Menopause and Your Pelvic Floor
Does the thought of coughing, laughing, or sneezing terrify you? Do you have the urge to pee and have little control over it? Has your libido decreased as you have aged? If so, this is the blog for you. We will be discussing menopause, how it effects your pelvic floor, and what a pelvic floor therapist can do for you.
What is menopause?
The “big M” or menopause typically occurs in your 40s and 50s. It is a natural process that marks the end of a woman’s menstrual cycles. Common symptoms associated with menopause include hot flashes, anxiety, changes in skin condition, night sweats, sleep problems, thinning hair, mood changes, low libido, palpitations, and more. The changes experienced are caused by a decreases of hormones, specifically estrogen.
Did you know what menopause occurs in three stages?
Most often, menopause is thought of as one event. However, menopause occurs in three distinct stages.
The first stage is perimenopause. Perimenopause occurs 3-5 years before menopause. During perimenopause, your estrogen levels are dropping rapidly, and you are experiencing all of the common symptoms of menopause. However, you are still having menstrual cycles and can get pregnant.
Menopause, or the second stage, is defined as the absence of menstruation for 12 straight months. This means your ovaries have stopped releasing eggs and stopped producing the majority of their estrogen.
The final stage is postmenopause. Postmenopause occurs when you have not experienced a period for an entire year. Menopause symptoms can get better as your body regulates; however, some people continue to experience menopausal symptoms for a long time due to lower estrogen levels.
How Does Menopause Affect My Pelvic Floor?
Estrogen is a key component of our pelvic floor health as it keeps the tissue of our vagina, bladder, vulva, and pelvic floor muscles flexible and strong. As our estrogen levels fluctuate and decline during perimenopause and menopause, our pelvic floor muscles and surrounding tissue become weaker, thinner, and lose their overall tone and elasticity. As this happens, there is also a reduction in vaginal lubrication and overall pelvic floor strength.
The decline of estrogen in the body can lead to pelvic symptoms such as:
Bladder Symptoms:
Needing to go more often and with urgency
Urinary incontinence or leaking
Getting up at night to go
Stress incontinence or leaking with coughing, laughing, sneezing, and activity
Painful urination
Recurrent urinary tract infections
Bowel Symptoms:
Constipation
Urgency to go to the toilet
Inability to control gas
Sexual Symptoms:
Pain with sexual intercourse
Low libido
Vaginal Symptoms:
Vaginal dryness, itching, and burning
Shortening or narrowing of the vagina
Pelvic Organ Prolapse
Prolapse of the bladder, uterus, or rectum
Indicated by a heaviness in the pelvic floor
How Can Pelvic Floor Therapy Help?
It is important to know that pelvic floor symptoms associated with perimenopause and menopause are not normal.
A skilled pelvic floor therapist can work with you to identify your symptoms, their causes, and support you throughout these changes. Research shows that pelvic floor muscle training can increase pelvic floor muscle strength and contractility leading to decreases in pain and discomfort, urinary symptoms, bowel symptoms, and pelvic organ prolapse. Further, a pelvic floor therapist can provide you with breathing strategies, positioning tips, tools, and supports that can alleviate your symptoms and improve your daily functioning.
You do not have to experience “the big M” alone. Check with your provider to see if you would be a good candidate for pelvic floor therapy. Kyrsten Spurrier, OTR/L at The Perinatal Pelvis is here to help and support you as you navigate the changes and symptoms related to menopause. Contact her today!
Molly Kolstad (she/her/hers)
Occupational Therapy Doctorate Student
Capstone at The Perinatal Pelvis
Resources:
https://perifit.co/pages/content-menopause-and-your-pelvic-floor
https://www.mulabandhapt.com/blog/menopause-and-your-pelvic-floor
https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397
https://my.clevelandclinic.org/health/diseases/21841-menopause