Sometimes when I poop, it's a struggle to get things out. At these times, I have to push kinda hard. Often, after this event, my vagina will bleed, and not because of other reasons. It only bleeds a little -- I'd say less than one ounce. What's the deal?

Attention All Male Readers:

The reply to this question quite possibly contains information that could potentially rupture some fragile parts of the male psyche and perhaps blow a few minds. If you proceed to read, do so with extreme caution.

Dear Erika,

Please make an appointment to see your gynecologist so that you can inform him/her of your situation before it progresses to something even far worse than what I suspect you are currently experiencing. As if it is not enough that females have to take great care to be sure to wipe from front to back to prevent urinary tract infections because of the close proximity of the sewer line to the water drain, and they have to spend the better part of each month dealing with bloating, cramping, pouring out blood, clots, and uterine lining through the opening between the two holes mentioned previously, there's more.

Sometimes--for various reasons--the walls separating the poop chute from the tunnel of love can become weakened, stretched, strained, and even ruptured. When this happens it is called a rectocele or enterocele. Wikipedia has this to say about it:

"A rectocele results from a tear in the rectovaginal septum (which is normally a tough fibrous sheet like divider between the rectum and vagina). Rectal tissue bulges through this tear, into the vagina, as a hernia. There are two main causes of this tear: childbirth and hysterectomy.

Presentation

Mild cases may simply produce a sense of pressure or protrusion within the vagina, and the occasional feeling that the rectum has not been completely emptied after a bowel movement. Moderate cases may involve difficulty passing stool (because the attempt to evacuate pushes the stool into the rectocele instead of out through the anus), discomfort or pain during evacuation or intercourse, constipation, and a general sensation that something is "falling down" or "falling out" within the pelvis. Severe cases may cause vaginal bleeding, intermittent fecal incontinence, or even the prolapse of the bulge through the mouth of the vagina, or rectal prolapse through the anus.

Causes

It can be caused by many factors, but the most common is childbirth, especially with babies over nine pounds in weight, or rapid births. The use of forceps is more likely a marker for the vaginal injury, than a direct cause of the tear. Episiotomy or lower vaginal tears play little role in the formation of a cystocele. The risk increases with the number of vaginal births, although it can also happen in women who have never borne a child.

A hysterectomy or other pelvic surgery can be a cause, as can chronic constipation and straining to pass bowel movements. It is more common in older women than in younger ones; estrogen which helps to keep the pelvic tissues elastic decreases after menopause. Another cause which is sometimes overlooked in younger women is sexual abuse during childhood.

Treatment

Treatment depends on the severity of the problem, and may include changes in diet (increase in fiber and water intake), pelvic floor exercises such as Kegel exercises, use of stool softeners, hormone replacement therapy for post-menopausal women, insertion of a pessary into the vagina (A pessary is a small plastic or silicone medical device or form of pharmaceutical preparation which is inserted into the vagina or rectum and held in place by the pelvic floor musculature), and various forms of surgery (usually posterior colporrhaphy - the suturing of vaginal tissue). More recent developments in surgery are directed at repairs to the rectovaginal septum, than simple excision or plication of vaginal skin, which provides no support. Both gynecologists and colorectal surgeons can address this problem."

Thanks for asking Motherload!

Sorry, guys!

Motherload is Certified Nurse Assistant as well as an IBS sufferer, which means she knows a lot about poop. Got a question for her? Ask it here.