Why Is Pelvic Health Important During Menopause?

4 min read

Menopause is one of the biggest transitions in a woman’s life, and yet it is something that many women know nothing about. 

Well, I’m here to help!

Let’s break down some of the major physical changes that women can experience during perimenopause and post-menopause and explain how pelvic health physiotherapy can help! 

What is Menopause?

First, let’s go over what some of the “menopause”-related terms really mean:

Menopause: the point in time 1 year after a woman’s last menstrual period. In Canada, the average age of menopause is 52 years old. 

Perimenopause: the time leading up to menopause. The perimenopause transition can start 10-15 years before menopause…yes, you read that correctly.

The perimenopausal time can be especially confusing, as your body’s hormones are fluctuating in an irregular fashion and can start to cause symptoms you have not experienced before.

Post-menopause: the time after a woman has reached menopause. Once you have reached menopause, you are post-menopausal forever, but it is usually during the first 5-7 years post-menopause that women will experience symptoms. 

Knowing these definitions, we can see why there is so much confusion about menopause. Unless you are avidly tracking your periods, you may not even realize that you have officially reached menopause. 

Amber’s Tip

 In order to understand what is happening in your body, one of the best things you can do is start tracking your menstrual cycles and the various symptoms you have each day. This will allow you to start noticing abnormal patterns or deviations and can help you advocate for yourself if and when you need to talk to your medical practitioner. 


what to expect when you’re expecting (and not expecting) menopause?

Symptoms  During Perimenopause

  • Irregular menstrual cycles, heavy bleeding, and cramping 

  • Anxiety/depression 

  • Insomnia 

  • Breast tenderness 

  • Heart palpitations 

  • Hot flashes/night sweats 

  • Headaches 

Symptoms During Menopause

  • Fatigue 

  • Sore muscles and joints 

  • Insomnia 

  • Hot flashes/night sweats 

  • Weight gain 

  • Urinary urgency, frequency and/or incontinence 

  • Vaginal dryness, painful intercourse and/or decreased libido 

  • Constipation 

It is important to note, these symptoms can vary from person to person, and some symptoms can appear in both perimenopause and post-menopause. 

how can pelvic floor physiotherapy help?

Some of the main symptoms of the menopause transition are related to pelvic floor function; up to 65% of women will report these symptoms within the first 7 years post-menopause. 

These symptoms are typically labelled genitourinary symptoms of menopause (aka GSM)  and include: 

  • Vaginal dryness, burning, itching, and pain 

  • Urinary urgency and frequency, painful urination, and recurrent UTIs 

  • Lack of lubrication, painful intercourse, decreased libido, and impairment of arousal and orgasm 

The decline in estrogen levels post-menopause is a large driver in many of these symptoms. Decreased estrogen levels contribute to decreased blood flow, decreased muscle mass and elasticity of muscles, and decreased support + elasticity of the bladder, itself.

Pelvic floor physiotherapy is a very well-supported treatment approach to help all these symptoms. 

A pelvic floor physiotherapist can complete a thorough examination of your pelvic floor function and teach you how to connect to and control your pelvic floor muscles, as well as provide education on lifestyle changes that can help support better pelvic floor function. 

Pelvic floor muscle training can help with GSM by: 

  • Improving blood flow to the pelvic floor 

  • Improving the ability to relax the pelvic floor muscles 

  • Improving elasticity of vulvovaginal tissues 

  • Improving muscle coordination and strength 

If you are in perimenopause (hint: late 30s to 50s), a pelvic floor physiotherapy assessment can be a great way to proactively assess your pelvic floor and start to work on coordination and strengthening. 

If you are post-menopausal, it is NEVER too late to have your pelvic floor assessed and improve your pelvic floor function. I’m here to help! 

Even if you are not experiencing any GSM symptoms throughout your menopausal transition, seeing a physiotherapist is a great idea because there are many other important global changes happening in your body throughout menopause - including decreased bone density and muscle mass. 

One of the best ways to combat these changes is exercise – specifically resistance training! 

A physiotherapist can assess you and then help guide you with an exercise program that is safe and effective. Exercise has been shown to: 

  • Improve bone density and muscle mass 

  • Improve mood 

  • Decrease weight gain 

  • Improve brain function 

  • Decrease hot flashes 

  • Improve insulin sensitivity 

With all of those benefits, you can see how important exercise is for your health and well-being, and our physiotherapists are ready to help you get started with an appropriate exercise plan! 

Our practitioners at wellbe family wellness understand how daunting and stressful menopause can feel, but we are here to help you understand what is happening in your body and empower you to take control of your symptoms to have a better menopause experience. 


Let’s take a moment and acknowledge this major life transition - in which you should feel supported and we are here to help you! We’ve got you!


This post was written by wellbe’s pelvic floor physiotherapist Amber Watkins. Click here to learn more about how pelvic floor physiotherapy can help and to book your first session.