Not Just a Man's World

At the start of the year I wrote about the fact that I often suffer from slight incontinence when I am doing strenuous multi-day walks.

It wasn’t something that I’d told anyone about, other than Chris, so I was surprised to get an email from Mum who explained that the incontinence could also be caused by the beginnings of a prolapse.

There followed an investigation into the causes and symptoms of both prolapses and incontinence to learn more.

What is a prolapse?

A prolapse occurs when structures designed to hold organs in place stretch or weaken and the organ then moves out of place and in some cases even turns inside out!  While I had heard of womb and bladder prolapses, I was surprised to learn that you can also have a prolapse of the rectum, vagina or urethra.

Symptoms of prolapses

It seems that, no matter where your prolapse, the symptoms of a prolapse are similar.  Broadly, they include:

• lower back pain;
• stress incontinence;
• constipation;
• difficult or painful sex;
• a sensation of “something falling out”.

Causes of prolapses

Different types of prolapse seem to have slightly different causes.  Featuring high on the list for all types is childbirth and long-term constipation.  Prolapse of the uterus can also be caused by changes from the menopause, being overweight, heavy lifting, long-term coughing and weak pelvic floor muscles.

Having tested my pelvic floor muscles and found them to be fairly strong, the obvious cause for concern in the list above is heavy lifting.  Given that I deadlift weekly and do max effort squats and bench press every week as well, where does that leave me in relation to a potential prolapse?

Learn more about prolapses

As an excellent guide to prolapses, I recommend reading Dr Marylin Glenville’s site where you can learn about the different types of prolapse, common causes and symptoms.  Other resources about causes, symptoms and treatment include:

• NHS – basic information about prolapse of the uterus;
• Wrong Diagnosis – more information on prolapse of the uterus; and
• eMedicineHealth.com – provides an in-depth article about rectal prolapses.

Urinary stress incontinence

In comparison to prolapses, stress incontinence is a common condition amongst women and may have a wide variety of possible causes.  After in-depth hunting, the truth seems to be that nobody really knows the causes of incontinence.  The most common causes are believed to be:

• weak pelvic floor muscles (in fact, a study showed that pelvic floor muscle exercises did help older women to manage urinary incontinence); and
• a weak sphincter muscle (the muscle that controls the opening to the bladder).

It has also been observed that body mass index (BMI) and parity are associated to the risk of incontinence, so it may be that having a low BMI or body fat percentage can cause incontinence.  This wouldn’t surprise me since, for the first time, I noticed slight problems with incontinence at the very end of my last cutting cycle, though this went away again a few weeks later when I had gained a percentage or two of body fat again.

Dealing with weak pelvic floor muscles

There are two common ways to strengthen the pelvic floor muscles:

• use of vaginal cones, explained in detail by Dr Marylin Glenville; and
• Kegel exercises.

You can learn more about Kegel exercises by watching the following videos:

My conclusion

There is no easy way to know if I have the beginnings of a prolapse.  Incontinence could be a sign of a prolapse of the bladder but this can also lead to recurrent urinary tract infection which is definitely not something I suffer from.

Looking at the lists of possible symptoms of prolapses, incontinence is the only one I seem to suffer from.  There also seems to be evidence that there are many likely causes of stress incontinence in addition to having a prolapse.  It is almost like prolapse is a sub-set of the wider issue of incontinence rather than incontinence just being an indicator of having a prolapse.  

In particular, I am still very much persuaded by the evidence that incontinence often occurs in young and middle-aged women practising recreational sports and appears to be specifically related to those sports (which may vary for each woman).  They don’t all have prolapses.

So, do I stop lifting weights on the basis that I might have a prolapse that will be made worse by lifting?  Given the wide-ranging list of other potential causes and the fact that incontinence is the only symptom of a prolapse that I have, I’ll keep lifting for now and take the risk. 

There are too many other benefits of lifting to make me stop for such a slim possibility.

Related posts:

1. Lessons learned this week: incontinence
2. Blog-watch: incontinence
3. Lessons learned: dehydration
4. Lessons learned: thoracic spine mobility (part 2)