Bladder leakage: Exercises to improve your pelvic floor
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Natashja Simone Wilson had just entered adulthood when she first noticed symptoms of a condition more commonly seen in women in their 50s. She would often pass urine when laughing or sneezing and struggled to insert a tampon. Then, one night, she felt a lump protruding from her vagina when she was on the toilet. Embarrassed and scared, Natashja didn’t seek medical help for two years.
“I was in my second year at the University of Kent in Canterbury living with friends, so I asked if they thought this was normal. They thought maybe it was a spot or a cyst so instead of speaking to a doctor, I tried things like FemFresh hygiene products, hoping they would fix the issue.”
Natashja, now 23, from London, had no idea that she had developed a uterine prolapse, a condition where the internal supports of the uterus become weak over time and the pelvic floor muscles are no longer strong enough to support the uterus correctly.
“I was embarrassed and didn’t know much about genitalia or anatomy, so I left it in the hope it would go away.
“Unfortunately, this didn’t happen and it started to feel as if something was falling out, a sensation that got worse after exercise and during my period.”
Natashja became anxious about having sex and never felt as though she had an empty bladder, so would often get up three times a night to have a wee.
In 2019, when Natashja was 20 and about to embark on a year abroad studying in Denmark, she plucked up the courage to tell her mother, who insisted she seek medical advice.
She underwent examinations and a hysteroscopy, transvaginal and renal ultrasounds, and a smear test. She was finally diagnosed with the most severe, grade 3 uterine prolapse.
According to the National Institute for Clinical Excellence (NICE), pelvic organ prolapse affects up to half of all women, with one in 10 of them needing at least one surgical procedure. But it’s rare before childbirth.
“I was referred to a physio who gave me pelvic floor exercises to do at home, and fitted a ring pessary to support my pelvic floor and help relieve the pressure and discomfort,” Natashja says.
“However, it was very painful because the pessary wasn’t the right size and irritated an undiagnosed skin condition. The doctors also tried a cube pessary but this caused the same problem.
“In the end, they decided it was best for me to stick to the pelvic floor exercises until I was able to relax my pelvic floor enough.”
It was around this time Natashja met her partner. Embarrassed to tell him aboutt her condition, she sent him links to websites about prolapses to explain the issue.
Despite this, she still worried about having sex, fearing he would be able to notice her prolapse or that it would disgust him.
She booked sessions with sychosexual therapist who encouraged her to dicuss her anxiety rounding sex.
“As we experimented together I became more aware and confident about which positions worked and which caused discomfort.”
In July 2020, Natashja decided to seek a second opinion. Surgery was not recommended due to her young age and the possibility she’d want to have children in the future, so again physiotherapy and a pessary were suggested.
Throughout, Natashja says she was repeatedly met with dismissive remarks such as “you are so young”, “prolapse only happens to older women” and “but you haven’t had kids” from medical professionals.
“I felt like I was the only person in the world who had a prolapse before childbirth – all the doctors were surprised.
“They still don’t fully know the cause, which has been one of the hardest things to process, though they think it may have been due to constipation as a child and holding my breath during exercise.”
Natashja says her heart sank when, during research online, she read the advice to avoid jumping, lifting weights, squatting, high impact sports, running and sit-ups.
She waved goodbye to high-impact exercises that she previously loved and was afraid to walk for fear of making her condition worse.
“Prolapse has affected every aspect of my life. Things I used to take for granted like exercise, walking, sex and breathing, I now have to pay close attention to. The lists were disheartening, frustrating and sapped the joy out of exercise for me. I instantly stopped all of it.”
Natashja is now campaigning for greater awareness and education about prolapse both among women and also medical professionals.
She believes if she had been more educated about her body from a young age, she’d have gone to the doctor about her prolapse sooner.
Working with a physiotherapist, Natashja has changed her perception of exercise.
She now goes to the gym three times a week and has been fitted with a ring pessary which has extra support so works much better than the original.
“I am astounded as to how many women I have met that are going through the same thing as me and also felt isolated when they were initially diagnosed.
“I am on a mission to open up conversations about prolapse and debunk the stigma.
“Although I wish I didn’t have a prolapse, I am trying to make the best out of it and use my platform to raise awareness.
“I don’t ever want any woman to feel the way I did when first diagnosed – alone and hopeless – because there is hope and there is a massive support network out there and you are most definitely not alone.”
You can find Natashja’s blog here or on Instagram @living_with_prolapse
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