Making sense of sensation
Have you ever been told that your anatomical presentation of POP is mild despite your symptoms being significant?
Or maybe your POP stage is considered more significant, but your symptoms are mild?
Have you found that your symptoms increase when you focus a lot on your pelvic floor? Or maybe that your symptoms intensified following the awareness that you had POP?
Do you experience more bothersome symptoms during periods of increased stress? Poor sleep?
Have you ever had the experience of having your symptoms decrease when you're more occupied, or when you're in a pleasurable setting?
What could be going on?
Sensation is governed by the nervous system, made up of our brain, spinal cord, and nerves. Before an output (like the sensation of heaviness, or pain) was produced, the nervous system considered several factors including *and beyond* what was actually occurring at the level of the tissues in the pelvic floor/vagina.
Some of these influential factors include:
✨ Information from joints, muscles, tendons and skin about the positions and movements of the body parts;
✨Information from nociceptors about the thermal, mechanical and chemical condition of the tissues
✨The five senses;
✨General health (sleep, diet, stress, social well-being;
✨ Cognition: knowledge, memory, feelings, perceptions, belief, logic, attention, expectations, etc.;
These factors can contribute to the ramping up or dialing down of the output (and our experience) of a sensation.
One of the hallmarks of the human body is its ability to adapt: sensitizing to a symptom (like heaviness, or pain, etc.) is an example of one's system becoming better (or, more efficient) at experiencing that sensation. Consider sensitization in the context of a garment worn: in the event of increased sensitization, we might feel the itchy fabric on our arms constantly during our day. We'll likely start scratching, and our degree of bother will escalate. All of our attention is given to the annoying sensation (and it might even persist after we take the shirt off). Or, we could habituate (which is what most of us do with our clothing). It's not that we *can't* feel it, or that it isn't there, it's that we become used to it. Our brain has decided this isn't something that warrants our attention, or an action; it isn't threatening.
Our relationship to POP symptoms can function similarly. Yes, the presence of POP might trigger an "alarm" in the nervous system. The anatomical changes are present. But the degree to which that concern is escalated and made a priority is dependent on more than the degree of POP itself.
We know that POP symptoms do not always strongly correlate with POP stage. We know that a person can feel drastically different in a matter of minutes with no change to their anatomy at all. We know that stress and hypervigilance and fear can amplify sensation.
So how do we get, well, worse at experiencing POP-related sensations?
Fortunately, we have a lot of options!
There is research to support that education on the neuroscience of pain can be beneficial for those experiencing persistent pain. We feel that those experience POP symptoms can also benefit from education about POP, sensation, adaptability, and more. And that's why we made POPUp: An Uplifting Guide!
Increasing social and psychological support allows a person with bothersome POP sensations to feel supported, to explore their feelings, to increase their positive affect, to reframe things, and to know that they are not alone. Managing symptoms of depression and anxiety is often an integral part of POP management.
Improving general health and habits is something that is often overlooked but can make a big difference. Improving quality of sleep, eating nourishing foods, moving in helpful ways, improving ability to cope with stress, etc. are all actions that can have a positive impact on one's perception.
Challenging limiting beliefs about POP is one of the essential tenets of the POPUp mission. We believe that a careful look into the evidence on POP management, the pelvic floor, psychology, etc. shows us clearly that fear-mongering material is not the key to self-efficacy and confidence in managing POP. We take an active role (and encourage our members to do the same) in challenging the limiting beliefs that we are told, and that we tell ourselves, about POP.
Engaging in meaningful activity can seem impossible in the presence of symptoms. We do not believe that one must be POP symptom free in order to participate in a desired activity. In fact, we believe that the assertion that one should always avoid things that seem to be associated with symptoms is potentially holding people back and setting them up for increased symptoms. Exercise and the participation in one's life are essential components of wellness. Our mission is to empower people to take back their autonomy in being able to make informed choices for themselves, not dictate what they can and can't do.
Allowing for sensitivity to "chill" can be helpful, especially early on. This enables one to engage in meaningful activities, and might decrease the chance that one's system becomes better equipped to feel POP symptoms. We love pessaries for this purpose, and a temporary deload of bothersome activity can be helpful for some. Prioritizing rest, positive affect, mindfulness, etc. can allow for the nervous system to calm down.
Increasing exposure to positive POP information - like us! We created POPUp because we believe in the power of evidence-guided information and support that uplifts and empowers individuals, increasing self-efficacy and confidence. We have seen this program change the lives of those working through it, and we believe there's likely something in it for you, too.