Pelvic Health at Every Season: Perimenopause & Menopause
Peri/post menopause is often misunderstood. Similar to the way that pregnancy and postpartum come with common symptoms that are assumed to be accepted as ‘this is just motherhood,’ menopause often is associated with symptoms that quickly assigned to ‘this is just what getting old is.’
This blog post will provide an overview of what exactly menopause is, common symptoms, the role of estrogen in our bodies, what we can do to age optimally, and how pelvic floor therapy can support common symptoms.
TLDR: Menopause is not a medical problem! It is a normal life transition, and the more we can add context to common issues, it’s clear there are everyday lifestyle habits can improve quality of life in this time period.
Normal Life Transitions
Perimenopause: literally means “around menopause”. It refers to the body’s natural transition before menopause - can be a few years or up to 15 years before
Menopause: marks the end of the menstrual cycle. The experience 12 months without bleeding. Worldwide the average age of menopause is 51 years old.
Postmenopause: the time after menopause, or 12 months without a period
Note that the definitions have no mention of disease or dysfunction. Because…not a medical problem. a normal life transition.
Common Symptoms
urinary leakage and/or urgency
decreased sex drive
vaginal dryness
pain with sex
aches and pains
hot flashes
mood swings
weight gain
anxiety and anxiety
difficulty sleeping
hair loss
What’s considered “normal” if these are common symptoms? Mild symptoms with a loss of period.
Role of Estrogen
Estrogen has 300 functions in the human body. From tendon and bone health, to lining in the bladder and passive closures of the sphincters, to cardiovascular function, to vulvar-vaginal health - estrogen plays a vital widespread roles.
How decreased levels of estrogen affects the body
decreased natural lubrication
less vaginal discharge
dryness of vulva and vaginal tissues
all of which contribute to pain with sex, bleeding with sex, itching, or irritation of tissue, and increased bacterial infections
decreased muscle bulk
increased risk of cardiovascular issues
Topical Estrogen: A Short Term Boost to Your Pelvic Health
Topical estrogen is a cream, gel, or suppository placed at the vulva in inside the vagina to locally support the vulvar and vaginal tissues, which can get thinner and less responsive with less estrogen. It can plump up tissues in the openings and help with continence and overall integrity of the vulvar and vaginal tissue.
It is a short term measure to help with troublesome symptoms, but not a long term solution
The long term solution? pelvic floor therapy
How Pelvic Floor Therapy Can Help
The gold standard for improving peri/menopausal symptoms is topical hormones + pelvic floor therapy.
Pelvic floor therapy can provide products such as vaginal moisturizers and vulva creams, improve blood flow to this area to decrease symptoms, assess and treat pelvic floor tension, retrain muscle patterns, improve sexual ergonomics, and set you up with exercises that support your body (and your pelvic floor) to decrease urinary, bowel, sexual, and pain symptoms.
Everyday Habits & Routines for Big Impact
Move well: move daily in ways that make you happy! Zumba? Yes! Walking? Sure! If it brings you joy, do it, and do it often.
Regular exercise improves gut health, sleep, improves circulation, and maintains/builds muscle bulk and bone density. Specifically, cardio has been shown to help with thermal regulation, and strength training supports the maintenance of bone density
Sleep well: Sleep is the body’s way of processing, restoring, and repairing. It’s important to create routines and rituals to optimize sleep.
Eat well: Michelle Lyons (an amazing pelvic floor therapist) says “you can’t supplement away a bad diet.”
Essential fatty acids, lots of hydration, vitamin C, reducing sugar and alcohol intake, and lots of plants in your diet are all recommended when thinking about ways to improve common symptoms.
Poop well: What we excrete says a lot about our gut health and overall health.
Decreased estrogen slows down the process of food passing through the GI tract. When the digestive process takes long, more water is reabsorbed back into the bloodstream leading to constipation, gas, and bloating. This is why increased fiber and lots of water are so important.
Menopause is not an excuse for diminished quality of life. Pain isn’t normal. Dysfunction isn’t normal. Acclimating to menopause and beyond is a change, and while it may come with newness - it can also be an opportunity to get to know your body in this new season.