Pelvic Floor & Menopause
What is the pelvic floor?
The pelvic floor is a group of muscles and ligaments in your pelvic region that act as a sling to support your organs in your pelvis. It comprises a collection of tissues that span the opening of the base of the pelvis from the tail bone to the pubic bone and out to the sit bones and groin area.
Our breathing muscle (the diaphragm), our lower abdominal muscles (transverse abdominus), and our spinal muscles - all work together to promote strength and stability from the inside out. For this reason, breathwork is often a component of treatment for pelvic floor dysfunction, along with activation of the pelvic floor muscles.
What is menopause?
Menopause is a point in time 12 months after a woman’s last period when estrogen levels begin to decrease. There are 3 stages – Perimenopause when the hormones start to decline and menstrual cycles become irregular; Menopause, which occurs once hormones are no longer being produced and Post-menopause, the time following menopause.
Symptoms of menopause start to occur during the perimenopausal period due to fluctuations in oestrogen 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 large role oestrogen and progesterone play in our bodies, can affect multiple bodily functions and systems.
What impact does Menopause have on the pelvic floor?
Oestrogen plays an important role in keeping the tissues of our vulva, vagina, bladder and pelvic floor muscles strong and flexible. When oestrogen levels drop due to menopause, it is common for women to experience pelvic symptoms.
Generally, muscle mass is lost with ageing. On average skeletal muscle strength is at its peak at 20-30 years and deteriorates by 5% per decade. The pelvic floor muscle is not immune to this ageing process and in combination with the changes that occur to oestrogen levels during Menopause, the pelvic floor muscles can be affected.
The pelvic floor muscles can be weak, overstretched, slow to work, too tight or torn just like the other muscles of your body. Pregnancy or childbirth, chronic constipation, heavy or repeated lifting, high-impact exercise, being overweight and smoking can all cause problems the pelvic floor muscles. Vaginal changes after menopause may make pelvic floor problems worse.
The gradual decline in oestrogen production that occurs during Menopause leads to weakened, atrophied muscles, along with circulatory changes. These may result in:
Pain
An onset or increase in bladder infections as the urethra tissues atrophy, becoming more sensitive to harmful agents
Urinary incontinence
The common symptoms that occur at this time are:
Leaking urine when you cough, sneeze, run, jump or do vigorous exercise. This is stress incontinence
Having frequency or urgency to pass urine. This is an overactive bladder/urge incontinence
Pain during sex, urinary infections/cystitis or sometimes itching and soreness of the vulva
Constipation
The health of your pelvic floor is very important to your whole physical wellbeing. Pelvic floor dysfunction is often curable or at the very least made much more manageable with the right help.
For more information on our Women’s Health Physiotherapy Service, email info@platinumphysio.ie or call our office team on 012789313