Understanding Pelvic Health During Menopause: A Guide to Wellness
Leeanna Maher PT, MSc PT, H.BSc
Entering menopause marks a significant phase in a woman's life, often accompanied by various changes in her body, including those related to pelvic health. While menopause affects each woman differently, understanding its impact on pelvic health and adopting proactive measures can greatly enhance overall well-being during this transition.
Menopause and Pelvic Health
Menopause typically occurs around the age of 45-55, signaling the cessation of menstrual cycles and a decline in reproductive hormone levels, particularly estrogen. Estrogen plays a crucial role in maintaining pelvic tissue health, including the lining of the vagina, bladder, and pelvic floor muscles. As estrogen levels decrease, these tissues may become thinner, less elastic, and more prone to issues such as:
Vaginal Dryness and Atrophy: Reduced estrogen levels can lead to vaginal dryness, irritation, and thinning of the vaginal walls (vaginal atrophy), which can cause discomfort during intercourse and increase the risk of vaginal infections and urinary tract infections (UTI’s).
Urinary Symptoms: Thinning of the urethral mucosa and changes in urethral sphincter muscle tone and strength can contribute to urinary symptoms such as urgency, frequency, nocturia (nighttime urination), and stress urinary incontinence (leaking urine when coughing, sneezing, or exercising).
Pelvic Organ Prolapse: Weakening of pelvic floor muscles and ligaments can result in pelvic organs (such as the bladder, uterus, or rectum) descending into the vagina, causing discomfort, pressure, or urinary and bowel issues.
Promoting Pelvic Health During Menopause
Maintaining pelvic health during menopause involves adopting proactive lifestyle habits and seeking appropriate medical care. Here are some essential strategies:
Regular Pelvic Floor Muscle Exercise: Learn the appropriate pelvic floor exercises through a pelvic floor assessment to strengthen the muscles that support the bladder, uterus, and bowel. Pelvic floor exercises help to improve the blood flow, oxygenation, elasticity, strength, and tone of the pelvic muscles.
Healthy Diet: Consume a balanced diet rich in fruits, vegetables, lean proteins, and whole grains to help prevent constipation. The strain associated with constipation can weaken the pelvic floor muscles over time and lead to increased risk of developing pelvic organ prolapse. If diet is not enough to address constipation, a pelvic floor assessment can assess whether the pelvic floor muscles may not be coordinating correctly for a healthy bowel movement. Adequate hydration is essential for maintaining both bowel and urinary tract health.
Optimize Sexual Health: A pelvic physiotherapist can help provide suggestions on types of lubricants to alleviate vaginal dryness and discomfort during intercourse. The benefits and regular administration of a vulvar and/or vaginal moisturizer may be recommended to further hydrate and provide moisture to the vaginal tissues. Exercise strategies will be provided to improve the elasticity and mobility of the pelvic floor, thereby enhancing comfort and pleasure during sexual practices.
Quit Smoking: Smoking can exacerbate vaginal dryness and increase the risk of pelvic organ prolapse due to its negative impact on circulation and connective tissue.
Medical Consultation: Discuss symptoms such as vaginal dryness, urinary changes, or pelvic discomfort with your pelvic physiotherapist. They can discuss non-hormonal options and exercise strategies to alleviate symptoms and improve pelvic health. It is also highly encouraged to discuss the potential benefits of hormonal based therapies with your doctor (oral or local vaginal hormones) during the menopause transition to see what options may be most appropriate for you.
Pelvic Health Screenings: Regular pelvic exams and screenings can help detect any changes or conditions early, allowing for prompt intervention and management.
Emotional and Psychological Wellbeing
Menopause is not just a physical transition but also a time of major emotional adjustment. Many women experience changes in mood, sleep patterns, and self-image during this period. The intensity and longevity of these psychological symptoms varies greatly. Practicing stress management techniques such as mindfulness meditation, yoga, Qi Gong/Tai Chi, regular massage therapy, exercise and talking to a trained counselor can support and optimize emotional well-being. At the same time, accessing a knowledgeable family doctor or nurse practitioner who can provide information on the latest medical insights, appropriate medication options and/or menopause specialist referrals is a key component of feeling supported and empowered during this formidable time in life.
Navigating menopause involves embracing changes and prioritizing pelvic health through proactive measures and medical support. By understanding the impact of menopause on pelvic health and adopting a holistic approach to wellness, women can effectively manage symptoms and maintain their quality of life during this transformative phase. Remember, each woman's experience of menopause is unique, so personalized care and self-care are key to promoting pelvic health and overall well-being.