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What Causes Pelvic Organ Prolapse Postpartum?
Question: Hello,
I am a 57 years old female. I am in a committed relationship for 5 years.
I was divorced 23 years ago. I gave birth to one child, but had 3 abortions (not medical necessity abortions).
This is my first relationship since I got divorced. I did not have any sexual relationship for 18 years.
3 years ago my partner told me that my vagina was very loose and he could not satisfy him. I was devastated.
But I also realized why sex was not the same as before for me also.
My partner suggested that I had many sex partners in the past and my vagina got loose due to too much sex. On the contrary , I had no sex after I got divorced till I met him. I read somewhere that lack of sex and lack of orgasm may cause loose vagina. Is this true?
I tired a lot of things to fix my vagina (kegels, Asian balls, electrical stimulation etc.) but I was so depressed about it that I did not follow through with anything I started.
Since then we worked things out and decided that our love and our relationship is very important to us and we decided to stay together with a lifetime commitment.
Having said all that, I still like sex and I still feel young. I want to enjoy sex like I used to and satisfy my partner. I will be sixty soon. Is there any hope for me to tighten my vagina if I seriously commit to it? Thank you.
I am a 57 years old female. I am in a committed relationship for 5 years.
I was divorced 23 years ago. I gave birth to one child, but had 3 abortions (not medical necessity abortions).
This is my first relationship since I got divorced. I did not have any sexual relationship for 18 years.
3 years ago my partner told me that my vagina was very loose and he could not satisfy him. I was devastated.
But I also realized why sex was not the same as before for me also.
My partner suggested that I had many sex partners in the past and my vagina got loose due to too much sex. On the contrary , I had no sex after I got divorced till I met him. I read somewhere that lack of sex and lack of orgasm may cause loose vagina. Is this true?
I tired a lot of things to fix my vagina (kegels, Asian balls, electrical stimulation etc.) but I was so depressed about it that I did not follow through with anything I started.
Since then we worked things out and decided that our love and our relationship is very important to us and we decided to stay together with a lifetime commitment.
Having said all that, I still like sex and I still feel young. I want to enjoy sex like I used to and satisfy my partner. I will be sixty soon. Is there any hope for me to tighten my vagina if I seriously commit to it? Thank you.
Brief Answer:
Pelvic muscles exercises
Detailed Answer:
Dear XXXX,
I do empathize your problem and feelings. I will definitely try to help you in this matter.
It is not necessary to have many sexual partners for the vagina to become loose. In fact too much stretching of vagina during vaginal delivery may render the vagina loose.
Vagina is not an open tunnel. It is a closed space having potential to open as per the object in it. The tightness of the vagina during sex depends upon the tone of the pelvic muscles.
In fact, at the menopausal age, the vagina becomes dry and hence the penile insertion may be difficult. Therefore, many couples use vaginal lubricant during sex at this age. Too much application of lubricant may not give the penis a feeling of vaginal tightness. Also at this age, the pelvic muscles do become supple rendering the vagina rather loose.
Also it is likely that at this age, your partner may not be having full hard erection. Therefore he might not be feeling the tightness in the vagina. Please try to assess his erection and hardness during next session of intercourse with him.
Till you answer my points, I would give you some advice which might help you:
1. Daily do pelvic muscle exercise - three times a day for 5 minutes each. Contraction and slow relaxation of the muscles.
2. If you are using lubricant, please use moderate quantity - sufficient only for easy penile insertion.
3. During intercourse, after the penis has entered the vagina, go on contracting and relaxing pelvic muscles as hard as possible.
4. Clitoral stimulation (not dry) might stimulate such contractions.
5. Get examined from a Gynaecologist to assess whether you have genital prolapse or rectocoele. These conditions may need surgical correction.
Please get back with more information on the issues I have raised for more detailed discussion. For any more information, I am always available for you, XXXX.
Dr. Nishikant Shrotri
Pelvic muscles exercises
Detailed Answer:
Dear XXXX,
I do empathize your problem and feelings. I will definitely try to help you in this matter.
It is not necessary to have many sexual partners for the vagina to become loose. In fact too much stretching of vagina during vaginal delivery may render the vagina loose.
