Menopause and the Pelvic Floor

Oh, the dreaded menopause! For women, it feels like the changes to our bodies are never-ending. We know the common symptoms of menopause: hot flushes, mood changes, sleep disturbances, and fatigue. However, one thing that often gets overlooked is the significant impact menopause can have on the pelvic floor.

WHAT HAPPENS DURING MENOPAUSE?
During menopause (and the years leading up to it, aka perimenopause), oestrogen levels drop significantly. Oestrogen plays a key role in keeping pelvic tissues strong, elastic, and well-lubricated.

EFFECTS ON THE PELVIC FLOOR
1. Weakened Pelvic Muscles
- Less oestrogen = less muscle tone.
- You might notice things like a heaviness in the pelvis, or even symptoms of pelvic organ prolapse (where organs like the bladder or uterus start to shift downward).

2. Urinary Incontinence
- One of the most common symptoms. This includes stress incontinence (leaking when you sneeze or laugh) and urge incontinence (feeling a sudden need to go).

3. Vaginal Dryness & Atrophy
- Thinner tissues, less lubrication, and more irritation—all of which can make sex uncomfortable and even affect bladder health.

4. Bowel Issues
- Constipation can worsen, and excessive straining to defecate puts further stress on the pelvic floor.

WHAT CAN HELP?

• Women’s Health Physiotherapy
  A physiotherapist trained in pelvic health can assess strength and function, and guide you through specific pelvic floor muscle exercises correctly.

• Hormone Therapy
  Local oestrogen (creams, rings, tablets) can help rejuvenate vaginal and urethral tissue.

• Lifestyle Adjustments
  Weight management, quitting smoking, and avoiding constipation all reduce pressure on the pelvic floor.

• Regular Exercise
  Caution with high-impact movements if your pelvic floor is already weak. Core strengthening and low-impact workouts like Pilates can help.

• Mind-Body Practices
  Yoga and breathwork can help with pelvic floor coordination and overall relaxation (many women tend to "hold" tension in the pelvic area).

If you're noticing any symptoms or just want to be proactive, it's absolutely worth booking an appointment with myself, Amy S, Alison, or Holly (Women’s Health Physiotherapists).

Gillian Burgess
Physiotherapist / Women’s and Men’s Health Specialist / Clinical Pilates Instructor

To see our Physiotherapists or book in for a Pilates consult, book an appointment with us online today or call our team on 07 55 04 7000.