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Mental Health Week: Can prolapse and incontinence cause depression?.

05 October, 2015

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Over the 25 years I have been specifically treating pelvic floor dysfunction I have encountered many women who have suffered with anxiety and depression due to their bladder, bowel and prolapse problems. It is very confronting to discover that you have these very personal problems and often surreal that it can be associated with one of the very special moments in life of delivering your babies. There are many things that can cause pelvic floor dysfunction, but there is no doubt that childbirth is a key one. Add that together with the burden of menopause and aging, and slight to moderate problems immediately after childbirth can escalate into major distressing degrees of incontinence, prolapse and other stigmatized issues of the pelvic region. After all, being continent is a skill which is acquired (and required, even demanded) by the age of two-ish and when it fails – well  it can be depressing, it can cause anxiety and it can change your life for the worse.

I have written many blogs about the courage it takes to speak to your health professional about these deeply personal issues, but as I was watching Q & A tonight, which was discussing mental health issues, one of the panelists said of ‘coming out’ about your mental health issues which also rings true with continence as well.

“Sharing something very deep is a sign of strength”.

So today I am sharing another patient story with you, which as this patient said in her email to me: she wants to give encouragement to other ladies to come forward to a Continence and Women’s Health Physio to seek help for their problem before the problem escalates.

I firmly believe that this earlier intervention may stave off some of the mental health suffering that women and men can endure due to pelvic floor dysfunction.

Here is A-M’s story.

Three years ago, in my early 50’s, I took myself off to the GP assuming I had a UTI after a bout of gastro and a course of antibiotics would see me right. After several weeks with little change a pelvic exam was performed and to my horror the diagnosis was anterior wall prolapse (cystocoele). I’d experienced vague symptoms for years but like most women shrugged it off as getting older, early menopause, a physically demanding job, childbirth etc etc. I do regret not seeking solutions earlier and just accepting the status quo. Hindsight is a wonderful thing!

I quickly embarked on seeking further treatment and so began the arduous journey of researching every detail I could find regarding this condition. Many things I read on the internet scared the living daylights out of me. To say I was catapulted into a deep sense of believing my life was over is an understatement. I felt so sick and overwhelmed. I commenced Physio treatment of many months duration, in the hope of avoiding surgery. While I achieved results in this 18 months, I instinctively knew I had reached a plateau and needed further investigation.

This lead me to a consult with a Urogynaecologist,  who diagnosed an additional condition of overactive, painful pelvic floor muscles, which was causing me pelvic pain. This would change the landscape of my treatment program. I was advised to visit Sue, who treats many women who are in pain- teaching them pain management skills – and from that moment on I knew there was hope my physical and mental health could be turned around.

We embarked on a series of new pelvic floor safe exercises, strategies, charts and the retraining of my brain to help deal with my symptoms. I also have the added dilemma of IBS (Irritable Bowel Syndrome) but through adhering to a low FODMAPS diet, under the initial guidance of a Dietician and Sue’s advice, I am on top of keeping my bowel in good working order. A properly functioning bowel alleviates prolapse symptoms tenfold.

Another bonus of my treatment which has surprised me greatly is that I now have more control over the psychological triggers of urgency/visiting the toilet. This development took determination and consistency but wow, I am so glad I dug my heels in!

One of the most important aspects I’ve learnt in having POP is acceptance. My bladder will never ever be ‘back to normal’ so I have accepted this as my ‘new’ normal and my new lifelong lifestyle. The commitment to forge ahead with various exercises/treatments is, at first incredibly daunting. Some days are better than others of course! I’ve learnt to accommodate the condition and for the first time in my life I don’t feel guilty in putting my feet up if my prolapse is urging me to.

I’m now proactive in discussing with friends and especially my grown daughter about pelvic floor health and I am determined to keep doing the things I need to do to ease my symptoms and live a fulfilling life.

I shall be eternally grateful that I have learned these strategies to help me cope with my prolapse.

As before when I have posted patient stories, I say that whilst this patient is mentioning me in this post, any Continence and Women’s Health Physio can teach you these same strategies and point you in the right direction. Patient stories are empowering for patients. We physios can bleat on for blog after blog about this working and that working, but when it comes from the pen of someone who has lived the condition and made the changes and seen them work, then I do believe it holds more credence.

So in Mental Health Week – if you have pelvic floor problems which are distressing you, making you anxious or depressed – then get help. The Continence Foundation of Australia has a Helpline 1800 33 00 66 and the APA has Find a Physio – both these organizations have registers that can point you to a trained physio close to you.

In my talks I often say Everything we do is science based, but it isn’t rocket science – what that means is, it isn’t that hard to make incredible changes to your condition. So be brave, come out about your pelvic health issues and turn your life around. After all, 50% of women over the age of 50 have a prolapse and 1 in 3 women leak urine – it’s more common than you think!

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One Comment
  1. I love these stories of other women’s experiences. It helps those of us coming along in their footprints to know what we are up against so we can take action now.

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