Pelvic Organ Prolapse

Gynecological Disorders

Each year more than 600,000 hysterectomies are performed in the United States. About one-third of American women undergo this operation by the age of 60.

It is performed to deal with a number of different diseases, including uterine fibroids, endometriosis, uterine prolapse and cancer. More information about hysterectomies can be found at the National Women’s Health Information Center website.

The website states that "no one knows the cause" of these diseases. But the fact that one out of every three women has her uterus removed indicates that something in our culture is fundamentally wrong.

Before the 19th century, hysterectomies were so rare that "most doctors were of the opinion that it was unlikely that one could survive a hysterectomy." The sharp increase in uterine disorders toward the end of the 19th century coincided with a similar rise in prostate disorders, leading to the suspicion that the two trends were somehow connected.

The connection became clearer as doctors learned more about another common pelvic ailment: bladder incontinence. They found that it typically results from damage to the pudendal nerve, which connects the pelvis to the spinal cord. This damage was traced to a "stretch injury" – caused by the progressive descent of the pelvic floor.

Why the Pelvic Floor Descends

The Australian researcher, Mr. Wallace Bowles, has offered the most plausible explanation for the high incidence of pelvic floor prolapse in the western world. (Other scientists, including Dr. William Welles, a San Diego chiropractor, independently proposed the same theory.) They observed that the sudden emergence of pelvic diseases near the end of the 19th century coincided with the adoption of sitting toilets.

Furthermore, they recognized that the porcelain throne is an "ergonomic nightmare" because it forces one to use the Valsalva Maneuver (holding one's breath and pushing down with the diaphragm.) No other animal uses this maneuver. The pelvic floor was not designed to handle this type of stress on a daily basis.

Like all primates, man was designed to use the squatting position, which empties the colon without putting any pressure on the pelvic floor. Instead of pushing downwards with the lungs, one pushes upwards with the thighs, in the following way:

The right thigh pushes the cecum's contents upward into the ascending colon. The left thigh squeezes and lifts the sigmoid colon, and opens the kink where it joins the rectum. Squatting also relaxes the puborectalis muscle to open the outlet valve.

A conventional toilet defeats the purpose of this ingenious design. Trying to evacuate while sitting is like trying to drive a car without releasing the parking brake. In frustration, one pushes down forcefully – depressing the pelvic floor many times each day. Over the years, the pelvic floor gradually descends more and more, and stretches the pudendal nerve beyond its capacity.

How Pudendal Nerve Damage Causes Disease

Damage to this nerve has serious consequences for pelvic health. The uterus and ovaries depend on continuous feedback from the brain to maintain proper hormonal balance. The pudendal nerve also supplies the electrical energy – the "life force" – on which all cellular activity depends.

Cut off from the source of energy and intelligence, the pelvic organs become dysfunctional and prone to disease. Cancer, endometriosis and uterine fibroids can be viewed as different forms of "dementia" on the cellular level.

Endometriosis provides a good illustration of how cells behave when they lose contact with the brain. In this disease, the cells lining the uterus wander off and attach themselves to other organs – much like an Alzheimer's patient who has forgotten where she lives.

"Endometriosis is a painful, chronic disease that affects 5.5 million women and girls in the USA and Canada, and millions more worldwide." (Endometriosis Association) It is the second leading reason for hysterectomies.

Why Women Are More Susceptible

Pelvic floor nerve stretch injury, the root cause of most pelvic disease, affects women more frequently than men. One reason is that the vaginal canal is a structural gap which is more vulnerable to the unique stress produced by the sitting toilet.

Repeated use of the Valsalva Maneuver will often force the uterus, the bladder, the rectum or the small intestine into this gap. These hernias are called, respectively, uterine prolapse, cystocele, rectocele, and enterocele. The term "pelvic organ prolapse" covers all of them.

Rhonda Kotarinos, MS, PT, is a renowned physical therapist who has trained physicians at Stanford Medical School in techniques for treating pelvic floor problems. In a recent lecture to members of the Interstitial Cystitis Network, she stated that long-term Valsalva voiding leads to pelvic organ prolapse.

The risk of prolapse is even greater during childbirth, when the Valsalva Maneuver is employed with maximum force. Here again, the modern toilet is to blame, because it has alienated women from the birthing posture they were designed to use. As explained in the Pregnancy and Childbirth section, squatting fully opens the birth canal and virtually eliminates the need for the Valsalva Maneuver.

