As a woman, your body undergoes several natural phases, one of which is perimenopause—a transition period leading up to menopause. But how do you know if you’re in perimenopause, and more importantly, how does it affect your pelvic floor and overall well being? Let's explore these questions and learn how targeted exercises and physiotherapy can support you through this stage of life.
What is Perimenopause?
Perimenopause is the time leading up to menopause, typically occurring in women between their mid-40s to early 50s. However, it can start earlier for some. It’s characterised by hormonal fluctuations, primarily a decrease in oestrogen levels, which can cause a variety of physical and emotional changes. Menopause officially begins when you’ve gone 12 consecutive months without a period, but perimenopause can last anywhere from a few months to several years before that.
How do you know if you’re in perimenopause?
The symptoms of perimenopause vary from woman to woman but commonly include:
Irregular periods
Hot flashes or night sweats
Mood swings
Trouble sleeping
Fatigue
Decreased libido
Vaginal dryness
Brain fog
Panic attacks
Heart palpitations
Achey joints and muscles
But one lesser-talked-about symptom is pelvic floor changes. Oestrogen plays a significant role in maintaining the strength and elasticity of the tissues in your pelvic area. As levels drop, these tissues can weaken, leading to potential issues like incontinence or pelvic organ prolapse.
Perimenopause and the pelvic floor
Your pelvic floor muscles help to support the bladder, uterus, and rectum. During perimenopause, these muscles can weaken, potentially causing:
Urinary incontinence (leakage when you cough, sneeze, or exercise)
Increased urgency to urinate
Pelvic organ prolapse (when organs move and press against the vaginal wall)
Pain or discomfort during intercourse
These changes aren’t inevitable, and many women manage these symptoms with the right care and support. This is where physiotherapy can be invaluable.
Exercises to strengthen the pelvic floor and core
Strengthening your pelvic floor is key to maintaining its function and preventing symptoms from worsening during perimenopause. Here are a couple of exercises that can help:
1. Kegel exercises
Kegels are one of the best-known exercises to strengthen the pelvic floor muscles. To do them:
Contract your pelvic floor muscles by imagining you are stopping yourself from breaking wind and then pull through to the front. It helps to start the squeeze as you exhale.
Hold for 5-10 seconds, then relax.
Repeat 10-15 times in a session, aiming for 3 sets per day.
2. Bridge
This not only strengthens your pelvic floor but also your glutes and core:
Lie on your back with your knees bent, feet flat on the floor.
Slowly lift your hips toward the ceiling, squeezing your glutes and pelvic floor muscles.
Hold for a few seconds before lowering your hips back down.
Repeat 10-15 times.
3. Transverse abdominis (TVA) activation
Your deep core muscles work closely with your pelvic floor:
Lie on your back with your knees bent.
Take a deep breath, then slowly exhale, pulling your belly button toward your spine, engaging your core and pelvic floor.
Hold for 5 seconds and repeat 10-15 times.
How physiotherapy can help
A specialised women’s health physiotherapist, like me, can guide you through tailored pelvic floor and core exercises that suit your individual needs. I can assess your pelvic floor strength and function, provide education, and offer manual therapy or biofeedback if necessary. Working with a physiotherapist can help you regain control over pelvic floor issues, prevent further complications, and improve your quality of life during perimenopause.
Final thoughts
Perimenopause is a natural part of ageing, but the symptoms—especially those related to pelvic floor health—don’t have to control your life. With the right exercises and physiotherapy support, you can manage your symptoms effectively and continue to feel strong and confident in your body.
If you're experiencing any symptoms of perimenopause or pelvic floor issues, get in touch with me. Together, we can develop a plan to help you navigate this transition with ease and strength.
Contact me today! For more information or to book a women’s health appointment, visit alicannphysio.co.uk.
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