Navigating Menopause and Peri-Menopause: How Pelvic Floor Physical Therapy Can Help

Menopause and peri menopause marks a significant transition in a woman’s life, and brings with it a variety of physical changes. Among these changes, pelvic floor health can be notably affected, leading to symptoms such as urinary incontinence, UTI’s, urinary urgency/frequency, vaginal dryness, and pelvic pain. While many believe these are symptoms we just have to live with as we age, there are actually things we can do to improve these symptoms!

Understanding Menopause and Pelvic Floor Health

Menopause is characterized by the cessation of menstrual cycles and a decline in estrogen levels. Estrogen plays a critical role in maintaining the elasticity and strength of pelvic tissues, so its reduction can impact pelvic floor function. Symptoms commonly associated with this phase include:

• Urinary Incontinence: Increased urinary urgency and frequency, as well as stress incontinence (leakage during activities that increase abdominal pressure, like coughing or sneezing).

• Urinary Tract Infections or Urinary Frequency/Urgency: Feeling like you need to go to the bathroom all of the time, painful bladder, or feeling like you need to go and very little coming out.

• Pelvic Organ Prolapse: A condition where pelvic organs, such as the bladder or uterus, descend due to weakened pelvic support tissues.

• Vaginal Atrophy: Thinning, drying, and inflammation of the vaginal walls due to decreased estrogen.

• Pelvic Pain: Discomfort or pain in the pelvic region, which may be exacerbated by hormonal changes and reduced support from pelvic structures.

The Role of Pelvic Floor Physical Therapy

Pelvic floor physical therapy offers a range of interventions designed to improve pelvic floor function and alleviate symptoms. Here’s how PFPT can help:

• Stong Muscles = Strong Pelvic Floor: PFPT involves exercises that target the pelvic floor muscles, which can enhance muscle strength and bladder control. 

• Improving Pelvic Muscle Coordination: Proper coordination of pelvic muscles is essential for controlling bladder and bowel functions. PFPT includes techniques for teaching correct muscle contraction and relaxation, which can reduce the incidence of leakage and improve overall pelvic function.

• Addressing Vaginal Atrophy: Exercises and manual therapy can help increase blood flow and strengthen surrounding tissues, potentially alleviating some symptoms of vaginal dryness and discomfort.

• Pelvic Pain Management: For women experiencing pelvic pain, PFPT can offer techniques such as manual therapy, stretching, and relaxation exercises to address muscle tension and improve comfort. All of our therapists are highly trained in internal pelvic floor assessments/treatments which can give you the best and most direct path to healing your pelvic floor pain. 

Pelvic floor physical therapy offers a multifaceted approach to managing the diverse symptoms associated with menopause. We incorporate individualized programs for all of our patients, which is shown to be most effective in treating urinary incontinence and pelvic organ prolapse symptoms for post menopausal women. If you’re navigating menopause and struggling with pelvic floor symptoms, give us a call so we can explore how targeted interventions can help you feel more comfortable and in control during this pivotal stage of life. It’s never too late (or too early) to get started on your pelvic health journey!

For those like me, who enjoy some nerdy reading, take a further look at these studies:

• Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018;10(10). Read the study

• van Reijn-Baggen DA, Han-Geurts IJM, Voorham-van der Zalm PJ, et al. Pelvic floor physical therapy for pelvic floor hypertonicity: a systematic review of treatment efficacy. Sex Med Rev. 2022;10(2):209-230. Read the review

• Alves FK, Riccetto C, Adami DBV, et al. A pelvic floor muscle training program in postmenopausal women: a randomized controlled trial. Maturitas. 2015;81(3):322-329. Read the review

• López-Pérez MP, Afanador-Restrepo DF, Rivas-Campo Y, et al. Pelvic floor muscle exercises as a treatment for urinary incontinence in postmenopausal women: a systematic review of randomized controlled trials. Healthcare (Basel). 2023;11(2):216. Read the study