Menopause

Menopause is often looked at as the “end of the road” – but we’re here to say, heck no! It is a natural life transition that individuals assigned female at birth (AFAB or as we will refer to as ‘women’ in this post) go through, and one that should be discussed, not silenced. While physical and emotional changes do occur, there are ways to address the challenges you may experience, so you can continue to thrive. The first step is empowering yourself with the facts.

What is Menopause?

Menopause is medically defined as when a woman has had at least 12 consecutive months without having a period. Typically, people enter menopause between 40 and 58 years of age, with the average being 52.

What is Peri-Menopause?

You may also have heard the term peri-menopause. Peri-menopause is the time period leading up to menopause. Peri-menopause lasts, on average, 6-8 years and often begin in one’s mid-to-late 40’s or early 50’s. During this phase, people experience fluctuations in hormone levels (primarily estrogen and progesterone), which can lead to a variety of symptoms.

Common symptoms of menopause and peri-menopause include:

• Systemic symptoms (meaning in the body), such as night sweats, hot flashes, fatigue, insomnia, weight gain, mood swings, and memory issues.

• Local symptoms (within the pelvis and vulvovaginal area), such as irregular menstrual cycles, vaginal dryness, decrease in muscle flexibility, changes in vulvar skin texture, burning, itching and skin irritation.

What Is The Role of The Pelvic Floor in Menopause?

During menopause and peri-menopause, estrogen and progesterone levels decrease over time. Both hormones are vital to collagen production and building muscle mass. So as levels lower, muscles in the pelvic area (and elsewhere in the body) start to thin and the surrounding collagen (which supports our muscles) weakens. This can lead to pelvic health conditions, including:

• Urinary incontinence (bladder leakage)

• Increased urgency or frequency of urination

• Increase in urinary tract infections since the pH balance of the vagina changes as hormone levels decrease

• Prolapse, which is when pelvic organs descend into the vaginal canal

 Decreased estrogen levels can also lead to vaginal dryness, which is considered a hallmark symptom of menopause. Vaginal dryness can cause discomfort and irritation, as well as painful intercourse (dyspareunia). Sexual changes are, in fact, quite common. A study by the North American Menopause Society (NAMS) study found that:

• 58% of women avoided intimacy due to vaginal discomfort

• 64% of women experienced loss of libido due to vaginal discomfort

• 64% of women experienced pain associated with sex

• 30% of men & women ceased having sex altogether due to vaginal discomfort

If you’re experiencing difficulties with sex or other symptoms associated with menopause, know that there are effective treatments that can help you.

How Can Pelvic Health Physiotherapy Help Me?

Menopause is a natural life process that happens to every woman. So, why not have tools in your corner to help you embrace the changes and thrive? One such tool is Pelvic Health Physiotherapy (also called Pelvic Floor Physiotherapy). Pelvic floor physiotherapists are specially trained in developing individualized treatment plans to optimize the strength and coordination of the pelvic floor muscles. This can include:

• A detailed assessment of your medical and hormonal history, as well as current symptoms (e.g., bladder habits, pelvic pain, concerns around sex)

• Exercises to strengthen the pelvic floor and innermost abdominal muscles

• Working on breathing and posture

• Tailored treatment for those experiencing painful intercourse, such as manual therapy, deep diaphragmatic breathing and use of vaginal dilators

• Recommendations for complementary therapy to address symptoms (e.g., naturopathic medicine)

Often, a number of sessions are required. Your Pelvic Health Physiotherapist will customize a plan to your unique needs and goals.

How Do We Approach Treatment For Menopause?

At Proactive Pelvic Health Centre, we are passionate about destigmatizing women’s health and pelvic health issues. We firmly believe that it’s time to debunk myths about what it means to age as a woman. By openly and honestly speaking about menopause and the changes women experience, we can collectively work to prioritize the health and wellness of women throughout their lifespan.

Our approach is compassionate, holistic and evidence-based using a combination of education and clinical care to put you on a positive course to achieving your pelvic health and wellness goals. Treatment plans are customized to your specific needs, with consistent check-ins to ensure you’re on the right path.