Vagina is not an open tunnel. It is a closed space having potential to open as per the object in it. The tightness of the vagina during sex depends upon the tone of the pelvic muscles.
In fact, at the menopausal age, the vagina becomes dry and hence the penile insertion may be difficult. Therefore, many couples use vaginal lubricant during sex at this age. Too much application of lubricant may not give the penis a feeling of vaginal tightness. Also at this age, the pelvic muscles do become supple rendering the vagina rather loose.
Also it is likely that at this age, your partner may not be having full hard erection. Therefore he might not be feeling the tightness in the vagina. Please try to assess his erection and hardness during next session of intercourse with him.
Till you answer my points, I would give you some advice which might help you:
1. Daily do pelvic muscle exercise - three times a day for 5 minutes each. Contraction and slow relaxation of the muscles.
2. If you are using lubricant, please use moderate quantity - sufficient only for easy penile insertion.
3. During intercourse, after the penis has entered the vagina, go on contracting and relaxing pelvic muscles as hard as possible.
4. Clitoral stimulation (not dry) might stimulate such contractions.
5. Get examined from a Gynaecologist to assess whether you have genital prolapse or rectocoele. These conditions may need surgical correction.
Please get back with more information on the issues I have raised for more detailed discussion. For any more information, I am always available for you, XXXX.
Dr. Nishikant Shrotri
Above answer was peer-reviewed by :
Dr. Priyanka G Raj
Dear Doctor,
Thank you so much for helping. I really appreciate your time and your expertise. I will follow your advice.
Meanwhile, I apologize that this will be a long follow up letter, because I went to different doctors before but I never had the comfort level to talk about EVERYTHING like I needed to with any of them.
I have questions because, I am trying to determine at my age should I even pursue a treatment.
At my age if I don't have a good shot at it I don't want to keep trying just to find out that there is really nothing I can do. I don't want to waste my time. I want to focus on other positive thing in life.
So , here are the things that are bothering me:
1. Between my divorce in 1993 and till I met my partner in 2011, I did not have any sexual activity. You know how they say, "if you don't use it, you will loose it".
Is it true that lack of sexual activity and lack of orgasms will cause vagina muscles to get loose?
If it is true, could more sexual activity and more orgasms be helpful at my age?
2. I gave birth in 1990. Would that be enough time for my vagina to heal from negative impact of child birth?
However, after my childbirth I had 3 abortions while I was married. Is it possible that 3 abortions damaged my vagina?
3. I don't use lubricant. Although I am past menopause I don't have dryness problem. On the contrary, I get very wet and slippery, that's when I feel loose. Which I suspect is because of from urine leak.
First I went to a gynecologist. She said that I did not have prolapse. She said that I was normal. She suggested that HE was not fully erected.
I was not satisfied with this because I still was feeling incontinence. I sometimes do the pee test in the bathroom and I cannot hold my pee.
Next I went to an urologist. A registered nurse examined me and said my muscle tightness was good. She sent me to a PT.
PT also said that my muscles were not bad. Suggested Kegels. Honestly, I was so depressed because we were fighting with my partner all the time, I could not concentrate and be dedicated to doing kegels.
Next PT advised me to get an electrical stimulator. It is a XXXXXXX PELVIC FLOOR EXERCISER SYSTEM. PT showed me how to use it one time. When I try it at home I am not sure if I am using it properly. I am afraid of damaging myself while trying to treat myself.
Next I went to another doctor who had expertise in gynecology and urology. He also said that the opening muscles were in good shape but in deeper walls may be weak. He gave me ESTRACE (estradiol vaginal cream) for a 3 months treatment. In the beginning this doctor told me that he could correct things with surgery. But during later visits it seemed like he was having second thoughts about surgery. Finally he said that a surgery might cause things to get TOO TIGHT. He said that many women at my age would kill to have my tightness (??) But I objected that I was still leaking so there was something wrong. At that time he suggested that I went back to the urologist.
Next I got laid off from my job, lost my health benefit and could not go back to urologist, couldn't even refill the estrace cream. But I am going to start my new job in couple months and will have health benefits in 5 months.
