Pelvic Floor Weakness

Muscles are a girl’s best friend post-menopause and that goes for the muscles that support the pelvic floor too.

Why do women’s pelvic floor weaken during menopause?

The hormonal decline in menopause is responsible for so many symptoms, but what far too many women don’t realise is that their dwindling hormones weaken their pelvic floor muscles when entering perimenopause which can lead to some pretty miserable problems if not strengthened regularly.

Your pelvic floor muscles are often ignored post-childbirth or completely if never having had a child, yet these muscles will certainly let you know if they’re being neglected in the most embarrassing ways pre, peri and post-menopause.

A responsive and healthy pelvic floor can prevent bladder and bowel incontinence, treat prolapse, and also make sex better too.

What are the symptoms of menopause pelvic floor weakness?

The most common (but never normal) symptoms of weakness that women may notice is difficulty controlling their bladder or bowel.

These are some of the signs of pelvic floor weakness you should look out for:

Stress incontinence: Leaking urine when you laugh, cough, sneeze, run, jump or do vigorous exercise.
Urge incontinence: Needing to get to the toilet in a hurry or not making it there in time. (Latchkey or key in the door syndrome). This is an overactive bladder.
Pelvic organ prolapse (POP): A feeling of heaviness around your lower tummy and genitals that wasn’t there before. A dragging discomfort inside your vagina. Feeling like there's something coming down into your vagina – it may feel like sitting on a small ball. Feeling or seeing a bulge or lump in or coming out of your vagina. It can be the womb (uterus), bowel, bladder or top of the vagina.
Constipation: Can be caused by pelvic organ prolapse (faeces sitting or trapped in a prolapse of the back wall of your vagina - a rectocele), a drop in your hormones and general ageing.
Vaginal dryness: Pain during sex, urinary infections/cystitis or sometimes itching and soreness of the vulva.

Other contributing factors to reduced pelvic floor muscle function in menopause can be due to:

Weight gain, a less elastic bladder
Anal trauma resulting from childbirth
Chronic conditions such as diabetes or asthma can cause bladder or bowel control problems
Hysterectomy

Pelvic floor exercises are important during this phase of life and can be incredibly beneficial if done correctly.

How to do pelvic floor exercises correctly?

Over 80% of pelvic floor weakness can be improved by pelvic floor exercises. You’ve nothing to lose by trying out our simple self-help solutions and plenty to gain!

We suggest you download the NHS-approved Squeezy App, which offers pelvic floor muscle exercise programmes.

It’s available for £2.99 on iPhone and Android, which is well worth the money if it prevents potential pelvic floor problems post-menopause.

When to seek medical treatment for weak pelvic floor muscles?

Please don’t put up with any leaks, you don’t want them to get worse and rely on the expense of pads for the rest of your life. Your doctor should refer you to a urogynaecologist or ask to be referred to a women’s health physiotherapist with experience in the field.

Watch our video with Women’s Health Physio Christien Bird ‘Menopause Incontinence, Prolapse and Pelvic Health’. You’ll learn everything you need to know and hopefully an encouragement to seek help from a specialist.

Can HRT improve pelvic floor weakness?

As quoted from the British Journal of Medical Practitioners ‘The role of hormone replacement therapy (HRT) is debatable. Although oestrogens may improve atrophic vaginitis (vaginal dryness), there is no evidence that oestrogens by themselves are beneficial in incontinence.’

What lifestyle changes can help improve pelvic health?

There’s never been a better time than menopause to reassess your lifestyle. It’s the perfect time to stand back and reflect on things that could affect your pelvic floor, bladder, bowel and digestive health.

Things that you can proactively manage are:

It’s advised that you drink two litres of fluid a day, as in water or herbal tea. Many women reduce their fluid intake hoping that this would help control leaks, but less fluid can lead to concentrated urine which can result in bladder irritation.
Weight: Eating a good well-balanced diet to manage menopause weight gain
Movement: Look at your exercise regime may be more swimming cycling and yoga rather than high-impact exercise.
Reduce your intake of caffeine, alcohol, and fizzy drinks.
Self-care: take a step back from your frenetic life and allow yourself more ‘me time’.

And the good news is….

By being proactive in perimenopause and strengthening your pelvic floor muscles, pelvic floor problems can be prevented. And, if you are already experiencing problems, they are reversible in most cases, so don’t be embarrassed to seek help, there are plenty of professionals who can boost your pelvic health.

Check our Menopause Movement Directory for professionally trained fitness and health professionals who know how to strengthen your pelvic floor in menopause.