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Bad Hot Flashes? Watch Out for Pelvic Organ Prolapse


If you’ve ever talked to a woman who’s had pelvic organ prolapse, you’ll be motivated to prevent it. It’s an uncomfortable condition in which one or more of the pelvic organs—the bladder, uterus, vagina and rectum—can bulge toward or out of the vaginal opening. It’s a common problem in women, especially as they age.

Now there’s a new way to know you’re at risk—the severity of menopausal symptoms. If you’re a postmenopausal woman and you’ve been experiencing severe hot flashes and other menopausal symptoms, it’s a wake-up call to take steps to help prevent this condition.  Fortunately, there’s a lot that you can do.

Background: The “pelvic floor” is a network of muscles, ligaments and other tissue that acts like a sling to support a woman’s pelvic organs. The bowel and bladder are controlled by contracting and relaxing these muscles and tissues. When the pelvic floor becomes weak, the organs above it can bulge toward your vaginal opening and even push out of it. The medical name for this hernia of the pelvic organs is pelvic organ prolapse.

Risk factors for it include menopause, age, obesity, repeated heavy lifting and traumatic injury—as may happen during childbirth, for example, or from a hip or back injury. But there’s been little research into whether menopausal symptoms themselves are linked to prolapse risk.

New study: Italian researchers analyzed data on 1,382 postmenopausal women attending an outpatient service for menopause at a university hospital.  The women were asked 21 questions to rate the severity of menopausal symptoms such as hot flashes, night sweats, fast heartbeats and sleep problems. The incidence of prolapse was also tracked.

Results: Women with a higher degree of menopausal symptoms were more likely to suffer pelvic organ prolapse—specifically, a prolapsed bladder. This study wasn’t designed to show how it might happen, but the researchers note that high levels of the stress hormone cortisol—which often rise in the menopausal transition—can impair collagen tissue that’s a key component of the pelvic floor.

Bottom line: If you have severe menopausal symptoms, explore ways to ease them—including mind-body approaches. But now is also a good time to check with your doctor to see whether you also have pelvic floor weakness that may lead to prolapse. You may be able to prevent this condition by losing weight and practicing Kegel exercises, which strengthen the pelvic floor muscles. Even if you already have prolapse but it’s not causing significant symptoms, such lifestyle approaches may be enough to keep it from getting worse. Treatment options include the use of a pessary—a medical device that provides structural support—or surgery.

Source: Angelo Cagnacci, MD, professor of gynecology and obstetrics, University of Udine, Italy, and lead author of the study “Association Between Pelvic Organ Prolapse and Climacteric Symptoms in Postmenopausal Women,” published in Maturitas, the European Menopause Journal. Date: July 3, 2017 Publication: Bottom Line Health
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