Pelvic Floor and Menopause

Menopause and the Pelvic Floor

The side effects of menopause are increasingly discussed and understood. As the taboos around the transition are broken down, society is becoming more comfortable with the symptoms, including hot flushes and night sweats.

But one menopausal side effect that is less well-recognised is the impact that it can have on the pelvic floor; Rowena Woods, Urology Clinical Specialist Nurse at King Edward VII’s hospital, discusses the impact of the menopause on the pelvic floor, and the steps women can take to prevent damage.

Why does the pelvic floor suffer during menopause?

Menopause is caused by a change in hormones, and in particular the female sex hormone, oestrogen. As women reach their 40s and 50s and begin to experience menopause, their oestrogen levels drop off, which can create issues for bladder control and the pelvic floor. Oestrogen is key for stimulating the muscles involved in supporting the pelvic floor, and so when this begins to decline, some women can experience incontinence and struggle controlling their bladder when they laugh or cough. This is particularly common amongst women who have had children in the past.

Those affected can feel like they’re less able to control their bladder, experiencing leaks or feeling like things are “dragging”, which can of course be unpleasant and distressing.

What other factors can affect the pelvic floor?

Staying healthy and active can also prevent incontinence and retain pelvic floor strength. If you’re overweight you should look to enjoy a healthy and balanced diet, particularly one rich in fibre to prevent constipation and the need to strain, which can in turn weaken the pelvic floor.

Building strength and supporting muscles can also help. Smoking is bad for muscle development and quitting may help improve your bladder control. Core strength can also help, and menopausal women should try to do low impact exercises like swimming, walking pilates and abdominal work outs.

How can I build my pelvic floor strength?

Pelvic floor exercises can help to improve bladder control, and all women from the age of 12 should be regularly exercising their pelvic floor to prevent incontinence. Women who have had children will have likely been taught to do these in the past, but these should be kept up throughout life.

This consists of practising three times a day - doing 10 slow exercises, squeezing for 10 seconds as if you were trying to hold a wee in, and then resting for four seconds; this should be followed by 10 quick squeezes. You can do this yourself, or use a “trainer”.

However, if you’re struggling with incontinence, or have little or no strength in your pelvic floor, you may need some initial help getting started. At pelvic floor clinics, women can benefit from electrical stimulation, which can prompt contraction in the muscles and begin to build them up.

In addition, menopausal women may benefit from vaginal oestrogen, which can be prescribed by your GP, this can address some of the hormone imbalances caused by menopause without the need for hormones to enter the bloodstream, as it is applied as a pessary or cream.

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