Menopause is a natural stage in life that marks the end of the reproductive years. Typically occurring between the ages of 45 and 55, it can happen earlier or later for some individuals (Peacock & Ketvertis, 2023). While this transition is a normal part of aging, it brings a variety of changes that can affect different areas of the body, including the pelvic floor. Pelvic floor physiotherapy offers vital menopause support, helping to manage symptoms and improve overall well-being during this transition.
Special Note: Throughout this piece, the term “woman” is used when discussing those experiencing menopause. We recognize that not everyone who goes through this transition identifies as a woman. Menopause is a significant life stage that affects individuals who menstruate, encompassing a range of gender identities. Our goal is to provide inclusive support for everyone navigating menopause
What is Menopause?
Menopause is defined as the point when a person has gone 12 consecutive months without a menstrual period, resulting from the ovaries stopping egg production and a significant decrease in estrogen and progesterone levels (Peacock & Ketvertis, 2023). This hormonal change can lead to various physical and emotional symptoms.
However, before reaching menopause, many experience perimenopause, a transitional phase marked by irregular periods, hot flashes, mood swings, and fluctuations in libido. This phase can last several years and significantly influences the overall experience of menopause.
Common Symptoms of Menopause
The experience of menopause varies widely, but some common symptoms according to Peacock & Ketvertis (2023) include:
- Hot Flashes: Sudden feelings of warmth, often accompanied by sweating.
- Night Sweats: Hot flashes occur during sleep, leading to disrupted rest.
- Mood Swings: Fluctuations in mood that can range from irritability to depression.
- Vaginal Dryness: Thinning and less lubricated vaginal tissues due to decreased estrogen levels.
- Sleep Disturbances: Hormonal fluctuations can lead to insomnia or interrupted sleep, making it challenging to achieve restorative rest.
- Pelvic Floor Dysfunction: Weakened pelvic muscles may lead to issues like incontinence or pelvic organ prolapse.
While these symptoms may be common, it’s important to note that they are not normal. Help is available to alleviate these challenges and allow you to live more comfortably.
Why Pelvic Health Matters During Menopause
The pelvic floor muscles play a vital role in supporting your bladder, uterus, and bowels. The drop in estrogen levels during menopause can weaken these muscles, making them less elastic and resilient (Peacock & Ketvertis, 2023). This can lead to several issues, including:
- Urinary Incontinence: Experiencing leaks during activities like laughing, sneezing, or exercising (stress incontinence), or having a sudden urge to urinate (urge incontinence).
- Pelvic Organ Prolapse: Weakened muscles may fail to support organs, causing them to shift or bulge into the vaginal canal.
- Sexual Discomfort: Vaginal dryness and tightness can result in painful intercourse and decreased sexual satisfaction.
How Pelvic Floor Physiotherapy Provides Menopause Support
Rochera et al. (2017) describe the main objective of pelvic floor physiotherapy in menopause support as restoring vaginal health while fostering greater knowledge and body awareness. The approach emphasizes enhancing muscle relaxation and toning, boosting tissue elasticity, and alleviating sensitivity in painful areas. Here’s how it can help:
1. Strengthening Pelvic Floor Muscles
Pelvic floor physiotherapists use targeted exercises to strengthen weakened muscles. These exercises aim to enhance muscle coordination and endurance, helping to reduce urinary incontinence and minimize the risk of prolapse.
2. Bladder Retraining
Bladder issues frequently arise during menopause, but pelvic floor physiotherapy can help. Physiotherapists often implement bladder retraining techniques to gradually enhance bladder control. This may involve maintaining a ‘bladder diary’ to track patterns, among other techniques, or establishing a scheduled routine for bathroom visits. Research indicates that pelvic floor physiotherapy is the gold standard for treating incontinence, significantly reducing symptoms and improving overall bladder function.
3. Addressing Vaginal Dryness and Sexual Health
Pelvic floor physiotherapy addresses vaginal dryness by teaching relaxation and stretching techniques to ease discomfort during sexual activity. Your pelvic floor physio may recommend dilators or over-the-counter lubricants and vaginal moisturizers which can help improve tissue elasticity and hydration, helping to alleviate dryness and pain during intimacy (Aninye et al., 2021).
Our pelvic floor physios love:
Dilator Set: The Intimate Rose Dilator Set is often recommended by our physiotherapists to help reduce pelvic pain, tension, and discomfort during accommodation and penetration.
