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Physical Therapy for menopause 

What is Menopause?

Menopause is the transition of a woman’s life when hormonal changes occur and menstruation halts.  The average age of menopause is 50 years, however bodily changes and hormone fluctuations can initially begin nearly 10 years prior to the last period.  This means that women in their late thirties and forties are likely in a phase called perimenopause. 

 

Perimenopause is the phase in which a woman is experiencing these changes and may be experiencing symptoms of various.  You may notice periods becoming less regular, may last longer, bleed more or less.

Symptoms of Menopause

During this decade of slow transition of hormone levels, the most impactful being the decline of estrogen, the women’s body may begin experiencing symptoms such as:

  • Hot flashes

  • Brain fog

  • Joint and muscle pain

  • Decreased in strength

  • Change in sleep

  • Mood changes

  • Sexual changes 

  • Urinary or bowel changes

  • Weight gain, change in body composition

  • Decline in bone health (fractures, osteoporosis) 

 

These symptoms are typically driven by a steady decline in estrogen. Estrogen is an integral hormone in tissue health, thus the decline impacts ALL body systems, including:

  • Cardiovascular - This is one of the reasons why women are at higher risk for cardiovascular events like heart attack and stroke than men. 

  • Muscle system - Without estrogen, the decline of movement and strength training causes women to lose muscle strength. This decline in strength can affect pelvic health (leaking, prolapse), balance and stability (falls), metabolic changes, and change in body composition, along with more injuries like tendonitis

  • Bone health - an increase in fractures, stress fractures, osteopenia and osteoporosis

  • Gastrointestinal - decreased stomach acid and slower speed of digestion can lead to bloating, gas, constipation or diarrhea. Other changes occur in the gallbladder as well. 

  • Endocrine system - the fluctuation of several hormones and how they affect the glands contribute to the symptoms of hot flashes, night sweats, changes in urination and vaginal dryness 

Menopause and the Pelvic Floor

The pelvic floor is made up of  muscles, tendons, ligaments, and bone and therefore is impacted by the changes the body undergoes as listed above. When estrogen is abundant and keeping the muscles lubricated, hydrated, and plump, the body is able to support our pelvic organs, maintain continence, promote normal bowel movements and digestion, and contribute to sexual activities.  Once the estrogen depletion begins taking its toll on the tissues the symptoms which may arise can include:

  • Vaginal dryness

  • Painful intercourse

  • Urinary leaking

  • Increase in UTIs, or UTI-like sensations (burning, urinary frequency, etc)

  • Pelvic organ prolapse (heaviness, bulging or dragging sensation in the pelvis)

  • Constipation 

  • Leakage of stool

  • Pelvic pain, hip pain, low back pain

 

Genitourinary Syndrome of Menopause is a newer term which collectively refers to the symptoms of menopause as they relate to pelvic health.  These include most often: vaginal dryness, painful intercourse, frequent urge to urinate, urinary leakage (incontinence), vulvar atrophy (thin, dehydrated tissue that causes pain with sitting, walking, urinating), and recurring bladder infections.  

Pelvic Floor Physical Therapy for Menopause 

As pelvic floor therapists we specialize in the pelvic region and all the body parts that connect to it, which include the abdomen, back, spine, hips, and rib cage. This means that pelvic floor therapists are the best provider to assist you in navigating your pelvic floor symptoms and those directly related to changes of menopause.  As holistic PT/OTs who have a lifelong commitment to women’s health care we consider an approach which incorporates:

  • Behavioral health

  • Mental health

  • Sleep hygiene

  • Stress management

  • Muscle strength, movement, exercise

  • Diet/nutrition

Along with the integration of all of these aspects, what sets pelvic floor therapists apart is being able to comprehensively assess and treat the pelvic floor muscles.  Due to the changes the tissues (skin, muscles, etc) go though we are able to teach you how to properly use your pelvic floor muscles to improve symptoms of:

  • pain (hip, low back, tailbone, pelvic)

  • incontinence (leaking)

  • intimacy changes (pain, changes in pleasure, dryness)

  • constipation, loose stool, or other GI discomforts

  • prolapse (heaviness, bulging)

  • urinary urgency and frequency​

Gaia Women’s PT and Collaborative care

Here at Gaia Women’s PT we use a holistic or “biopsychosocial” approach to all our care, but especially the management of menopause. Because menopause affects all body systems it is many times imperative to have a team of providers to collaborate with to manage symptoms.

We frequently collaborate with:

  • Gynecologists 

  • Primary Care providers

  • Functional/Naturopathic Medicine

  • Sexual Medicine specialists 

  • Acupuncturists/Massage therapists 

  • Chiropractors 

  • Mental Health providers 

  • Nutritionists/Dieticians 

  • Many others for specific needs

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