Amy Turpin, a Harwood resident, is unusual in some ways. At 50 years old, this grandmother of four is exceptionally fit, working as a strength and conditioning coach, and competing in marathons and triathlons. “I’m physical all day long, and then running or cycling is what I choose to do for fun,” she says.
But there is one way in which Amy is not unusual. Just like almost a quarter of American women, she experienced a pelvic floor disorder.
Pelvic floor disorders occur when the muscles or connective tissues that support a woman’s pelvic organs weaken or are injured. This is commonly a result of pregnancy and childbirth. But obesity, smoking and genetic predisposition are also risk factors.
The most common problems are incontinence and pelvic organ prolapse. In prolapse, organs such as the uterus, bladder or bowel collapse into the vagina.
For many women with prolapse, there are no symptoms, other than some pressure or a vague feeling that something is different, until an organ begins to protrude out of the vagina.
Physical and Mental Changes
“For me, the changes were fairly subtle over a period of time,” says Amy. She began to feel pelvic pressure while jumping rope. On long runs she would feel the same pressure, plus numbness in her legs.
Then, one day, the change became dramatic. “I was out for a run, and I just felt like, literally, the bottom fell out.”
At this point, Amy had to change her training routine and avoid some activities she enjoyed. “It affected every aspect of my life physically,” she says. “Then there’s the mental pain when you can’t do the things that you’re used to doing.”
AAMC Urologist Mara Holton, MD, says it’s important for women to remember that pelvic health corresponds to overall health and wellness. This includes good nutrition, physical fitness and maintaining a proper body weight.
Pelvic floor muscles support the bladder, uterus, vagina and rectum, and help these organs function. The best way to maintain pelvic floor fitness is to do Kegel exercises.
“Everyone has heard of them, but most women do them incorrectly,” she says. “Kegels are a dedicated exercise that need to be done properly to get the benefit. There are online resources, as well as physical therapists who specialize in pelvic floor strengthening.”
Dr. Holton advises women to do Kegels twice a day and says women who follow this regimen can see improvement in urinary continence and sexual comfort in six to 12 weeks. She says exercises that strengthen the core muscles, such as jumping jacks, crunches, wall squats and the bridge pose in yoga, can help strengthen the pelvic floor, too.
Seeking Treatment
Studies suggest that a woman has an 11 to 19 percent chance of needing surgery for pelvic organ prolapse in her lifetime. While lifestyle changes or pelvic floor exercises (called Kegels) can help some women with early prolapse, often the degree of muscle damage or tissue relaxation requires other treatments.
One option includes trying a pessary—an insertable device that supports the pelvic organs. But Amy’s active lifestyle demanded a more permanent solution.
“For me, surgery was a very clear answer, because I just couldn’t perform at the level that I was used to performing,” she says.
She ended up undergoing a minimally-invasive robotic procedure.
This involved having small incisions put in her abdomen no wider than her pinky. The operation involved controlled robotic arms that worked through the incisions to move Amy’s pelvic organs back into place and secure them. Amy also had a mesh sling inserted under the urethra, the tube through which urine comes out, to prevent urine leakage.
Back to Full Speed
“With the great technology that we have, you don’t end up with huge scars, but that doesn’t mean the surgery should be minimized,” says Amy. After her surgery in May 2015, she was careful to follow instructions to avoid stairs and not drive or bend over for at least two weeks, then begin returning to regular activities slowly. Recovery time is typically about six weeks.
“I think being compliant and not moving around as much as I’m used to was the most challenging part,” she says.
“I feel amazing. I got my life back,” says Amy. “In fact, I recently did a triathlon.”
Through her work, Amy meets a lot of women.
“I know I’m not unusual,” she says. So she made a conscious decision to be open about the personal nature of her surgery, and she often hears, “Oh my goodness, I have the same thing.”
Her advice to the millions of women experiencing a pelvic floor disorder is, “We can’t be quite so proud. If you have symptoms, you need to find out what your options are, because you don’t have to live that way.”
Have a sensitive health question you’d like an answer to? Call The Smart Woman Connection, your new go-to health resource focused on one thing—your needs as a woman. Call 443-481-5995, email SmartWoman@AAHS.org.
Mara Holton, MD, is a urologist at Anne Arundel Medical Center.
