Mysterious Girl: Pills, pregnancy and pelvic organ prolapse

Almost three decades after the release of the Peter Andre hit single, Mysterious Girl, the trope that women are perplexing creatures beyond understanding is still rife in film, literature, radio, and even medical science. This, combined with the traditional (and arguably primitive) view that women’s bodies are too complex to treat due to hormone fluctuations, is perhaps why such a gender bias exists within medical science. 

Many women feel neglected in their struggles because there is an inadequate level of research conducted about our bodies. In fact, less than 2.5% of publicly funded research is dedicated to women’s reproductive health despite over 90% of women experiencing issues with their periods… The gender disparity becomes embarrassingly clear when considering that 12.5% of publicly funded research is dedicated to erectile dysfunction; that’s a significant amount of money considering it affects less than 20% of men. The lack of research on women’s issues only serves to propagate unsubstantiated claims and facilitate the stigma around natural experiences such as periods, pregnancies, and issues after child-birth, such as pelvic organ prolapse.

Disparity between male and female public funding. Image: Head et al. (2013).

Quite recently, the panic and protests ensued by blood-clotting risks of the Astra-Zeneca vaccine seemed somewhat amusing to many women. Clotting as a result of the contraceptive pill is considered a side effectrather than a risk, despite the risk of clotting being far greater than the vaccine. The risk of blood clots from the Astra-Zeneca vaccine is only 1 per 250,000 people, around 0.0004%. In comparison, the risk of blood clots from the pill is 5 per 10,000, or 0.05%… We should be less shocked about a vaccine causing a minimal risk of blood clotting, and more concerned that 3.1 million women have to put themselves at risk every single day on the pill.

While the stats here may be different, the message is still very much the same. Source: @tobithomas_ on Twitter.

Fortunately, the University of Leeds is making great progress to fill the paucity of research relating to women’s health. Dr. Clare Harley, a lecturer in applied health research, and Anna Crowle, a women’s health physiotherapist, have recently conducted a clinical case series on Pelvic Organ Prolapse, quite humorously termed POP. Most of us have heard a gruesome tale about childbirth, about the blood and all the gore, but not many women talk about the struggles they experience in the weeks, months, or decades after. POP is just one of these issues. 

During childbirth, the pelvic organs (think bladder, uterus, vagina, and rectum) undergo intense trauma to push the baby out and in doing so they can distend, which means bulging out of the vagina. In the past it was thought that this was due to a weakened pelvic floor, a hammock-like flap of muscle that lies above the urethra, anus, and vagina. Women that experienced a high degree of pain as a result of pelvic organ prolapse can even undergo surgical intervention, where the inner walls of their vaginas are cut to help lift the organs back up. Crowle and Harley, however, think alternative, less invasive procedures may be the key to treating POP. 

In their recent clinical case series, the researchers found evidence to disprove this age-old theory of a ‘weakened pelvic floor’. In fact, they found the complete opposite. Crowle and Harley focussed on tensegrity, a relatively new concept about the structural relationship between objects in order to maintain their spatial positioning. Learning about tensegrity is like the first time you hear of the golden ratio – it is everywhere – from the structure of new-age NASA Rovers, to the intricate modelling of a human cell’s cytoskeleton. Tensegrity is, quite literally, in our DNA.

What are pelvic floor muscles and what do they do? Souce: Continence Foundation of Australia.

But what has it got to do with our organs? Well, the theory of biotensegrity suggests that all our organs are balanced within our bodies through these tension-compression forces. These forces are disrupted during childbirth, causing the organs to essentially fall out of place. When investigating this further, Crowle and Harley were able to find that POP wasn’t actually due to a weakened pelvic floor, but a stiffened one. Relaxing the stiffened pelvic floor through massages was found to help the distended organs move back into their original positions. How fascinating is it that the answers to modern medical dilemmas, like pelvic organ prolapse, can be found in the microscopic networks within our cells?

This remarkable finding will not only improve the quality of life for millions of women who are currently suffering, but the many more that will experience similar struggles in the future. Yet, it still acts as a poignant reminder of all the things that still remain a mystery regarding women’s health. The impact of these findings has the potential to change our understanding of the female body during pregnancy, but above all, change attitudes towards women’s health and emphasise the importance of funding such critical research.

By Tharushi Wijesiri

Header image from the World Health Organisation.