Vaginal health is of notable significance regarding women’s sense of sexual wellness, but is a seldom openly acknowledged or discussed aspect of women’s health. Females typically put their health needs last, whether they are CEOs of large corporate entities, clerks at Walmart, stay-at-home moms, or deeply embedded in medical practice.

Vaginal laxity is an overlooked, often cryptic aspect of health many women find bothersome. Why can’t women bring themselves to talk out loud about vaginal laxity or the “gap”, that gaping vaginal opening and stretched out internal tube of vaginal space that typically occurs after vaginal birth? Vaginal laxity impacts sexual sensation, and women not only have less than satisfying sexual encounters, they also worry whether their partners are. The gap impacts women’s self-esteem in ways that seldom make it into sexual conversation with intimate partners. Discussions seldom occur during pelvic exams. Women worry that their vulva is unattractive and may be a turn-off for their intimate partners.

If you ask any 10 women how they feel about having a hysterectomy, you will likely get 10 completely unique responses, varying between a very strong interest in eliminating periods through horror at sacrificing what is felt to be the core of sexuality and/or femininity. While uterine-sparing surgical procedures are becoming more common to treat uterine prolapse (UP), hysterectomy continues to be the most commonly recommended surgical treatment. While some women reflect on how a hysterectomy will impact their sexuality, few realize it may impact their ability to have an orgasm, or the degree of orgasm intensity. Women experience two types of orgasm: external by means of clitoris stimulation or internal as a result of the thrust of a penis against the cervix within the vaginal canal. Women prefer to keep their orgasms intact and full-bodied regardless which type of orgasm they enjoy, thank you very much.

If you randomly asked any woman whether she would consider having her vagina sewn shut to eliminate a long-term health issue, she’d likely react with horrified silence. Ask any woman who has suffered for years, and in some cases decades, with the discomfort of vaginal tissue bulge, vaginal pressure, or pain with intimacy that often accompanies pelvic organ prolapse (POP), and you might be surprised at the response. These women simply want to feel normal again, and some are willing to do anything to recapture their former quality of life.

One of the symptoms of pelvic organ prolapse that women find highly stigmatizing is fecal incontinence (FI). Regardless when it occurs, women are typically devastated, but when it occurs during an act of intimacy, the impact is difficult to move past. The fear of a repeat episode, the fear of judgement by an intimate partner, the fear of never again having a normal sex life can create a significant roadblock in a woman's life. Fecal incontinence is one of those POP symptoms women struggle to admit to, much less talk about openly. But as in all aspects of POP, it is possible to find balance again, once you understand the right path and a few tools to utilize. A brave patient in APOPS’s following agreed to share her journey in the interests of providing hope for others walking this particular walk.

We women tend to address the needs of everyone ahead of ourselves. We nurture our significant others, feed the kids, walk the dogs, pick up groceries, clean the house, while simultaneously navigating employment. As we address the needs of a multitude of layers that impact personal and family flow, we tend to overlook one of the most significant, how we physically feel. And while we are all aware of the basics in women’s wellness screenings to address breast, heart, diabetes, and menopausal health concerns, current wellness exams seldom effectively evaluate one of the most common conditions impacting women, pelvic organ prolapse.