Amy Marsh, Sexologist & Hypnotist

Supporting Your Sexual Human Rights & Quest for Pleasure

Pelvic Organ Prolapse (POP)

This page is evolving. Please come back frequently for added content.

Check this brand new podcast with Sherrie Palm, founder of the Association of Pelvic Organ Prolapse Support, interviewed by Jessa Zimmerman, MA, LMHC, CST.


As a sexologist, as well as a patient diagnosed with POP, I am attempting to learn as much as I can about these conditions and symptoms, and their potential impact on sexual health, response, and enjoyment. Treatment options may also have an impact, for better or worse. I first posted about this topic in 2017: Out of the Body Shame Closet. And then I realized that I was not emotionally ready to take on this topic, even for my own health’s sake. So… it’s been awhile.

But now I’m ready and I’m trying to take a larger, professional view as well as the more personal one.  As I do this, two things become apparent. First, that there is an enormous lack of clear, well-organized information about POP, suitable for both laypeople (patients) and those helping professionals who are not medical specialists. Second, that there is an enormous opportunity here for the helping professionals to get up to speed and provide very valuable assistance to people who suffer from POP.

With regard to my own practice, I begin to see how sexological counseling and/or hypnosis could assist some people diagnosed with POP (counseling and hypnosis as complementary to other treatments, of course). Some examples include:

• counseling after the initial shock of a diagnosis;

• general adult sex ed and counseling for individuals and couples experiencing problems with sex and intimacy due to POP or post-surgical conditions;

• counseling and/or hypnosis for body image issues;

• sexual enrichment counseling for an expanded repertoire;

• erotic hypnosis as an alternative or option to vaginal penetration for women who have pelvic pain or who undergo colpocleisis. And affectionate, “romantic” hypnosis to encourage bonding and intimacy;

• hypnosis to ease pre-surgery “jitters” and to decrease blood at incisions sites, minimize infection, and promote healing;

• hypnosis to manage pelvic pain.

• hypnosis and self-hypnosis to encourage compliance with treatments and healthy habits.

• hypnosis to assist weight loss for those who may need to do this prior to surgery.

As I learn, I am also creating a module on this topic for my Hypnosis for Sexual Concerns course for helping professionals (150-hour course). From now on, POP will be part of my curriculum.


What Human Sexuality Counselors, Sexologists, and Sex Therapists DON’T Know about Pelvic Organ Prolapses

I am sorry to say this, but human sexuality professionals–myself included–have neglected this topic, probably because their (my) own education did not include much if anything about it. I wrote about this in my above mentioned blog post, but I can also make this claim after scouring all my relevant human sexuality books for mentions of anything that could be related to POP, especially its impact on sexuality. Spoiler alert: From Kinsey’s research into Sexual Behavior in the Human Female (1953) to much more recent sex therapy and self-help books, there isn’t much at all, and what’s there is piecemeal. I’ve summed up my findings in this link to my Book Chart #1 (Rev.)

The good news is that there are organizations and spokespeople who are creating greater public education and awareness about pelvic organ prolapses. People in organizations like AASECT (American Association of Sexuality Educators, Counselors, and Therapists) are starting to talk about this more.

Overview

Pelvic organ prolapses (POP) are changes in anatomy, often presenting as bulges in or around the entrance to the vagina as the conditions worsen. It’s mostly cis-gender women who suffer from uterine (uterus), cystocele (bladder), and/or rectocele (rectal) prolapses (though people of other genders can also experience organ prolapses). Many POP patients are over the age of fifty, and some are quite elderly. As we all know, women and the elderly often get short shrift, especially when it comes addressing sexual health and enjoyment.

Additional symptoms can include urinary incontinence, difficulty with bowel movements, dyspareunia (painful intercourse), and other kinds of pelvic pain. Surgeries can cause nerve damage and a decrease in sensation and pleasure. POP and its symptoms can affect a person’s body image and confidence, sexual response, sexual comfort and function. Post-surgical effects can also be troublesome (or not). All of the above can have a negative effect on sexual relationships. In some cases, POP cause quality of life to diminish considerably.

Scroll down for a screen capture of an excerpt from a recent study. Notice the prevalence of this condition, estimated in this study to be between 30-70% of “women presenting for routine gynecological care” and about “1 in 12 women” living in the UK. Other studies from other countries also show high incidence. This APOP website page cites some of these studies, and takes the position that 50% of all cis-women over 50 are probably suffering some degree of POP and related symptoms, though this condition affects cis-women of all ages.

Trans, Non-Binary, and Other Folks Suffer From POP Too

I am currently collecting studies about this, as well as information about services and providers who are working with trans and gender diverse folks.

I did come across this video from the Pelvic Guru Academy which offers training pertaining to pelvic health for trans and non-binary folks, for Pelvic floor therapists and those in related fields.

Please watch this space for more info soon. Thank you.

Websites and Resources

Here is a list of POP Studies (PDF), some pertaining to sexual concerns. Others are more general.

Association for Pelvic Organ Prolapse Support (founded by Sherrie Palm). Here is their “POP Risk Factor Questionnaire.”

Podcast interview with Sherrie Palm, on Top Cosmetic GYN. Episode 11: Sherrie Palm, The Prolapse Warrior. (Oct. 19, 2019).

Voices for PFD (Pelvic Floor Disorders). Here is the FAQ for this website.

My blog, Put Pelvic Organ Prolapse on Your Sexual Wellness Radar, on the American Counseling Association website.

Mesh Down Under – Australian site regarding complications of mesh surgeries for POP.

Books

Sherrie Palm, Pelvic Organ Prolapse: The Silent Epidemic.

This one looks good for general pelvic health.


Barber_2016_POP


That’s it for now. Keep checking back for more info!

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