 II: What is the Pelvic Floor? Page 2 III: What is Pelvic Organ Prolapse (POP)? Page 3 IV: What are the Symptoms of POP? Page 4 V: What are the Causes of POP? Page 5 VI: Conventional Medical Solutions for POP Page 6 VII: AlternativeSolutions for POP Page 7 VIII: Yoga Nashit Solutions for POP Page 8 IX: Yoga Nashit Practice for POP (20 Mins) Page10 X: Personal Summary Page15 XI: Bibliography About Yoga Nashit Yoga Nashit - Women's Yoga - is a unique type of yoga practice which specifically takes into account women's bodies and women's health, and was developed by Mira Artzi-Padan in the late 1990s. Though Yoga Nashit was pioneered in Israel, it soon gained international recognition and is followed and taught by many female enthusiasts, worldwide. More information can be found at http://www.yogaforwomen.co.il Yoga Nashit is appropriate for EVERY woman and at EVERY time in her life - no matter how challenging that time might be for her. Yoga Nashit gives a woman her own individual set of tools to introspect and connect with her own mind, body and spirit so that she can strengthen and support herself and live a life of optimal health. Yoga Nashit allows a woman to connect with her inner-self and empowers her with the tools to deal with the hormonal and life cycle changes that she experiences through and during puberty, menstruation, childbearing years, possible infertility, menopause, aging and more. Yoga Nashit supports a woman by enabling her to listen and to understand how her body changes over her life cycle, and as a result of natural hormonal cycles or other changes in her life, and assists her to acquire and equip her own "toolbox" to be better prepared for these changes. For example, Women's Yoga helps a woman deal with some of the physical and emotional changes associated with menopause - including heat flashes, urinary incontinence, potential prolapse of the pelvic floor and the pelvic organs (prolapse of the bladder or other internal organs) and more. Women's Yoga not only assures women that these are not uncommon symptoms, but also provides tools and techniques which - when practiced during physical exercise and in daily life - a woman can relieve many of the symptoms in order to lead a healthy and comfortable quality of life. Such tools and techniques include strengthening her pelvic floor muscles and her internal core muscles, changes in her posture, lifestyle adjustments, breathing techniques, awareness and more. Yoga Nashit combines breathing techniques and pelvic floor exercises (mula bandah) with a diversified yoga practice. Yoga Nashit enables each woman to experience improvements in her physical health, emotional state and overall well-being. Yoga Nashit can assist each and every women to take ownership over her mind, body and spirit in a way that is best and most appropriate for her. What is the Pelvic Floor? The pelvis is a bony structure which is located at the base of the spine. It is shaped like a "basin" and composed of several large and strong bones which are naturally fused together to form a strong and stable base of the body. The pelvis is the center of posture and movement of the entire body. The lower part of the pelvis includes a complex muscular system, which looks like a large cradle or "hammock" and supports all of the organs within it. This muscular system includes a layer of ring-like muscles which close over the lower pelvic organs and form a layer of muscles which elevate the internal pelvic organs against the force of gravity. The pelvic muscles are connected to the pubis bone and the sacral bone, and form the supporting cradle structure. These muscles encircle the pelvic floor's three openings: the urethral opening, the vagina opening and the rectum opening. These three levels of muscles create an action of closing and elevating the internal pelvic organs against the force of gravity, as well as releasing and relaxing when there is need to urinate or to give birth (and while sleeping). The strength and flexibility of these pelvic muscles affects the position of the pelvic organs within the pelvis and their ability to function efficiently. Think of the pelvic floor like a floor in a building: in order to support the weight of whatever is on it, it must be firmly attached to the structural beams. Similarly the pelvic floor. What is Pelvic Organ Prolapse (POP)? Pelvic organ prolapse (POP) is the descent or drooping of pelvic organs from their normal and natural positions. POP happens when the fibromuscular tissue, fascia, and ligaments which are supposed to be supporting the pelvic organs become weak, damaged or relaxed. This allows one or more of the pelvic organs to drop or press into the vagina or anus, or out of the vagina or anus. POP can happen to any of the pelvic floor