Meanwhile, we worked our differences with my partner. He said that he wanted to be with ME for a lifetime, but NO OTHER woman.
Now that I can look into this without getting emotional, I want to know what my options are. I really suspect that my urinary incontinence has something to do with it.
4. I get strong orgasms when I masturbate. Is accurate for me think that I still can be sexually active?
5. Should I continue using my electric stimulator?
Or should I use a KegelMaster or Gyneflex which are not electric but have resistance?
I also have XXXXXXX Wa balls too, but I am not strong enough to work with them.
I am so confused that all these doctors are telling me that I don't have a problem but I cannot do the pee test nor I can exercise with the pelvic balls. (??)
You mentioned surgical correction also. Can surgery help me?
6. I keep going to the same question, at age 57, do I have a shot at this or should I stop trying?
Thank you very much for your time. Now that I got everything out of my system my next question will not be this long :)
Sincerely,
Thank you so much for helping. I really appreciate your time and your expertise. I will follow your advice.
Meanwhile, I apologize that this will be a long follow up letter, because I went to different doctors before but I never had the comfort level to talk about EVERYTHING like I needed to with any of them.
I have questions because, I am trying to determine at my age should I even pursue a treatment.
At my age if I don't have a good shot at it I don't want to keep trying just to find out that there is really nothing I can do. I don't want to waste my time. I want to focus on other positive thing in life.
So , here are the things that are bothering me:
1. Between my divorce in 1993 and till I met my partner in 2011, I did not have any sexual activity. You know how they say, "if you don't use it, you will loose it".
Is it true that lack of sexual activity and lack of orgasms will cause vagina muscles to get loose?
If it is true, could more sexual activity and more orgasms be helpful at my age?
2. I gave birth in 1990. Would that be enough time for my vagina to heal from negative impact of child birth?
However, after my childbirth I had 3 abortions while I was married. Is it possible that 3 abortions damaged my vagina?
3. I don't use lubricant. Although I am past menopause I don't have dryness problem. On the contrary, I get very wet and slippery, that's when I feel loose. Which I suspect is because of from urine leak.
First I went to a gynecologist. She said that I did not have prolapse. She said that I was normal. She suggested that HE was not fully erected.
I was not satisfied with this because I still was feeling incontinence. I sometimes do the pee test in the bathroom and I cannot hold my pee.
Next I went to an urologist. A registered nurse examined me and said my muscle tightness was good. She sent me to a PT.
PT also said that my muscles were not bad. Suggested Kegels. Honestly, I was so depressed because we were fighting with my partner all the time, I could not concentrate and be dedicated to doing kegels.
Next PT advised me to get an electrical stimulator. It is a XXXXXXX PELVIC FLOOR EXERCISER SYSTEM. PT showed me how to use it one time. When I try it at home I am not sure if I am using it properly. I am afraid of damaging myself while trying to treat myself.
Next I went to another doctor who had expertise in gynecology and urology. He also said that the opening muscles were in good shape but in deeper walls may be weak. He gave me ESTRACE (estradiol vaginal cream) for a 3 months treatment. In the beginning this doctor told me that he could correct things with surgery. But during later visits it seemed like he was having second thoughts about surgery. Finally he said that a surgery might cause things to get TOO TIGHT. He said that many women at my age would kill to have my tightness (??) But I objected that I was still leaking so there was something wrong. At that time he suggested that I went back to the urologist.
Next I got laid off from my job, lost my health benefit and could not go back to urologist, couldn't even refill the estrace cream. But I am going to start my new job in couple months and will have health benefits in 5 months.
Meanwhile, we worked our differences with my partner. He said that he wanted to be with ME for a lifetime, but NO OTHER woman.
Now that I can look into this without getting emotional, I want to know what my options are. I really suspect that my urinary incontinence has something to do with it.
4. I get strong orgasms when I masturbate. Is accurate for me think that I still can be sexually active?
5. Should I continue using my electric stimulator?
Or should I use a KegelMaster or Gyneflex which are not electric but have resistance?
I also have XXXXXXX Wa balls too, but I am not strong enough to work with them.
