DEAR DR. DONOHUE: Please discuss fallen uterus. I have one. I am 58 and have six children, all of whom are now grown. I feel a heaviness in my lower pubic area, and my doctor tells me it comes from the fallen uterus. He advises surgery. What are my options? – B.H.

ANSWER: Ligaments and muscles hold pelvic organs – uterus, bladder, rectum – in place. Aging, having had children and a life of hard, physical labor stretch the supporting ligaments and muscles. The bladder, uterus or bowel then drops downward into the vagina. Dropped or fallen organs are also called prolapsed.

Symptoms of a fallen uterus can be many. Back pain is a possibility. Or the dropped organ can cause a sensation of pelvic pressure like you describe. It can interfere with the passage of urine or stool. If the uterus drops so low that it passes out of the vaginal opening, the exposed uterus often develops painful ulcerations. A dropped uterus is not likely to shorten life, but it frequently is a source of discomfort that can become intolerable.

You are the one in charge of what to do about it. If you are not having symptoms that interfere with your life or cause you pain, you can choose to ignore it.

Or you can try a mechanical solution, such as propping up the dropped uterus with a device called a pessary. Pessaries come in many shapes and sizes, and it is best to have one fitted specifically to your anatomy. These devices are doughnut-shaped affairs that encircle the cervix of the uterus and keep it in place. They are not the perfect answer to the problem, but they can provide temporary support. They have to be removed from time to time to give the vaginal tissues a chance to heal from the irritation they often cause.

Surgery is the definitive answer. You are the one to tell the surgeon when and if you want it done.

DEAR DR. DONOHUE: My husband keeps me awake most of the night because of his teeth grinding. I am sleep-deprived – no kidding. He says he is not going to see anyone about it because it doesn’t bother him and he thinks I am exaggerating. Would you tell him for me what this might be doing to him to get him motivated? – S.D.

ANSWER: Bruxism – teeth-grinding – might not be affecting your husband at present, but it will. It inevitably wears down teeth, and he will eventually face dental repair and a hefty dental bill.

Some teeth-grinders waken with a headache. That too can lie in store for him. Others have chronic jaw pain, another possible consequence of ignoring the condition. When a tooth-grinder hears popping noises in the jaw while chewing food, that points to jaw joint problems that can result from bruxism or cause it.

Anxiety can bring it on. Is your husband under any stress? Although I assume this doesn’t apply to your husband, some people on antidepressants develop bruxism. A poor alignment of the upper and lower jaws is another bruxism cause.

In fluffing off his problem, your husband can be courting trouble down the road. He is foolish not to consult his dentist. He might need nothing more than an inexpensive mouth guard, obtainable at many sporting-goods stores, to control the condition.

Such guards work for some, but many find them impossible to tolerate for an entire night. A dentist can provide him with a fitted mouth guard that is more expensive but infinitely more comfortable.

DEAR DR. DONOHUE: My dad is said to have Parkinson’s disease. He is a consummate actor, and I wonder about the diagnosis. I think he might be faking the symptoms. I have seen him asleep, and he has no trembling. – C. D.

ANSWER: The tremor of Parkinson’s disease almost always disappears with sleep.

Your dad might be a consummate actor, but I can’t believe he has the knowledge to fool his doctor into making a diagnosis of Parkinson’s disease if he doesn’t have some Parkinson’s symptoms in addition to its tremor. Those symptoms are not well-known to the public, nor are they easy to imitate.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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