Vaginal Moisturizers: Our physiotherapists frequently suggest the Menopause Chicks Hyaluronic Acid Vaginal Moisturizer (hyaluronic acid and vitamin E) and Iris Moisturizer to alleviate dryness, restore moisture, and improve comfort.
4. Managing Pelvic Organ Prolapse
If you’re experiencing early signs of pelvic organ prolapse, pelvic floor physiotherapy can help. Specialized exercises can restore strength and support to pelvic muscles, preventing further prolapse. In more complex cases, a pelvic floor physiotherapist may collaborate with a specialist for additional treatment options.
5. Emotional and Psychological Support
Menopause can be an emotionally challenging time. The combination of hormonal fluctuations and physical symptoms can lead to anxiety, irritability, depression, and even a sense of loss. While pelvic floor physiotherapy offers a holistic approach, providing both physical and emotional support, it’s important to note that mood challenges should be overseen by a general practitioner and a registered clinical counsellor.
A registered clinical counsellor can help you process your emotions and develop or strengthen coping mechanisms to navigate this transitional phase. Physiotherapists create a safe environment for you to discuss your symptoms and concerns, offering guidance and reassurance throughout the process.
Why Early Intervention Matters
Early intervention is key to maintaining pelvic health during menopause. Effective preparation and symptom management can prevent the transition from worsening conditions that impact quality of life and life expectancy (Aninye et al., 2021). Pelvic floor physiotherapy offers proactive strategies to manage menopause-related changes. Moreover, even mild symptoms should prompt a consultation with a pelvic floor physiotherapist, as regular check-ins can strengthen pelvic muscles and support overall health throughout and beyond menopause.
Education: A Cornerstone of Menopause Support at Bump
Knowledge is empowering. By helping you understand what’s happening in your body, we equip you to take control of your health and comfort. Our team is here to guide you through the changes that menopause brings, explaining why symptoms occur and what we can do to help!
Here are a few practical tips to support your pelvic health during menopause:
1. General Movement: Incorporate gentle movement into your daily routine, such as walking, stretching, or yoga to keep your body active and support pelvic health.
2. Exercise: Regular physical activity strengthens the pelvic floor, improves bone density, and enhances cardiovascular health.
3. Hydrate: Staying hydrated is crucial. Drinking enough water can help alleviate vaginal dryness and support optimal pelvic floor muscle function.
4. Moisturize: As mentioned earlier, vaginal moisturizers and lubricants can help alleviate dryness and improve comfort during intimacy.
5. Building Your Care Team: Create a team of healthcare professionals to support you during menopause. This can include your pelvic floor physiotherapist, gynecologist, endocrinologist, dietician, naturopathic doctor, mental health professional, and other specialists.
By understanding the why behind the symptoms and how to manage them, you can feel more confident and in control throughout this journey. Our goal is to help you make informed choices that enhance your comfort and quality of life.
Menopause Support for All
Menopause doesn’t have to mean discomfort or loss of control. As discussed, exploring pelvic floor physiotherapy as part of your menopause support plan can strengthen your pelvic muscles, improve bladder function, and boost sexual health. Whether you’re in perimenopause, menopause, or post-menopause, pelvic floor physiotherapy empowers you to manage symptoms and maintain (or elevate!) your quality of life.
Taking care of your pelvic floor is an important part of menopause support that deserves attention. Reach out to a Bump pelvic health physiotherapist today to start your journey toward better pelvic health during menopause.
~the Bump team
Bump Physio & Co is a community of health care providers dedicated to changing the way pelvic health and obstetrical services are delivered. Our clinics are located in Port Moody, Langley, and New Westminster BC. We treat beyond the Bump and welcome clients from all stages and phases of life. Our team has advanced training in Pelvic Health, Orthopedics, Obstetrics, Clinical Pilates, and Active Rehabilitation.
Citations
Aninye, Irene O. PhD; Laitner, Melissa H. PhD, MPH; Chinnappan, Shivani BA. Menopause preparedness: perspectives for patient, provider, and policymaker consideration. Menopause 28(10):p 1186-1191, October 2021. | DOI: 10.1097/GME.0000000000001819
Peacock K, Carlson K, Ketvertis KM. Menopause. [Updated 2023 Dec 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507826/
Rochera, M. , Andreu, C. , Madrid, Y. , Bouallalene, K. and Pau, E. (2017) Physiotherapy as a Way to Maintain Vaginal Health during Menopause. Advances in Sexual Medicine, 7, 97-104. doi: 10.4236/asm.2017.72007.
https://www.scirp.org/journal/paperinformation?paperid=75458