I am so confused that all these doctors are telling me that I don't have a problem but I cannot do the pee test nor I can exercise with the pelvic balls. (??)
You mentioned surgical correction also. Can surgery help me?
6. I keep going to the same question, at age 57, do I have a shot at this or should I stop trying?
Thank you very much for your time. Now that I got everything out of my system my next question will not be this long :)
Sincerely,
Brief Answer:
You will enjoy your sexual life
Detailed Answer:
Dear XXXX,
You need not be apologetic; in fact I appreciate your detailed exhaustive history.
At the outset, let me clarify you about one misbelief: Women cease to have their sexual life after menopause. It is not so. The women can and do continue to have their sexual life with full enjoyment to both the partners many years after menopause. In fact, to have a sexual desire or urge (libido) is a function of the mind while to perform sex is the function of the body. If the mind wants it, there are ways to find solution for physical limitations, if any.
Now let me clarify your doubts one by one.
These many years are more than sufficient for the reproductory system to regain its strength to its pre-pregnant state. However, if there is any physical damage, it has to be repaired actively rather than letting it heal of its own optimistically.
What you mentioned is in a way correct. There is something called as disuse atrophy; meaning thereby that unused organs become lethargic. Therefore I had advised you pelvic muscle exercises.
If you are having copious wetness, it is good sign which proves that you are not depleted of Oestrogen. Moreover, you get strong orgasm while masturbating. Again a good sign. Is it clitoral masturbation or vaginal masturbation? If vaginal, are you using too large a dildo? Can you specify the size of the dildo. Too big a dildo may render vaginal and pelvic muscles stretched. This might result into 'looseness' of vagina.
You might seriously think of surgical approximation of Levator muscles with tightening of perineal muscles if your Gynaecologist feels so. It will not make your vagina 'too tight'. The repair can be done by discretion and under control.
You have mentioned about Urinary incontinence. This proves that there is weakness in your pelvic muscles - may be only anteriorly at the urinary system or may be (mostly) posteriorly also. Do you have any bowel problems? Please get this urinary incontinence issue solved; it may help you increase the tone of the pelvic diaphragm. If required, you may opt for surgical intervention.
I would advise you to continue with vaginal and pelvic muscle exercises (physiotherapy). However, please do not use to oversized intravaginal gadgets which may stretch the muscles to such an extent that you are not in a position to contract your muscles with good force. You have to increase the tone of the muscles. KegelMaster or Gyneflex are good for the purpose. Even you may use your own fingers which can assess the tonicity of the muscles.
And finally let me assure you, you do not have to forego your sexual life. You can and will enjoy it and also will give satisfaction to your partner. I would like you to refer to an XXXXXXX book of sexuality science which is world famous for centuries together. Kamsutra written by Vatsyayan is available in many languages in the world, definitely available in English. After you read it, we may discuss many of your sexual issues more in details.
Please feel free to communicate with your doubts to me any number of times and I shall be trying my level best to help you out in this embarrassing situation. I feel you are finding this communication satisfactory and useful So would you mind posting a good review with 5 stars rating for me?
Dr. Nishikant Shrotri
You will enjoy your sexual life
Detailed Answer:
Dear XXXX,
You need not be apologetic; in fact I appreciate your detailed exhaustive history.
At the outset, let me clarify you about one misbelief: Women cease to have their sexual life after menopause. It is not so. The women can and do continue to have their sexual life with full enjoyment to both the partners many years after menopause. In fact, to have a sexual desire or urge (libido) is a function of the mind while to perform sex is the function of the body. If the mind wants it, there are ways to find solution for physical limitations, if any.
Now let me clarify your doubts one by one.
These many years are more than sufficient for the reproductory system to regain its strength to its pre-pregnant state. However, if there is any physical damage, it has to be repaired actively rather than letting it heal of its own optimistically.
What you mentioned is in a way correct. There is something called as disuse atrophy; meaning thereby that unused organs become lethargic. Therefore I had advised you pelvic muscle exercises.
