Menopause and Pelvic Floor Strength: Why It Matters and How does Physio help?

Menopause and the pelvic floor are topics that often come up in conversation, but have you ever considered how they impact each other? The hormonal shifts that occur during menopause can have a significant effect on pelvic floor strength, leading to issues such as bladder leakage, prolapse, and discomfort during intimacy. The good news? Strengthening your pelvic floor can help counteract these changes and improve your overall well-being. 

What is the Pelvic Floor?

The pelvic floor is a group of muscles and connective tissues that stretch like a hammock from the pubic bone at the front to the tailbone at the back. These muscles support the bladder, uterus, and bowel, playing a vital role in:

• Bladder and bowel control – Preventing leakage and ensuring proper function.
• Core stability – Working with deep abdominal and back muscles to support posture.
• Sexual function – Enhancing sensation and comfort during intercourse.
• Pelvic organ support – Keeping the bladder, uterus, and bowel in their correct positions.

When these muscles weaken or become dysfunctional, problems such as incontinence, prolapse, and sexual discomfort can occur—issues that can become more common during menopause.

Understanding menopause and its effects on the Pelvic Floor

Menopause marks the natural transition in a biological woman’s life when menstrual periods permanently stop, signifying the end of reproductive years, typically occurring between the ages of 45 and 55, though timing varies for each individual. 

While menopause is a normal part of aging, it brings a multitude of changes that can impact the strength and function of the pelvic floor. These include:

1. Hormonal changes

Oestrogen plays a key role in maintaining muscle tone and tissue elasticity. As Oestrogen levels decline during menopause, the pelvic floor muscles can weaken, making it more difficult for them to support the bladder, bowel and uterus. 

2. Muscle Weakness

Aging naturally leads to a reduction in muscle strength throughout the body, and the pelvic floor is no exception. When combined with hormonal changes, this can result in a noticeable decline in pelvic floor function, increasing the risk of bladder leakage and discomfort.

3. Pelvic Organ Prolapse and Incontinence 

 Weakened pelvic muscles may struggle to provide adequate support for the bladder, uterus, and rectum, leading to conditions like pelvic organ prolapse (a feeling of heaviness or pressure in the vagina) and urinary incontinence (leaking urine when coughing, sneezing, or exercising).

4. Changes in Sexual Function 

 Menopausal hormonal changes can contribute to vaginal dryness, reduced elasticity, and decreased sensation, making intercourse uncomfortable or even painful. A strong pelvic floor can help improve blood flow to the area, enhancing sexual function and comfort.

The Importance of Pelvic Floor Strength During Menopause

 Starting a pelvic floor strengthening program before menopause can provide long-term benefits, but even if you’re currently going through or have already experienced menopause, it’s never too late to start. Strengthening these muscles can:

✅ Improve Bladder & Bowel Control – Reducing leaks and urgency.

✅ Help Prevent Pelvic Organ Prolapse – Providing better support for pelvic organs.

✅ Enhance Sexual Function & Comfort – Increasing sensation and reducing discomfort.

✅ Support Core Strength & Posture – Improving stability and reducing lower back pain.

When should I see a Physiotherapist for my pelvic floor?

 If you’ve noticed any changes in bladder control, pelvic discomfort, or sexual function during menopause, a Physiotherapist can guide you through a tailored pelvic floor muscle training program. These exercises can help you maintain strength, confidence, and comfort throughout this stage of life.

Author: Haley Barr, Physiotherapist – Burleigh clinic

Haley Barr

Physiotherapist

View Haley Barr’s profile

References

Hyun-kyung Kim, So-yeon Kang, Youn-jee Chung, Jang-heub Kim, & Mee-ran Kim. (2020). The Recent Review of the Genitourinary Syndrome of Menopause. Journal of menopausal medicine, 26(2), 56.

Mercier J, Morin M, Zaki D, Reichetzer B, Lemieux MC, Khalifé S, Dumoulin C. Pelvic floor muscle training as a treatment for genitourinary syndrome of menopause: A single-arm feasibility study. Maturitas. 2019;125:57-62.