Hope

Age at interview: 75

Brief Outline:

Hope currently self-manages a suspected uterine prolapse (when the uterus slips down into or out of the vagina). Her symptoms have shown some improvement from pelvic floor exercises and oestrogen cream. While Hope hasn't felt much emotional impact, she worries about becoming inactive as she ages.

Background:

Hope lives with her husband and has two adult children. She enjoys walking and playing with her grandsons. Her ethnicity is White-Scottish. 

Condition: pelvic organ prolapse

More about me...

Hope first noticed that something was off around two years ago after having a urinary tract infection that never fully cleared up. Hope continued to feel pelvic irritation and had urinary urgency, which settled into a “kind of constant discomfort”. While she wasn’t experiencing pain, Hope felt a consistent dragging, as if there was “something there that shouldn’t be”.

A few months into her symptoms, Hope began to suspect that she had a pelvic organ prolapse. She first went to the NHS website, which she considers a reliable source of medical information. Hope later spoke to her GP over the phone, who agreed with Hope’s self-diagnosis and recommended pelvic floor exercises. As a result of Covid-19 pandemic, Hope has been unable to have an in-person examination.

Hope regularly did pelvic floor exercises for several months following her doctor’s guidance. She felt there was some improvement, but this “seemed to diminish somewhat” over time. Once her symptoms started to worsen, Hope sought more information online. She came across topical oestrogen cream, which her GP readily prescribed upon Hope’s request. The cream has brought about “some slight improvement”.

Hope has considered the future option of a hysterectomy but plans on waiting until she’s “explored every other avenue first”. While she finds this surgery “daunting”, she thinks it would likely be more effective than other treatment options. Hope is aware of pessaries but finds the idea of having it inserted and removed regularly “slightly unpleasant”. While she hadn’t initially considered pelvic floor physiotherapy, Hope thinks that she may have been “too defeatist” and that this may be worth pursuing. She thinks seeing a physiotherapist in the future may help her stay motivated and be confident that she’s on the right track with pelvic floor exercises.

Currently, Hope finds that her discomfort fluctuates but is a “constant nuisance”. Hope has found it unfortunate that her symptoms make activity more difficult. She believes exercise is necessary to stay “moderately fit or alive even” at her age. She still aims for walking 10,000 steps a day and manages to achieve these most days. Going on walks can make her vaginal discomfort more severe, so she has found ways to adapt her gait. When she goes into town, Hope plans around her urinary frequency. She typically avoids longer trips, as it can be “awkward” to need to find a lavatory.

Hope hasn’t felt emotionally affected by her prolapse. She thinks this is likely related to being sexually inactive. If she had been younger, it might have caused her to see herself differently. Her husband has been “sympathetic” throughout, and Hope feels able to talk to him about her prolapse. She has spoken to a few people about her prolapse but hasn’t found anyone with the same condition.

While Hope has yet to receive medical care for her prolapse, she hopes that her care will consider her individual needs. Hope would like to see healthcare providers give prolapse patients the full range of options beyond pelvic floor exercises. While doing a pelvic floor regimen, Hope found that the correct way of tensing was “a little bit mysterious” and that it was hard to stay disciplined. She thinks it would be helpful if women were taught about pelvic floor strength at younger ages to prevent the onset of problems. To women navigating care for prolapse, Hope recommends seeking out information about all of the treatment routes available.

Hope looked online for information about her symptoms before contacting her GP. The doctor agreed she probably had prolapse, and signposted her to some online resources about pelvic floor exercise.

Well I think after, after perhaps a couple of months of experiencing these symptoms I obviously suspected it could possibly be a prolapse and I think the first thing I would do would have been to look up an NHS website, possibly other websites that I felt were-, were reliable and it did lead me to think that probably a prolapse was what I was experiencing and that gave me some information. I probably after a while, I decided I would speak to my GP about it, which I did. It was a telephone appointment, as so many are in the time of the Covid pandemic and the GP told me, suggested that she agreed with the diagnosis, it probably was a prolapse and she said, she implied that pelvic floor exercises were kind of more or less all that could be done certainly for the time being so- she, I think she pointed me in the direction of a YouTube video showing how to do the pelvic floor exercises. Also, the NHS website I think has a link to a video talk, describing pelvic floor exercises, so all that is quite useful.

 

Hope wondered why oestrogen cream hadn’t been brought up as an option earlier.

I kind of wish my healthcare provider had mentioned more options the first time it was, it’s so called diagnosed over the phone and I thought it would have done no harm to have mentioned the oestrogen ointment because that’s, as I understand it, completely safe to take and really because after menopause that has such an effect, lack of oestrogen has quite a lot of effect I think on the, in that region, in the pelvic floor region, in the organs there so I think there’s be no harm in offering that kind of almost routinely to someone who have, who mentioned prolapse but that wasn’t mentioned to me, I had to bring it up and ask for it. So, perhaps if they were, it was suggested to healthcare providers that they could mention a, a range of options to patients and that could be one of the options perhaps.