There are two times in women's lives that we see a hormonally similar profile, that may drive an exacerbation in pelvic floor symptoms, and those times are during the timeline of breastfeeding, and in menopause. These two timelines are driven by a reduction in estrogen, an issue that can effect so many other areas outside of just the pelvis.
Some of the more common symptoms we see with menopause include hot flashes and night sweats, sleep disturbances, mood fluctuations, and "genitourinary syndrome", which can include vaginal dryness, urine leakage, vulvar irritation, pain with urination, and pain with intercourse. One other major issue that is less often discussed but absolutely still a component piece of the puzzle in menopause is joint pain, and a change in bone density.
Where does the role of pelvic floor physical therapy, or physical therapy in general, fit in?
While we cannot change someone's hormonal profile, we absolutely can have an influence on someone's musculoskeletal system!
In regard to urinary incontinence, pelvic floor muscle training has been show to be beneficial in the management of both stress (leakage with activities that cause a high intraabdominal pressure like sneezing, running, coughing, jumping) and urge (leaking that results from increased urgency for urination) urinary incontinence. Vaginal atrophy can also be addressed through pelvic floor muscle training, which may be a potential root cause for other pelvic floor symptoms in and of itself.
Zooming out of just the pelvic floor, physical therapy can help provide education on HOW to exercise. It is imperative for those in the season of menopause to maintain bone density and aerobic capacity. Resistance training and aerobic training both have been shown to have beneficial effects on vasomotor symptoms of menopause, like hot flashes and night sweats. There is also evidence that physical activity can have an effect on severity of genitourinary syndromes, causing a significant decrease in the symptom intensity overall.
Outside of exercise, ensure you are fueling properly, which means no only eating well but eating ENOUGH. So often we see people unintentionally underfueling, which effects your body's ability to recover, including your pelvic floor. Underrecovered pelvic floor muscles can lead to pelvic floor symptoms!
Overall, the symptoms of menopause can be challenging and frustrating. We are here to come alongside you in this season and help to ease the struggles to help you continue to feel your best, no matter what stage of life you are in!
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