By Leah Kubale, Women’s Health Physiotherapist
What is menopause?
Menopause is the time in life when you stop having monthly periods. This marks the natural end of the reproductive stage of your life and is defined as having gone 12 months without having a period. There are currently no blood tests or imaging available to diagnose menopause, nor any tests that will predict when it will happen. Menopause occurs for the majority of women between 44 – 56 years. Each woman experiences menopause differently.
Peri-menopause
Peri-menopause refers to the time during which your body makes the natural transition to menopause. Your periods may become irregular and you may experience symptoms such as fatigue, hot flushes, sleep disturbance, headaches, low libido and vaginal dryness. 75% of women will experience menopause symptoms, and the severity of symptoms can vary greatly. A quarter of women rate their symptoms as severe. Only 5% will still experience symptoms after ten years.
Effect of menopause on pelvic floor muscles
Hormonal changes that occur during menopause result in the ovaries producing much less oestrogen. As oestrogen levels start to fluctuate it can cause weakening of the pelvic support structures that hold up the bladder, uterus and bowel, as well as weakening of the pelvic floor muscles. Lower oestrogen also causes vaginal dryness (due to a reduction in natural secretions) and changes in vaginal flora and pH to increase the risk of infections and trauma. Lastly, reductions in blood flow to vaginal tissues lead to reduced thickness and elasticity of vaginal walls causing vaginal shortening and narrowing.
Pelvic floor conditions that can be associated with menopause
- Urinary frequency and urgency
- Stress, urge and mixed urinary incontinence
- Painful urination
- Recurrent urinary tract infections
- Pelvic organ prolapse – bladder, uterus/vault, bowel
- Sexual dysfunction – low desire, painful sex, orgasmic disorders
How can a physiotherapist help?
A pelvic health physiotherapist can take a detailed history and do an examination, if necessary. This will enable them to explain what is happening and advise on how to treat the symptoms. Treatments can include postural correction and muscle retraining, relaxation and strengthening exercises, and manual techniques. They will also be able to prescribe vaginal trainers and give advice on over-the-counter products while liaising with other healthcare providers to ensure that you are receiving the best care possible.
If you are experiencing peri-menopause or menopausal symptoms and would like to know more, call us to make an appointment with one of our experienced pelvic health physiotherapists. Call (08) 6389 2947 or click here to book online.