organs, including: Bladder/Urethra Uterus/Uterine Vagina Small bowel Rectum The following are different types of Pelvic Organ Prolapse: Cystocele: A prolapse of the Bladder into or out of the Vagina, the most common condition Urethrocele: A prolapse of the Urethra (the tube that carries urine) Uterine prolapse: A prolapse of the Uterus into or out of the Vagina Vaginal vault prolapse: A prolapse of the Vagina Enterocele: A prolapse of the Small Bowel or of the Small Intestine Rectocele: A prolapse of the Rectum into or out of the Vagina What Are the Symptoms of POP? Symptoms of POP (Pelvic Organ Prolapse) are felt differently depending on which organ is drooping. For example, if the bladder prolapses, urine leakage may occur. If the rectum prolapses, constipation and uncomfortable intercourse may occur. Small intestine prolapse might cause a backache as well as uncomfortable intercourse. Uterine prolapse is also often accompanied by backache and uncomfortable intercourse. Common symptoms of POP include: Vaginal tissue bulging or the feeling that "something is coming out" of the vagina Pelvic heaviness/fullness or pressure in the pelvis Pelvic pressure that gets worse with standing/coughing or as the day goes on Lower backache or pelvic pain Lower abdominal pressure or discomfort Urinary problems including: leaking of urine (incontinence), a chronic urge to urinate, urine retention, difficulty getting all of the urine to empty from the bladder due to bladder pressure on the urethra, frequent urinary tract infections (chronic UTIs) etc. Fecal leaking (fecal incontinence) Bowel emptying problems including chronic constipation Flatulence Problem inserting tampons Needing to manually reposition the prolapse to empty the bladder or bowel Spotting or bleeding from the vagina Painful intercourse or problems with sexual functioning Some women develop more than one pelvic floor disorder simultaneously, such as pelvic organ prolapse with urinary incontinence or needing to manually reposition the prolapse in order to urinate as well as frequent/chronic UTIs. What are the Causes of POP? Essentially anything that puts increased downward pressure in the abdomen can lead to pelvic organ prolapse. Common risk factors of POP include: Pregnancy, labor and childbirth (the most common causes) Vaginal childbirth (multiple vaginal childbirths) Giving birth to heavy babies Menopause and hormonal changes/loss of estrogen Increasing age/aging Obesity and being overweight Chronic constipation and straining Respiratory problems with a chronic, long-term cough Previous pelvic surgery (including prolapse surgery or hysterectomy) Pelvic organ cancers Pelvic floor muscle dysfunction Regular heavy lifting Exercise overload According to some studies, family history and genetics may also play a role in pelvic organ prolapse. The collagen of the connective tissues/fascia may be genetically weaker in some women, perhaps placing them more at risk. Pelvic floor disorders affect one in five women in the United States. Pelvic organ prolapse happens more often in older women and in white and Hispanic women than in younger women or women of other racial and ethnic groups. According to Dr. Christiane Northrup, M.D. in her book "Women's Bodies, Women's Wisdom" - "Prolapses of all kinds are more common in women of northern European heritage and in those with red hair. The reason for this is that blondes and redheads have a collagen layer that is thinner than those who have darker skin. African Americans and those with darker skin are the least likely to experience prolapse." In women, the front wall of the vagina supports the bladder. This wall can weaken or loosen with age. Significant bodily stress such as childbirth can also damage this part of the vaginal wall. If it deteriorates enough, the bladder can prolapse, meaning it is no longer supported and descends into the vagina. This may trigger problems such as urinary difficulties, discomfort, and stress incontinence (urine leakage caused by sneezing, coughing, and exertion, for example). Prolapsed bladders are commonly associated with menopause. Prior to menopause, women’s bodies create the hormone estrogen, which helps keep the muscles in and around the vagina strong. Women’s bodies stop creating as much estrogen after menopause, and those muscles tend to weaken as a result. Conventional Medical Solutions for POP Conventional treatments for pelvic organ prolapse depend on the type of prolapse, the woman's symptoms, her age, other health problems and whether she sexually active. Conventional medical solutions for POP may include one or more of the following: Hormone Therapy by vaginally inserting estrogen cream which helps to replenish vaginal tissue thickness (due to loss of natural estrogen produced by the body).