Exercise has once again proven to be the human body’s very own medicine.

A growing number of studies have found that regular exercise can benefit gut microbes regardless of your diet.

Recent evidence from a number of studies suggest that exa

Why does a prolapse happen?

Essentially a prolapse can result from anything that puts pressure on the pelvic floor, such as:

• Pregnancy and childbirth

• Regularly straining when going to the toilet to pass bowel motions or urine

• Repetitive lifting of heavy weights

• Repetitive lifting of children or grandchildren

• Chronic coughing

Postmenopausal women are more susceptible to prolapse. This is because oestrogen levels decline significantly during perimenopause, falling to extremely low levels after menopause.

Oestrogen helps to keep the pelvic floor muscles toned. Once oestrogen levels drop these muscles become thinner, weaker and less elastic. The vaginal tissues also weaken, meaning the pelvic organs are more likely to bulge into the vagina.

Symptoms of prolapse

The symptoms of prolapse can vary significantly for people and depend on individual factors such as the severity of the prolapse and the level of physical activity. Some symptoms can include:

• A feeling of fullness or pressure in the vagina

• A bulge or swelling the vagina

• A feeling of heaviness or dragging

• Problems completely emptying the bladder or bowel when going to the toilet

• Bladder or bowel urgency or incontinence

• Difficulty starting the flow of urine or a slow flow that starts and stops

• Lower back ache

If you are still menstruating, the symptoms of prolapse can feel worse at different times of your cycle; as well as if you are oestrogen depleted such as after giving birth and for at least the first 6 months of breast feeding.

It can also feel different after exercise or certain daily activities.

Where do I go to seek help?

A prolapse is diagnosed by taking a thorough medical history and do a physical examination. This will help to determine how severe the prolapse is, what organs are involved in the prolapse, and the function of the pelvic floor muscles.

You can start by seeing your General Practitioner, local continence clinic, Gynaecologist or Women’s Health Physiotherapist.

Tips for exercising with a prolapse

Some forms of exercise can make a prolapse worse. If you have a prolapse it is likely that you have weakness in your pelvic floor muscles and supportive tissues. Exercise places downward pressure on the pelvic floor. If the pressure is too great for the pelvic floor to withstand, it can contribute to stretching, and further weakening of the muscles and supportive tissues and make them less able to support your already prolapsed organs.

If you have a prolapse, it is important to consider if the exercise you are doing is safe. Additionally, some exercises can help to support the prolapse.

Some key questions to ask yourself:

1. How much downward pressure or strain does this exercise have on my pelvic floor?

2. How strong and well-functioning is my pelvic floor?

Some general tips are:

• Avoid or reduce high impact exercise ‘

  o This includes running, jumping, skipping etc

• Integrate low impact exercise

  o Walking

  o Road cycling

  o Water based exercise (e.g. deep water running)

  o Indoor cycling (stay seated and choose low gears)

  o Low impact fitness classes

• Try stepping instead of jumping in your group exercise classes

• Maintain a good posture

• Be mindful of your strength exercises:

  o Reduce the amount of weight or resistance you are using

  o Avoid holding your breath (exhale with effort)

  o Choose supported positions when using weights i.e. lying or sitting when using hand weights

  o Avoid wide leg deep squats

• Be mindful of abdominal or core exercises. Avoid or modify:

  o Traditional or weighted sit-ups or crunches

  o Traditional pilates Hundreds

  o Traditional Planks

• Integrate extra rest breaks into your routine as needed, or reduce the number of reps you do

What about pelvic floor exercises?

Pelvic floor muscle exercises are important and do have a role in improving motor control and function of the pelvic floor; however, these exercises alone are unlikely to improve your prolapse.

The management and prevention of prolapse includes a range of interventions, best overseen by a suitably qualified health professional such as your GP, Gynaecologist, Continence professional or Women’s Health Physiotherapist.

Where to get more information

For more about pelvic organ prolapse in general, or how to safely exercise with a prolapse, try:

1. Jean Hailes for Womens Health

2. Pelvic Floor First

3. The Continence Foundation of Australia

4. Exercise Right

ercise can enhance the number of beneficial microbial species and improve microflora diversity. These changes could provide benefits to health and disease prevention.

In one particular study from the University of Illinois, co-authored by Jeffrey Woods, researchers found that exercising for just six weeks could have an impact on your gut’s microbiome. In the study, 32 sedentary adults completed an exercise program consisting of cardiovascular exercises for 30-60 minutes three times a week for six weeks. They sampled the participants gut microbiomes before and after the program and found that many participants had an increase in gut microbes that assist in the production of short-chain fatty acids. These acids are produced when the friendly gut bacteria ferment fiber in your colon, and are the main source of energy for the cells there. They also reduce the risk of inflammatory diseases as well as type 2 diabetes, obesity, and heart disease.

After the initial period of six weeks, the participants then returned to six weeks of their normal sedentary lifestyle. When the researchers sampled participants’ microbiomes again, they found the microbiomes had reverted back to how they were before the period of exercise.

“This tells us that exercise needs to be done regularly and that stopping exercise causes reversion, not surprising as this is evident in other exercise training-induced adaptations in other tissues like muscle,” Woods explained.

Similar results have been replicated in several other studies and have shown that exercise alters gut microbiota composition, functional capacity, and metabolites. What remains unknown is the effects of different exercise frequencies, types, and intensities. What is clear is the link between exercise and gut microbes shows that the rewards of physical activity go beyond burning calories and boosting fitness. All the more reason to get moving.