My ob-gyn snapped her rubber gloves off and told me the “good news.” My uterus was not falling out.
“The bad news,” she continued, “is that your vagina is falling out.”
I knew something was obviously wrong but when I heard the inconceivable diagnosis, I had to lie back down on the stirruped table. The night before I had shot up from the passenger seat in pain, convinced I must have sat on a hairbrush left carelessly on the seat, only to realize the mass was actually inside my pants.
I sprinted into the house, ripped off my jeans, and cupped my hand over my underwear. Bulge.
The room started spinning as I stumbled to the bathroom and pulled down my undies, terrified I was unknowingly pregnant and giving birth. There was no baby, but there was definitely…something. I called my doctor frantically, screaming. She asked me a few questions to ensure I was safe, then directed me to use my fingers to shove the protruding flesh back in, and to come to her office first thing the next morning.
“My vagina is literally falling out?” I repeated back to her in disbelief from the exam room.
“Just a little,” she said reassuringly. “A small surgery should fix it.” A “little” bit of vagina falling out? A “small” surgery? I was far from comforted.
My doctor pulled out a brochure, circling my condition: vaginal prolapse.
My doctor explained that childbirth and age had weakened my vaginal walls. When the muscles of the pelvic floor and layers of connective tissue (which are called fascia) become stretched or are torn, any or multiple pelvic organs—which include the bladder, uterus, vagina, and rectum—may fall downward.
The condition is more common than you might think: Harvard Health reports that “if you’re over 50, half of your contemporaries have pelvic organ prolapse, although they probably aren’t talking about it.” Approximately 50 percent of women will experience some degree of pelvic organ prolapse (POP) in their lifetimes, according to University of Chicago Medicine, though only about 12 percent of American women end up needing surgery to correct it.
Often, prolapse occurs in stages, with mild cases characterized by those in which the organs have dropped only a short distance. In more severe cases like mine, women may actually feel or see tissue coming out of the opening of their vagina, which is from prolapsing vaginal walls, the cervix, or even the uterus.
According to the American College of Obstetricians and Gynecologists, some prolapse cases are triggered by surgeries such as hysterectomies. (When the uterus is removed, there is opportunity for additional complications, like the dropping of the small intestine.) Menopause and family history can also play a role.
My doctor told me I hadn’t done anything to cause this like wild sex or too much exercise (lifting heavy weights can be a cause but that’s not my workout routine). Most likely, my prolapse was just a result of my two pregnancies and vaginal deliveries combined with my age of 43.
Fortunately, prolapse is fixable. Treatments for milder cases can include pelvic floor physical therapy and Kegel exercises or the use of pessaries: custom-fitted silicone devices that are inserted in the vagina to lift pelvic organs. If I planned to have more children, my doctor would have recommended I try these options, but she cautioned pessaries had to be changed often, by the doctor or the patient.
My bulge was extremely uncomfortable, but still I inquired about postponing the surgery. Perhaps indefinitely. My doctor explained that while prolapse in not typically life-threatening, it can lead to urinary or fecal incontinence, difficulty going to the bathroom, and painful sex. My case had already progressed rapidly, so other treatments would not suffice.
The outpatient surgery was unavoidable. I’d have to take a week off of work and there’d be no sex, no bathing, no carrying more than a couple of pounds for eight weeks. How would I care for my two kids, especially when I wouldn’t be able to lift my two-year-old into her car seat, highchair, and crib?
“I know how hard the last few years have been on you,” my doctor said, resting her arm on my shoulder. During my last pregnancy, I’d come in to see her at least once a month for checkups, and each appointment would end with me wiping snot and mascara off of my face. She knew that my sister’s marriage had collapsed, and I was trying to help her pick up the pieces. That my healthy, work-out-every-morning dad ended up in the hospital, mostly paralyzed, with a life-threatening autoimmune condition that he would never fully recover from.
She had witnessed my wails of despair. My exhaustion from trying to keep my entire family up and running. Monitoring my dad’s business emails, helping my mom juggle online banking, watching my sister’s kids, so she could have a few minutes to breathe. She had heard my fear that all of this stress would threaten my pregnancy, my baby. My concern that my then 4-year-old and husband weren’t getting the best of me. My dread that nothing would get better.
My ob-gyn also knew how hard I’d been struggling in the two years since I had my second baby. I was sleep-deprived and out of shape. My husband was a huge help with the day-to-day, but I was inconsolable. I willed myself out of bed each morning, with trepidation, waiting for the next catastrophe.
“You’ve been trying to be there for everyone,” she said gently. “I know you’ve been trying to keep it together.” But there was no denying the truth. As I stood there, my body was exposing my secret: I was actually falling apart.
So what do you do in life when the bottom literally falls out? I’d already muscled through so many challenges. I thought I had been heroic by carrying on, determined not to let my family down or my commitments slide. In exchange, though, I’d become a shell of the fun, witty woman I used to be. I powered through, but at what cost? I was tired, bitter, 20-pounds heavier, and while I was getting tasks done, I was miserable, and running myself into the ground.
My stress didn’t directly cause my vaginal prolapse, but I felt confident that if I didn’t handle this crisis differently than all the rest, things would only get worse for me, mentally and physically. I was intent on coming out the other side of this surgery with not only a new and improved vagina, but an upgraded life, as well.
My first decision was to raise the white flag and ask for help. A lot of it. Immediately I called my husband, my sister, and my mom, the three people I’d attempted to be the strongest for. I told them about my upcoming surgery and my limitations to follow. I fought off every urge to reassure them that I had everything covered, instead accepting their offers of assistance. My mom would fly in to help with the day-to-day. My sister would babysit during surgery. My husband would arrange his real estate clients around me, popping home each morning and afternoon to do the “heavy lifting” for the months ahead.
“But babe,” I said regretfully, “the doctor said no sex either.” He almost sounded hurt when he responded, “Are you kidding? I may have the sex drive of an 18-year-old, but I don’t care if we could never have sex again, as long as you’re okay and we’re together.” My husband will be the first to tell you he’s not typically deep. He has no interest in talking about the meaning of life, and while he’s smart and extremely informed, he rarely gets passionate about anything. He’s not the type to write a love letter, but to me this felt like poetry.
I was worried when I sat with my 6- and 2-year-olds to tell them how “worthless” I’d be the next few months. I laughed when I said it, but I felt tears clouding my eyes. I saw my older daughter’s disappointment that we wouldn’t spend the summer swimming, that there would be no piggy-back rides.
There was silence for a few moments, until she anxiously asked, “But can you still cuddle, Mommy?”
“Definitely,” I replied, my heart swelling.
“We’ll all take care of you,” she continued. “Right Daddy?” My husband smiled and nodded.
I hugged them all and cried. Worried for all of the support I’d need, but grateful that I’d undoubtedly receive it. I had to take this opportunity to put myself back together.
Within a couple of weeks, my doctor had fixed my broken vagina. It was still up to me to do the rest.
Felice Keller Becker is an LA-based freelance writer specializing in health and wellness, parenting, and entertainment. She’s also a songwriter, who worked as an on-air music reporter for Sirius/XM radio. You can see more of her writing here.
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