This is why women in the developing world are "relatively unaffected by pelvic floor problems" while the United States spends more than $10 billion each year on pelvic reconstructive surgery and $26 billion to treat urinary incontinence.

The high rate of C-Sections is another consequence of using the wrong posture for delivery. Natural (vaginal) childbirth is feared because it is performed in an unnatural and dangerous way. 30.2% of US births in 2005 were by C-section.

The View of Gynecologists

Most gynecologists are unaware of the importance of squatting for bodily functions. They believe that the female reproductive system is prone to ailments because it was "poorly designed." In medical school, they are taught that the pelvic floor was designed for quadrupeds and cannot support the pelvic organs of women who walk on two legs. They are saying, in other words, that Nature is incompetent.

But their theory ignores the fact that the pelvic floor has performed quite adequately throughout human history, with only rare exceptions. It is only recently, in modern westernized countries, that pelvic organ prolapse has reached epidemic proportions. In the developing world, among squatting populations, these disorders are rare or unknown.

...African and Asian women seem to be relatively unaffected [by pelvic floor problems]. Prolapse appears to be comparatively uncommon in much of the developing world, despite the much greater multiparity of its mothers ... [Multiparity means having many children.]

This evidence has baffled western doctors, since it contradicts their assumption that the pelvic floor is unsuited for bipeds. Their usual response is to claim that the problem is simply "underdiagnosed." Like the quadrupedal theory itself, this claim is asserted without any supporting evidence.

For example, the last quotation goes on to say, "It is uncertain if this is a real difference; [women in the developing world] may merely complain less."

But women in those cultures have to perform strenuous physical labor, just to survive. Daily chores include carrying buckets of water, tilling the fields, and washing clothes by hand. Pelvic hernias would make them virtual invalids.

If they do not "complain" it can only mean that they do not dislodge their pelvic organs by the habitual use of the Valsalva Maneuver. Unlike women in our society, they perform their bodily functions (including childbirth) as nature intended.

A Conflict of Interest

To test for rectoceles and other forms of prolapse, gynecologists instruct patients to use the Valsalva Maneuver, which makes the prolapse bulge out. They are aware that excessive use of this maneuver can cause prolapse in the first place. But cultural insularity has made them view straining as unavoidable.

"Unavoidable" ailments mean job security, so gynecologists are quick to dismiss the possibility that "female troubles" can be prevented. Enormous amounts of money are at stake, creating an obvious conflict of interest.

The average cost for a hysterectomy ranges from $7,000 to $16,800 ... the annual cost for hysterectomies in the U.S. exceeds $5 billion. ... the cost of surgical management of genital prolapse has surpassed $10 billion annually in the United States alone.

Fortunately, a few gynecologists have a more enlightened perspective. Dr. Stuart Stanton and Dr. Ajay Rane were quoted above, strongly advocating the squatting posture for pelvic health. Other physicians have deplored the harm done by their colleagues by performing unnecessary surgery. Richard W. Te Linde (1894-1989) was the editor of the standard textbook on gynecological surgery. He is quoted in the Spring 2004 Whole Woman Newsletter:

...in the practice of gynecology, one has ample opportunity to observe countless women who have been advised to have hysterectomies without proper indications...I am inclined to believe that the greatest single factor in promoting unnecessary hysterectomy is a lack of understanding of gynecologic pathology...

A Case History

Dr. Akilah El, ND, PhD, is a naturopath with a deep understanding (and personal experience) of gynecologic pathology. In 1991, while still a student, she was diagnosed with cervical cancer and uterine fibroids. Ignoring the dire warnings of her gynecologist, she cured herself without the use of drugs, surgery or radiation.

A key factor in her recovery was the adoption of the squatting posture for elimination. This relieved the pressure on the pelvic floor and allowed the pudendal nerve to repair itself. In this way, the pelvic organs were reconnected to the central nervous system – the energy and intelligence that protects us from disease.

Dr. Akilah has repeatedly verified the effectiveness of this simple lifestyle change in helping her patients resolve gynecological ailments. The results have convinced her that "98% of all hysterectomies are unnecessary and dangerous." Dr. Akilah has summarized her program of self-cure in a tape called "Healing Our Womb - The Cause, Cure, and Prevention of Uterine Fibroids."