If you are having copious wetness, it is good sign which proves that you are not depleted of Oestrogen. Moreover, you get strong orgasm while masturbating. Again a good sign. Is it clitoral masturbation or vaginal masturbation? If vaginal, are you using too large a dildo? Can you specify the size of the dildo. Too big a dildo may render vaginal and pelvic muscles stretched. This might result into 'looseness' of vagina.
You might seriously think of surgical approximation of Levator muscles with tightening of perineal muscles if your Gynaecologist feels so. It will not make your vagina 'too tight'. The repair can be done by discretion and under control.
You have mentioned about Urinary incontinence. This proves that there is weakness in your pelvic muscles - may be only anteriorly at the urinary system or may be (mostly) posteriorly also. Do you have any bowel problems? Please get this urinary incontinence issue solved; it may help you increase the tone of the pelvic diaphragm. If required, you may opt for surgical intervention.
I would advise you to continue with vaginal and pelvic muscle exercises (physiotherapy). However, please do not use to oversized intravaginal gadgets which may stretch the muscles to such an extent that you are not in a position to contract your muscles with good force. You have to increase the tone of the muscles. KegelMaster or Gyneflex are good for the purpose. Even you may use your own fingers which can assess the tonicity of the muscles.
And finally let me assure you, you do not have to forego your sexual life. You can and will enjoy it and also will give satisfaction to your partner. I would like you to refer to an XXXXXXX book of sexuality science which is world famous for centuries together. Kamsutra written by Vatsyayan is available in many languages in the world, definitely available in English. After you read it, we may discuss many of your sexual issues more in details.
Please feel free to communicate with your doubts to me any number of times and I shall be trying my level best to help you out in this embarrassing situation. I feel you are finding this communication satisfactory and useful So would you mind posting a good review with 5 stars rating for me?
Dr. Nishikant Shrotri
Above answer was peer-reviewed by :
Dr. Priyanka G Raj
Thank you very very much. You have been very very helpful. Definitely 5 STARS for this consultation!
To answer your questions:
I do not use a dildo for masturbation. Its is clitoral masturbation. And thank you for the warning on the size of the gadgets.
Also, I don't have bowel incontinence. Have a wonderful week!
Will get the book you suggested and follow up all your advice.
Thanks again! Have a wonderful week!
Dear Doctor,
Please reply to me one more time, so I can click on review. I am very new on this site and I missed to click on close and review. Thanks again.
To answer your questions:
I do not use a dildo for masturbation. Its is clitoral masturbation. And thank you for the warning on the size of the gadgets.
Also, I don't have bowel incontinence. Have a wonderful week!
Will get the book you suggested and follow up all your advice.
Thanks again! Have a wonderful week!
Dear Doctor,
Please reply to me one more time, so I can click on review. I am very new on this site and I missed to click on close and review. Thanks again.
Brief Answer:
Experience vaginal orgasm
Detailed Answer:
Dear XXXX,
I am happy to note that I could appropriately counsel you on your issues.
Let me inform you that even though you have reached clitoral orgasm during the sex, further continuation will take you to vaginal orgasm when both you and your husband will be at the acme of sexual pleasure. If you cannot get details about vaginal orgasm, please revert back so that I can furnish the information. Less than 10% of the women in the world have ever experienced vaginal orgasm.
You have to manage about your urinary incontinence issue.
I thank you for your review about me. However, I have not received the 5 stars rating which you have to click.
For any more guidance, please feel free to ask me anytime, XXXX. I am always available for you.
Dr. Nishikant Shrotri
Experience vaginal orgasm
Detailed Answer:
Dear XXXX,
I am happy to note that I could appropriately counsel you on your issues.
Let me inform you that even though you have reached clitoral orgasm during the sex, further continuation will take you to vaginal orgasm when both you and your husband will be at the acme of sexual pleasure. If you cannot get details about vaginal orgasm, please revert back so that I can furnish the information. Less than 10% of the women in the world have ever experienced vaginal orgasm.
You have to manage about your urinary incontinence issue.
I thank you for your review about me. However, I have not received the 5 stars rating which you have to click.
For any more guidance, please feel free to ask me anytime, XXXX. I am always available for you.
Dr. Nishikant Shrotri
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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