March 2012 Edition
A note from Dr. Michele Couri
Understanding Pelvic Organ
Prolapse
The female pelvic organs, which include the uterus,
bladder and rectum, are normally held in place by a
web of muscles and connective tissues called the
pelvic floor muscles. When these muscles are
damaged or weakened, the pelvic organs them
support can shift positions and wither fall into the
vagina or press against the vaginal wall, causing
discomfort and affecting sexual and physical activity.
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According to one study, roughly 55% of women
between the ages of 50 and 59 have some form
of prolapse.
Approximately 200,000 inpatient procedures are
performed annually for prolapse in the United
States.
The average chance that a woman will undergo
some type of surgery to repair pelvic organ
prolapse during her lifetime is 1 in 10.
Who is at risk?
Prolapse is a condition affecting millions of women.
The incidence of prolapse has been found to increase
with age, with the peak occurrence among those
aged 60-79.
What are the different types of prolapse?
It is not uncommon for women to have more than
one type of prolapse at a time. Common types
include:
 Uterine prolapse. In this case, the uterus drops
down into the vagina. This can sometimes be
referred to as “falling of the womb.”
 Enterocele. In women who have undergone a
hysterectomy and no longer have a uterus, the
intestines and top of the vagina can protrude into
the lower vagina.
 Cystocele. When the bladder pushes on the front
vaginal wall and causes it to protrude into the
vagina, this results in a cystocele.
 Rectocele. When part of the rectum pushes on
the back vaginal wall and causes it to protrude
into the vagina, this results in a rectocele.
How is prolapse diagnosed?
Pelvic organ prolapse can be diagnosed by a
traditional pelvic examination. Sometimes, Dr. Couri
will ask a patient to stand during the exam to
determine weather the pelvic organs may drop out of
place in an upright position. (Cont’d on next page…)
What are symptoms?
Women with pelvic organ prolapse may experience a
range of symptoms including:
 Pressure and pain in the pelvic area or lower back.
Some women report feeling a lump or having a
“dropping” or “falling out” sensation.
 Difficulty emptying the bladder or stress urinary
incontinence (urine is leaked during day-to-day
activities, such as laughing or coughing)
 Bowel problems, including constipation
 Recurrent bladder infections
 Painful intercourse
6708 North Knoxville Avenue, Peoria, Illinois
309.692.6838
www.peoriaintegrativewomenshealth.com
A note from Dr. Michele Couri continued...
Is prolapse treatable?
Prolapses vary in severity, and not all women with
the condition have symptoms that require treatment.
Mild cases often respond to non-surgical
approaches such as:
to the surrounding tissues and ligaments. There are
several types of reconstructive surgeries used to
treat prolapse, including:
 Synthetic Mesh Repair: Using small incisions
inside the vaginal, the surgeon repositions the
prolapsed organs and secures them to
 Kegel exercises: Contracting and releasing the
surrounding tissues and ligaments using a mesh
pelvic floor muscles may help a woman
- a material similar to that used for abdominal
diagnosed with prolapse but not currently
hernia repair.
presenting with symptoms.
 Posterior and Anterior Colporrhaphy: These
 Biofeedback: Exercising the pelvic floor muscles
procedures involve folding and then suturing, or
while connected to an electrical sensing device
stitching, the back (posterior) or front (anterior)
can provide “feedback” that may help patients
wall of the vagina to support prolapsed organs.
learn to use their pelvic muscles to decrease
 Hysterectomy: A hysterectomy may be done in
sudden urges to urinate and lessen certain types
combination with other pelvic floor repair
of pelvic pain.
procedures, depending on the type of pelvic
 Pessary device. A device can be inserted into the
organ prolapse.
vagina to help support the pelvic area and relieve
mild symptoms of prolapse. Our team of
Prior to undergoing surgery, patients should have a
healthcare providers work with patients to
thorough evaluation to ensure a proper diagnosis.
correctly fit the pessary to each individuals need. You do not have to live with symptoms of pelvic
organ prolapse any longer. Call us today to learn
For women whose symptoms don’t respond to non- more.
surgical methods, Dr. Couri may recommend pelvic
reconstructive surgery. During the surgery, Dr.Couri In health,
repositions the prolapsed organs and secures them
Dr. Couri
Recipe of the Month: Black Bean Hummus and Avocado Cream
Black Bean Hummus
2 cups cooked black beans, or 1~15 oz. can, drained, rinsed,
and mixed with a spritz of fresh lemon juice and a pinch of
sea salt
1/2 teaspoon chopped garlic
2 Tbsp. water
1 Tbsp. tahini
1 Tbsp. freshly squeezed lemon juice
1/2 tsp. ground cumin
1/4 tsp. sea salt
1/4 tsp. paprika
1/8 tsp. cayenne
1/8 tsp. Ground cinnamon
1 Tbsp. extra-virgin olive oil
1/4 cup finely chopped fresh cilantro (opt)
Avocado Cream
1 ripe avocado, pitted and peeled
1/4 cup loosely packed fresh cilantro (opt)
1 Tbsp. water
1 Tbsp. freshly squeezed lime juice
1/4 tsp. sea salt
Combine all of the ingredients in a blender or food processor
and process until smooth. Do a taste check. You may want to
add some extra lime juice or a pinch of salt.
These recipes can be found in The Cancer-Fighting Kitchen by
Rebecca Katz with Mat Edelson. This book can be purchased
from our Retail Center located in the Couri Center or at
www.couricenter.com.
Combine the beans, garlic, water, tahini, lemon juice, cumin,
salt, paprika, cayenne, and cinnamon in a food processor and
process until smooth. Add the olive oil and process to
combine. Do a taste check and add a spritz of lemon and an
additional pinch of salt if needed. Serve garnished with
cilantro.
Author’s Note: If you really want to put this dip over the top,
place a dollop of Avocado Cream on top, or for a quick fix,
add a few slices of avocado.
6708 North Knoxville Avenue, Peoria, Illinois
309.692.6838
www.peoriaintegrativewomenshealth.com
Atrophic Vaginitis
Atrophic vaginitis has several names
such as vaginal atrophy or urogenital
atrophy. It is an inflammation of the
vagina and the outer urinary tract due
to the thinning of tissues as well as
decreased lubrication from a decline
of estrogen. Vaginal atrophy may
occur at times of decreasing or
unbalanced estrogen such as during
peri-menopause and menopause.
Declining estrogen can also occur
when a woman breast feeds or takes
medication for a variety of reasons
that impact estrogen levels.
Genital and urinary symptoms of
atrophyic vaginitis may include pain
with intercourse, bleeding after
intercourse due to the thinning of the
vaginal tissues, vaginal itching and
discomfort, discharge, soreness,
pressure and burning sensations,
painful urination, blood in your urine,
increased frequency an incontinence.
We know that if sexual intercourse is
uncomfortable that we may eliminate
it due to the discomfort.
Treatment for atrophic vaginitis can
include but is not
limited to replacement
of the estrogen,
lubricants that are water
based or moisturizers
such as vitamin e oil,
extra virgin olive oil or
coconut oil.
Moisturizers and
lubricants may be used
by themselves or in
conjunction with
estrogen products.
Moisturizers and lubricants help
maintain natural secretions. (Caution
- if you are sexually active; oils can
break down condom integrity.)
Sexual intercourse may provide
lubrication also if compatible with a
woman’s physical needs and
lifestyle.
Locally absorbed estrogens such as
Estrace, Premarin, Vagifem, and
Estring work well for restoring
normal pH levels, thickening and
revascularizing the epithelium. Oral,
trans dermal, and topical estrogen
can also be used to treat atrophic
vaginitis. Estrogen delivery method,
doing and usage should be discussed
with your provider. So, if you are
having symptoms that interfere with
your life and cause you discomfort,
see your provider and make a plan
together to improve or eliminate your
symptoms.
Susan F. Lang, APN
Cooking Classes are BACK!
April 24, 2012
June 19, 2012
August 21, 2012
October 16, 2012
“Food and Mood”
“ In the Herb Garden”
“Vegetarian Cuisine”
“The Power of Detoxification”
Guest Speaker: Dr. Joy Millker, Ph.D
Guest Speaker: Jan Powers, Peoria Herb Guild
Guest Speaker: Susan Waltrip, MS, RD, LDN
Guest Speaker: Dr. Melissa Young, MD
We are excited to announce our 2012 Cooking Class schedule. Please join us for evenings full of great speakers,
healthy food, and spectacular information. All Cooking Classes cost $10* per class. We prefer you call 692 -6838 to
sign up in advance. Payment will be taken at the door. Classes are from 6:00pm -8:00pm each night.
*All money collected from all the Cooking Classes will be donated to medical research.
“Restoring Health to Women’s Healthcare.”
Dear Friends,
We don’t lack anything! Our essential nature is
changeless, limitless, pure awareness. Pure awareness is
limitless, so we don’t lack anything. Out of our ignorance
we entertain “lack mentality.”
Here is a sample list of our
“lack list:”

