Background: Pelvic organ prolapse (POP) occurs in 10% of women in Nepal, even 6% of nulliparous women have symptomatic POP.1 This may be linked to the heavy lifting tasks performed by women using a head strap.2 This study explored the impact of hormonal changes on the pelvic floor when performing these tasks during each phase of the menstrual cycle. Methods: The study included 22 female Nepali participants with a mean age of 27.4(3.6) years; all were from rural villages and frequently carried with a head strap. Using intravaginal pressure transducers (IVT), the mean change in intraabdominal pressure (IAP) was found to be 37.1(4.3) cmH20 when lifting a load with a mean weight of 19.8(3.2)kg using a head strap. Lifting tasks were simulated with isometric ballistic lifts against a head strap secured to the plith with the participant lying supine. The mean increase in IAP from rest was 31.6(2.1)cmH20. Displacement of the pelvic floor was measured by transperineal ultrasound. Mean displacement of the pelvic floor at ovulation was 5.1(0.4)mm and a mean of 5.9(0.4)mm during the early follicular phase (p 0.03). Conclusion: during the early follicular phase, when basal body temperature and beta estrogen are lowest, the compliance of the pelvic floor is greatest. Repetitive lifting during this time may predispose some woman to POP.

LLU Discipline

Physical Therapy


Physical Therapy


School of Allied Health Professions

First Advisor

Lohman, Everett B., III

Second Advisor

Brandon, Karen

Third Advisor

Berk, Lee

Fourth Advisor

Daher, Noha

Fifth Advisor

Petrofsky, Jerrold

Degree Name

Doctor of Science (DSc)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Generative organs; female; Menstruation; Lifting and Carrying

Subject - Local

Pelvic Floor Muscles; Pelvic Organ Prolapse; Intravaginal Pressure Transducer; Heavy Lifting



Page Count


Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives