NEW YORK (Reuters Health) - Women who are overweight or perform heavy
lifting or have certain conditions affecting the body's connective tissue may be
at increased risk of having weakened pelvic muscles, a new study suggests.
The study, of nearly 5,500 Swedish women, looked at the potential risk factors
for pelvic organ prolapse, a disorder in which weakened muscles and supporting
tissue allow one or more pelvic organs to drop down and protrude into the
vagina.
Some symptoms include pressure in the vagina, and chronic pain in the lower
abdomen or lower back.
It's known that childbirth raises a woman's risk of developing prolapse, but the
"nonobstetric" risk factors are less clear.
In the current study, reported in the journal Obstetrics & Gynecology,
researchers found that women who were overweight or obese were about twice as
likely as thinner women to have pelvic organ prolapse.
The risk was similarly elevated among women who regularly performed heavy
lifting at work, versus those who did not.
In
addition, women with a family history of pelvic organ prolapse or a personal
history of varicose veins, hernia or hemorrhoids were also at increased risk.
Both of those findings point to an inherent vulnerability, according to Dr. Ann
Miedel and her colleagues at the Karolinska Institute in Stockholm.
As they explain, a family history of pelvic organ prolapse suggests a genetic
predisposition toward the disorder, while conditions like varicose veins and
hemorrhoids indicate that a woman may have a general weakness in her connective
tissue.
The findings are based on a one-time survey of 5,489 women ages 30 to 79.
Because the study did not follow the women over time, it's not clear whether
lifestyle factors -- like being overweight and habitual heavy lifting -- caused
prolapse in some women.
However, Miedel and her colleagues point out, excess weight and heavy lifting
put strain on the pelvic floor muscles, and both factors have been linked to
prolapse in previous studies.
The researchers also found a heightened prolapse risk among women who reported
frequent constipation. However, they note, chronic constipation is also
considered a common symptom of prolapse, and it's not clear which problem came
first in these women.
Long-term studies, according to Miedel's team, are needed to establish whether
these modifiable factors do cause pelvic organ prolapse in some women.
SOURCE: Obstetrics & Gynecology, May 2009.
