How midlife transitions affect pelvic health and what you can do about it…
Research shows that approximately 6,000 women in the US enter menopause each day. So whether you’re reading this as someone in your 20s or 30s or someone who has already gone through menopause, this article is for you. To all you men reading – if you have any women in your life it can be helpful to understand the impact this has on quality of life, stress, and sexual function so that you can support those women in the best way possible.
There are many directions we could take this blog post but I am going to stay in my lane as a pelvic floor physical therapist and just speak on the changes that happen to the musculoskeletal system and your pelvic health.
Lets start with some definitions:
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Menopause – the point in time where a woman has not had a period in 12 months (1).
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Perimenopause – the period of time leading up to this when the menstrual cycle becomes irregular (2).
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Estrogen -a hormone produced by the ovaries, adrenal glands, and fat cells and has a major impact on pelvic health. (3)
During perimenopause estrogen levels begin to decline and further decline as women progress into menopause. This can impact your pelvic health in the following ways:
Your Muscle Mass Decreases
On average people lose between 0.4kg-0.8kg in muscle mass per decade and this happens more rapidly in women than men (4). Decreasing estrogen in the system secondary to perimenopause and menopause further decreases muscle mass. Research shows that by age 70 a woman can lose between 30-50% of their muscle mass (5). Since your pelvic floor is a group of muscles, this means that it can be impacted as muscle mass declines. This can lead to an increase in urinary leakage, pelvic organ prolapse, and sexual dysfunction.
Some of you may be thinking… oh great, I guess I’m doomed… BUT there is hope and it comes in the form of STRENGTH TRAINING!
Beginning a whole body strengthening routine at least 2-3 times per week can maintain muscle and prevent accelerated loss of muscle mass (4). This is where we come in as pelvic health PTs. We can make you a customized strengthening program that takes into account the pelvic floor to help you take back control of your menopause journey!
Your Risk of Weight Gain Increases
As muscle loss occurs it can be replaced with fatty tissue further impacting pelvic health as it increases cumulative load to the pelvic floor. This can also be combated with the addition of strength training and cardiovascular fitness.
Your Vaginal Lubrication Decreases
Estrogen plays an important role in helping the vaginal tissue secrete lubrication which can make penetrative sexual intercourse more comfortable. As women go through perimenopause and menopause this lubrication decreases and can oftentimes cause pain with sex, so they avoid it or just assume there is nothing to be done. BUT this doesn’t have to be your story. There are a variety of over-the-counter vaginal moisturizers as well as prescription medications to help with this. Talk with your primary care provider or gynecologist about these options and how they may help.
As a pelvic floor physical therapist I recommend my patients use additional lubricant with sex if they are experiencing pain related to dryness. You can use oil based, water based or silicone based. Some of my favorites to recommend are Uberlube, Good Clean Love, and Slippery Stuff.
In short, start preparing NOW for your midlife journey. Whether you aren’t there yet or are already in a postmenopausal state – its never too late to get started with strength training, cardiovascular fitness, and improving your pelvic health!
If you want to learn more about specific strategies to take control of your menopause journey join us for a FREE workshop at the Enhancing Life Studio led by Kelsey Karnes, Pelvic Floor PT and Lisa King, Yoga Instructor and Menopause Movement Specialist on June 5th at 6:30pm. The registration link can be found at:
https://movesmartky.com/events
If you can’t make that but would like more information, give us a call. Kelsey would be more than happy to speak with you regarding your journey and share how we at Move Smart can help!
Written by: Kelsey Karnes PT, DPT
References:
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https://www.cancer.gov/publications/dictionaries/cancer-terms/def/menopause
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https://www.cancer.gov/search/results?swKeyword=perimenopausal
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https://www.apta.org/apta-magazine/2019/09/01/menopause-pts-help-to-ease-the-change
