How does menopause affect pelvic floor health? Good question! Menopause is officially diagnosed after a woman has gone 12 consecutive months without a menstrual period. The lead-up to this point, known as perimenopause, can span several years, during which symptoms such as irregular periods, hot flashes, sleep disturbances, and mood changes may occur due to fluctuating hormone levels. Following menopause, the postmenopausal phase of a woman’s life begins, marking a time when the symptoms of perimenopause can continue before gradually diminishing.
Understanding menopause is crucial, not just from a biological standpoint but also for its broader implications on health and wellness. Menopause can impact bone density, heart health, and more, making it important for women to engage with healthcare providers about symptom management and preventive care. It represents a phase of change, embodying both challenges and opportunities for health, emphasizing the importance of support, knowledge, and care as women navigate this natural progression in life.
According to the World Health Organization, menopause can occur between your mid-40s and mid-50s, with an average age of approximately 51. Menopause comes with a myriad of symptoms, such as hot flashes, night sweats, whole-body aches and pains, fatigue, and irritability. However, beyond these noticeable changes, menopause can also significantly affect pelvic floor health!
Understanding these changes is paramount to all people with a vagina! Much can be done prior to, during, and after menopause to minimize the often hidden genitourinary symptoms.
At menopause, ovulation no longer occurs, and the production of estrogen and progesterone declines. The hormonal shifts of menopause have a profound effect on the pelvic floor. The pelvic floor muscles, which support the uterus, bladder, small intestine, and rectum, rely on estrogen to maintain their strength and elasticity. As estrogen levels decline during menopause, these muscles can weaken. According to the Colorado University Department of Urogynecology, this weakening may lead to several conditions, including urinary incontinence, reduced vaginal lubrication, pelvic organ prolapse, and changes in urinary frequency and urgency. Additionally, the decrease in estrogen can affect the lining of the urethra, leading to increased susceptibility to urinary tract infections.
Menopause happens in stages!
Perimenopause – the time leading up to menopause when a woman may start to experience a variety of symptoms; these are a result of fluctuations in hormone levels.
Menopause -The time when the final menstrual period occurs.
Postmenopause – Starts when a woman has had no menstrual period for 12 months.
What are the Symptoms of Menopause?
Symptoms of menopause start to occur during the perimenopausal period due to fluctuations in estrogen and progesterone levels. These symptoms often last for 4-8 years but are typically more frequent and intense around the final menstrual period. Symptoms will present differently from woman to woman and, due to the multifaceted role estrogen and progesterone play in our bodies, can affect multiple bodily functions and systems.
Your menopause symptoms may include:
Hot flashes/night sweats
Menstrual changes – irregular bleeding, changes in flow
Whole body aches and pains (particularly in the shoulders!)
Loss of muscle tone
Fatigue
Irritability
Sleep Disturbances
Anxiety and Depression
Low libido
Pelvic symptoms
Pelvic Health and You
Vaginal health is an essential component of healthy, active aging for all women. Estrogen plays an important role in keeping the tissues of our vulva, vagina, bladder, and pelvic floor muscles strong and flexible. When estrogen levels drop due to menopause, it is common for women to experience pelvic symptoms, particularly genitourinary symptoms.
The vagina, vulva, urethra, and bladder all contain high levels of estrogen receptors. As estrogen levels decline with menopause, those tissues can become thinner and lose their elasticity; there is a reduction in lubrication of the vagina, and the pelvic floor muscles also become thinner, less flexible and have decreased strength.
You may experience Vaginal/Vulval symptoms:
Dryness
Burning/itching
Vaginal shortening and narrowing
Bladder symptoms:
Urinary Urge
Urinary Incontinence
Bladder infections
Recurrent urinary tract infections
Stress Urinary Incontinence
Pain with urination (Dysuria)
Sexual symptoms:
Pain or discomfort with sexual intercourse (Dyspareunia)
Loss of libido
Pelvic organ prolapse
With Menopause, bowel symptoms such as the inability to control gas and fecal incontinence may also be present. This is due to pelvic floor muscle weakness caused by estrogen loss. These symptoms are more common in women with an underlying weakness in their pelvic floor muscles, possibly caused during childbirth or a chronic history of constipation or coughing.
It has been reported that genitourinary symptoms of menopause occur in more than 50% of postmenopausal women. Unfortunately, due to the taboo nature of symptoms or perhaps a lack of awareness of treatment options, women may not seek medical advice. However, in contrast to menopause symptoms like hot flashes and night sweats, which ease up and eventually stop over time, pelvic symptoms persist and can continue to progress.
At Relax Therapy Seattle, we collaborate with you to make a tailored management plan based on your unique symptoms and goals optimizing your strength, health, and wellness. This can include pelvic floor muscle retraining, bladder training, and guidance on lifestyle factors that can help minimize your symptoms. It is never too late to address these symptoms!
Consulting a Pelvic Floor therapist prior to menopause can help ensure optimal pelvic function is maintained for longer and minimize future symptom development. You don’t have to let menopause compromise your pelvic floor health!