By Dr. Rita Khanna
Prolapse is a very common problem for women, but very few women are aware of the possibility of doing something about it. Apart from surgical correction, there are many Yogic techniques, which help to reintegrate the pelvic structure and which often prove more beneficial in the long run than surgical intervention. Before taking any major steps towards removing this problem, it is important that we understand what prolapse is and how it comes about.
WHAT IS PROLAPSE
Prolapse is the falling out of place of the internal organs in the pelvic region of the body. Sometimes, organs move from their original position and impinge on other parts in the pelvic cavity. There are many types of Prolapse, but two are very common. They are Prolapse of the rectum and Prolapse of the bladder.
1. RECTOCELE (PROLAPSE OF THE RECTUM)
In Rectocele, parts of the body involved are vagina, rectum, muscle and tissue separating and supporting the rectum and vagina. A rectocele usually occurs if the lower part of the vagina becomes weak; when this happens the rectum can then bulge into the vagina. The rectum may collapse into, or even beyond, the external anal sphincter, causing lower back pain on defecation, and irritation -with some pain in the anal area. The uterus may drop from its original position into the vagina, or in severe cases, protrude externally. This is not painful, only a dull ache in the lower back is apparent. This condition is associated with frequency, or inability to control the flow of urine, so it may be passed when you laugh or cough.
Normally, the uterus is anteverted, facing forward, but it may turn backward and lie against the rectum, in which case, it has retroverted. This may be a congenital condition (a malformation which one is born with) or it may develop later from strenuous lifting, etc. If a retroverted uterus impinges on the rectum, it produces the symptoms of constipation and an uncomfortable sensation when seated or pain when having sex. In pregnancy, it can lead to miscarriage.
2. CYSTOCELE (PROLAPSE OF THE BLADDER)
In cystocele, parts of the body involved are vagina, bladder, muscle and tissue = separating and supporting the bladder and vagina. With the bladder sitting directly on top of the vagina, if there is weakness at the top of the vagina, then sometimes the bladder can drop and bulge into the vagina. The bulge happens through a defect in the fascia (This is the connective tissue that separates the vagina from the bladder). A bulge of this type is called an anterior prolapsed and indicates problems with pelvic support tissues (fascia, ligaments, and muscle). The symptom presented in cystocele is frequency of urine because the bladder can never be fully emptied; urine retention (known as stasis) also occurs, giving rise to recurring bladder infections.
HOW IT COMES ABOUT
The pelvic contents collapse because weakened ligaments and muscles fail to hold the organs in their correct position. The ligaments are fibrous structures and resemble strong ropes. These are attached to the bony pelvic wall and form a network in the pelvic floor, offering their support to organs and anchoring them in position. The central point of this ligamentous and muscular framework is the perineal body, a fibro-muscular node lying approximately two inches inside the body above the perineum (the area between the anus and vagina). From this node, eight important muscles and their ligaments arise, in addition to connecting fibers to the rectal and anal canal. If this is damaged, the function of the whole supporting system is affected, and the organs drop out of place. This allows gravity, another influence exerting itself on the pelvic area, to have an effect too. Gravity pulls and draws the organs downward, and due to impaired support, they are unable to resist its force.
CAUSES
The cause of weakened ligaments and muscles is often from childbirth or may occur due to constipation or frequent bouts of diarrhea. At the time of childbirth, excessive energy is used and a tremendous amount of stress and strain is brought to bear upon the floor of the pelvis. In cases of diarrhea or constipation, this is also true. So, these muscles need to be strong to facilitate the tremendous strain that is brought to bear on them during these periods. In prolapse, this strain is so great that some muscles and ligaments are unable to withstand it, and they either stretch or tear.
Though there is not a lot of pain associated with these conditions, continual discomfort is experienced, which tends to make you very concerned about yourself. An understanding of your inner framework and what brings about these conditions, is helpful in alleviating anxiety, and enables you to confront the problem with common sense.
BECOME AWARE OF YOUR BODY
If you become aware of your physical body, you will realize that energy is the ingredient that activates every cell within it. In Kundalini Yoga, the basic seat or source of this energy is Mooladhara Chakra – the root or support centre. Its physical counterpart is the same perineal node as previously discussed. On the psychic level, this node is considered to be the seat of the life force, or Shakti, which is not only the fuel for our physical body, emotions and feelings, but for our spiritual aspirations, as well. This area is very sensitive to the impact of energy or to the lack of it. With emotional upsets and conflicts, the energy is blocked or depleted; its creative potential is lost, and physical vitality diminishes. If the blockage continues, energy buildup intensifies until the energy explodes, dissipating itself in a direction of quick release, such as diarrhea. Such explosions may have a damaging effect on the muscles and ligaments, especially if they are already in a weakened 
condition.
