News & Views

“I defy gravity!” No, unfortunately we do not; what to do when things fall down

W. Gifford-Jones MD & Diana Gifford-Jones

March 30, 2023

BY W. GIFFORD- JONES MD & DIANA GIFFORD-JONES

The law of gravity means our bodies are pulled down to earth. This fact inevitably spells trouble over time, but for some women, it causes inconvenient and annoying issues, and sometimes surgery, to address what’s called vaginal prolapse.

Not all women are born equal. Some inherit tougher pelvic tissues and do not experience prolapse, even after bearing several children, but the more pregnancies, the greater the risk in older age of weakened all pelvic structures leading to the sagging of the vagina, urinary bladder and often the rectum.

The most common complaint is the loss of urine on coughing and sneezing. A large survey of women in North America revealed that 4% suffer from this annoying problem.

Apart from pregnancy, what else can contribute to prolapse? Obesity is a factor, causing so many other medical complications too. It is staggering that some women still smoke. If cancer and respiratory diseases aren’t incentives enough to quit, then maybe vaginal prolapse should be more prominently added to the list. Why? A smoker’s cough pushes on the urinary bladder. Prolapse can also be worsened by heavy lifting.

Here’s another concern; many women continue to suffer needlessly from chronic constipation. Why do they strain their innards and try to solve the problem with laxatives? This harms the bowel over the course of years.

One of the best-kept secrets is that vitamin C is a safe, inexpensive, effective, and natural remedy for constipation, but it must be in higher doses than found in most supplements. Start with taking 2,000 milligrams before bed. If no results, increase to 4,000 mg the following night. It invariably works.

Remember, simply because prolapse has developed does not mean that it is always treated. This is an important point to stress because many women with prolapse will never know they have the condition. Awareness usually becomes evident when they start to experience troublesome urinary incontinence.

What can be done depends on the severity of prolapse and if it’s causing annoyance. The most frequent treatment is the use of a vaginal pessary, which is easy to insert and can be removed for cleaning.

The use of a pessary will help to elevate the urinary prolapse, and may stop the loss of urine, but sometimes in elderly women another easy and effective treatment is acceptable. Inserting a large vaginal tampon to push up the bladder can help ease the loss of urine.

Prevention is advantageous for those not yet dealing with serious prolapse, so in addition to maintaining a healthy weight, not smoking, eating a nutritious diet, and sleeping well, don’t forget moderate exercise for the entire body, including those easy-to-miss pelvic muscles. Develop a habit of doing Kegel exercises several times a day. Concentrating on pulling up the pelvic and rectal muscles does this. It’s possible to do this seated, standing, or lying down. Identify a consistent place and time each day and do it. The more you exercise these muscles, the stronger they will become.

If all this fails, doctors will suggest surgery. There are several methods. One is to stitch up the position of the bladder. Your surgeon may also advise an artificial support for extra strength, or the prolapse can be repaired during a hysterectomy.

Do men develop prolapse? Yes, but much less often and it’s usually a prolapse of the rectal area.

Marilyn Monroe famously said, “I defy gravity,” but such fortunes elude most people. Talk with your doctor and see if treatment can get the annoyance resolved.

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Written By W. Gifford-Jones MD & Diana Gifford-Jones

Dr. W. Gifford-Jones, MD is a graduate of the University of Toronto and the Harvard Medical School. He trained in general surgery at Strong Memorial Hospital, University of Rochester, Montreal General Hospital, McGill University and in Gynecology at Harvard. His storied medical career began as a general practitioner, ship’s surgeon, and hotel doctor. For more than 40 years, he specialized in gynecology, devoting his practice to the formative issues of women’s health. In 1975, he launched his weekly medical column that has been published by national and local Canadian and U.S. newspapers. Today, the readership remains over seven million. His advice contains a solid dose of common sense and he never sits on the fence with controversial issues. He is the author of nine books including, “The Healthy Barmaid”, his autobiography “You’re Going To Do What?”, “What I Learned as a Medical Journalist”, and “90+ How I Got There!” Many years ago, he was successful in a fight to legalize heroin to help ease the pain of terminal cancer patients. His foundation at that time donated $500,000 to establish the Gifford-Jones Professorship in Pain Control and Palliative Care at the University of Toronto Medical School. At 93 years of age he rappelled from the top of Toronto’s City Hall (30 stories) to raise funds for children with a life-threatening disease through the Make-a-Wish Foundation. Diana Gifford-Jones, the daughter of W. Gifford-Jones, MD, Diana has extensive global experience in health and healthcare policy. Diana is Special Advisor with The Aga Khan University, which operates 2 quaternary care hospitals and numerous secondary hospitals, medical centres, pharmacies, and laboratories in South Asia and Africa. She worked for ten years in the Human Development sectors at the World Bank, including health policy and economics, nutrition, and population health. For over a decade at The Conference Board of Canada, she managed four health-related executive networks, including the Roundtable on Socio-Economic Determinants of Health, the Centre for Chronic Disease Prevention and Management, the Canadian Centre for Environmental Health, and the Centre for Health System Design and Management. Her master’s degree in public policy at Harvard University’s Kennedy School of Government included coursework at Harvard Medical School. She is also a graduate of Wellesley College. She has extensive experience with Canadian universities, including at Carleton University, where she was the Executive Director of the Global Academy. She lived and worked in Japan for four years and speaks Japanese fluently. Diana has the designation as a certified Chartered Director from The Directors College, a joint venture of The Conference Board of Canada and McMaster University. She has recently published a book on the natural health philosophy of W. Gifford-Jones, called No Nonsense Health – Naturally!

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