Women often complain about a foreign body sensation, pressure or heaviness inside the vagina after childbirth.
Should I worry?
In the puerperium (within 6 weeks after giving birth) it is common for the soft tissues including muscles and ligaments to stretch and feel unsupportive. These structures are still rapidly regenerating during this time. It is very important, therefore, for the mother to rest her body , allowing for healing to happen. You can do this by spending time lying flat, allowing the pelvis to be in a position where gravity does not put an extra load on it. If possible, it is great to breastfeed in a side lying position or when you have a free minute to lie on your back with a pillow under the pelvis.
When should I seek help?
If you continue to feel this dragging or heaviness after 6 weeks, if it came on spontaneously, or did not start immediately after childbirth but started after strenuous exercise, it is a good idea to seek a specialist’s help. It may be due to some grade of pelvic organ prolapse: This may continue to get better spontaneously within the first 3 months postpartum. Sometimes, heaviness can be a sign of tight, overactive muscles.
Therapy
Seeing a urogynecologist or a gynecologist specialized in pelvic organ prolapse and pelvic floor muscles is a good start. They can help determine the grade of the prolapse, if one is present, and help with conservative therapy including lifestyle modifications and pessary therapy. Pessaries are supportive devices placed inside the vagina to help position the organs closer to their original location and offload the pelvic floor muscles. You can learn to insert and take out the pessary yourself, allowing for sexual intercourse without the pessary.
Pelvic floor physiotherapy is essential if you feel pressure in the vagina. If it is caused by weak, lengthened muscles, then connecting mind and muscles, strengthening the muscles in and around the pelvis and the deep layer of the abdominal muscles is necessary. If the sensation is due to tension building up in the pelvic floor muscles, Kegel exercises can actually worsen symptoms. Breathing techniques, muscle relaxation, hip mobility exercises etc. are the therapy of choice. If you have trouble managing stress in your everyday life and that is contributing to the tension, it may be helpful to involve a psychologist as well.
By Zsofia Agg