Thus, it is extremely important to keep the perineal area strong and active. This will help you in childbirth and ensure that you avoid prolapse in later life. It will also help to rectify menstrual and sexual disorders. When you become aware of your pelvic structure and the seat of energy centered in the perineal node, you can begin to strengthen them through specific Yogic practices. This will help you to integrate and balance the energies responsible for physical, emotional, mental, and spiritual well being, so that you, again, become a healthy, happy and whole woman.
YOGIC TREATMENT
If you suffer from Prolapse or its complications, here is a specific Yogic treatment for these conditions. If possible, you should come to our studio to meet us, so that full instruction can be given about the Yogic treatment.
1. Begin with Aum chanting for 5 minutes, and then perform some, or all, of the following Asanas:
ASANAS
Prepratory practices part 2 (Read my article Yogic Home Work)
Vajrasana, Shashankasana, Majariasana, Kandharasana, Naukasana, Bhujangasana, Shalabhasana, Vipareeta Karani Mudra.
PRANAYAMA
Ujjayi, Anulome-Vilom / Nadi-Shodhana
BANDHAS AND MUDRAS
Sit in a comfortable Meditation posture, preferably Siddha Yoni Asana, and perform the following Mudras and Bandhas. You may practice all of them or choose the one which is most relevant to your specific condition:
• Ashwini Mudra – Contraction of the anal sphincter
• Vajroli Mudra – Contraction of the urinary opening
• Moola Bandha – Contraction of the perineal node
• Uddiyana Bandha – Contraction of the abdominal muscles
NOTE
Always practice on an empty stomach, preferably early in the morning after bathing and emptying the bowels. Use a quiet room where you will not be disturbed, and allow yourself at least half an hour for the practices.
SOME MORE SUGGESTIONS
• Repeat the same program in the evening.
• Throughout the day, lie down in Uttan Padasana, with both legs stretched out straight in front of you, in preference to other sitting postures, as it pulls the pelvic organs upward.
• Avoid sitting in the squatting position, as it strains the pelvic muscles and pushes the organs downward. Excessive use of the squatting position, over a long period of time, may bring on prolapse in ladies who are weak in the pelvic area.
• Before lunch do Vipreetkarni Mudra, for up to 5 minutes.
• Lie down after a meal with a pillow under your back.
• The most important exercise is keeping a hard pillow under the buttocks, instead of under the head. Sleeping in this position will help the uterus to return to its normal position. If you lie with your knee touching your breasts, that will also help the uterus to resume its normal position.
• All these exercises should be followed for at least 6 months for better results.
• Don’t lift heavy weights.
• Hip Bath is very useful.
CONCLUSION
With regular practice of these Asanas, Mudras, and Bandhas, you will find that your condition becomes more manageable. It may even fully correct itself, but don’t expect immediate or miraculous results. In the Yogic Treatment of Prolapse, progress is generally slow, especially if the structural damage is severe. Once a ligament has torn away, it is not easy to reconstitute it through Yogic Therapy, but it is still worth a try before submitting yourself to the surgeon. However, if the structural damage is less severe, and the ligament is only stretched or slightly torn, you will find Yogic Therapy most beneficial. During the course of your practice, you will also discover that emotional instability, lethargy, and depression have become problems of the past, and you will enjoy a more energetic and fulfilled life.
AUM SHANTI
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Courtesy: Dr. Rita Khanna’s Yogashaastra Studio.
A popular studio that helps you find natural solutions for complete health.
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Dr. Rita Khanna
Dr. Rita Khanna is a well-known name in the field of Yoga and Naturopathy. She was initiated into this discipline over 25 years ago by world famous Swami Adyatmananda of Sivananda Ashram in Rishikesh (India).
She believes firmly that Yoga is a scientific process, which helps us to lead a healthy and disease-free life. She is also actively involved in practicing alternative medicines like Naturopathy. Over the years, she has been successfully practicing these therapies and providing succour to several chronic and terminally ill patients through Yoga, Diet and Naturopathy. She is also imparting Yoga Teachers Training.
At present, Dr. Rita Khanna is running a Yoga Studio in Secunderabad (Hyderabad, India).
Dr. Rita Khanna
