Pelvic health during menopause:

One of the most reported symptoms that women experience at menopause but do not like to openly talk about is pelvic floor dysfunction. The pelvic floor is the area between your pubic bone at the front, coccyx (tailbone) at the back and the two sitting bones on each side.

Your pelvic floor muscles stretch like a hammock from front to back and side to side between these 4 bony landmarks.

The functions of the pelvic floor muscles are:

1. To support the organs – bowel, bladder and uterus and in pregnancy to support the weight of the growing baby

2. To allow you to control the release of urine, faeces, and gas.

3. Sexual function.

Pelvic floor dysfunction is an umbrella term encompassing all the symptoms that can arise from being unable to control, relax and co-ordinate your pelvic floor muscles. Pelvic floor dysfunction is more likely in and post menopause due to the bladder and surrounding tissues being rich in oestrogen receptors, this means they are sensitive to changes in oestrogen levels, which drop as you enter and stay in mesopause.

Below is a diagram of the pelvic muscles and surrounding structures.

What are the symptoms of pelvic floor dysfunction?

Urinary incontinence 1 in 3 women – stress (leak on a cough, laugh or sneeze) or urgency (being unable to reach the toilet on time) or a combination of both.
Anal Incontinence 1 in 5 women over 40, this includes the inability to control the release of wind.
Pelvic Organ Prolapse up to 50% of women post childbirth
Sexual Dysfunction – pain on intercourse, decreased libido (vaginal dryness and atrophy can be linked to this).
A combination of these.

How you can help and strengthen your pelvic floor:

You do not need to be in the menopause to care about your pelvic floor. Symptoms can happen post-childbirth and at any age, especially with period problems such as endometriosis. You can begin and learn pelvic floor exercises at any time in your life, but if you are concerned, you can also talk to a healthcare provider such as a GP. Technology has also come a long way, you can now buy devices to help with pelvic floor dysfunction or general strengthening. These can be vaginally inserted and hooked to your phone via bluetooth to help you make it a habit. There are also other tips and tricks to help with both urinary symptoms, which are most common in those who have come to menopause.

Urinary dysfunction tips:

Don’t limit fluid intake 1.5 – 2 litres per day. It is normal to go to the toilet 6-8 times per day.
When you limit fluid intake the bladder gets used to holding small amounts and becomes over sensitive. Ideally you should be seeing 300-400ml per trip i.e. not a trickle
Don’t go, “just in case,” wait until you are sure you need to urinate.
Avoid bladder irritants – caffeine, fizzy drinks especially diet, alcohol especially spirits, acid in fruit juice.

Pelvic Floor Exercises:

You can find out more about specific pelvic floor exercises, recommended by the NHS here

Find out more