I lack peace.

I lack happiness.
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I lack ideas.
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I lack creativity.
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I lack knowledge.

I lack skills.

I lack loving relationships.

I lack time.
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I am not good enough.
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I lack confidence.
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I lack security.

I lack power, control.

I lack name and fame.
The list goes on. You may ask—”Who is going to fulfill my
basic needs if I don’t have money?” Sure, we may need
money to fulfill our basic needs, but then without sunshine, water, air, earth, and forces of nature, our bank balance cannot fulfill our basic needs.
Lack mentality is so entrenched in us that we are constantly seeking outside to gain fullness. We don’t lack anything.
Everything is provided for us. All good things in life are
free of cost.

We don't need money to love.

We don't need money to be kind.

We don't need money to buy time.

We don't need money to help and support others.

We don't need title or position to be powerful.
How can we develop sense of abundance? We need to
focus on what we have, not on what we lack. We see
what we pay attention to. We don’t lack anything. We
just have to shift our vision.
“Gratitude is the open door to abundance.” -unknown
Peace, Venkatesh
*Meditation is practiced Saturday’s at 10am. This service is free
and open to the public. Check our website for updates.
Mark Your Calendar!
Dr. Couri will be speaking at the 2012 Living
Healthy Series presented by the University
of Illinois College of Medicine at Peoria.
Proven to CHANGE your life
in 15 weeks...
She will be speaking on “Do you need
Vitamins?” March 20th from 6:30-7:20 pm.
30% OFF
OrthoMolecular PRObiotic
225*
TLC™ is a disease reduction and prevention program that is
used to reduce or eliminate the effects of cardiometabolic
diseases, adrenal fatigue, gastrointestinal disorders, bone
deficiencies, and/or weight problems.
Great to use while taking
an antibiotic!
*Coupon good 3/1/2012-3/31/2012. Must turn over
coupon at time of purchase. Limit 4.
Meet our staff:
Dr. Michele Couri M.D., FACOG
Susan F. Lang MS, APN, CNM, LCCE
Terry Polanin MS, APN, FNP-BC
Leslie Rusch-Bayer BS, CPT
Doctor of Gynecology and Integrative Medicine
Advance Practice Nurse
Nurse Practitioner
Certified Personal Trainer
“Restoring Health to Women’s Healthcare.”