Perimenopause and the menopause

Very few women seek advice for perimenopausal and menopausal symptoms.

Pelvic Health Physiotherapy consists of an individualised pelvic floor programme and personal guidance on exercises and lifestyle modifications. The aim is to relieve discomfort, empower you to manage your menopausal symptoms better, and improve your overall quality of life. No matter your age!

Statistics published in the NICE guidelines about ‘Urinary incontinence and pelvic organ prolapse management’, say ‘the prevalence of pelvic organ prolapse is high; in primary care in the UK, 8.4% of women reported vaginal bulge or lump, and on examination prolapse is present in up to 50% of women. One in 10 women will need at least 1 surgical procedure, and the rate of re-operation is as high as 19%.’.

Much of my work is in supporting women in 'third age’ (peri and post menopause), when hormonal changes can lead to loss of oestrogen, weakening of the pelvic floor muscles, incontinence, prolapse and vaginal dryness. Too many women suffer symptoms in silence , thinking it’s fairly normal, or are too embarrassed to look for help and support.

What can women proactively do to help themselves?

1. Focus on your pelvic floor

Pay some extra attention to your Pelvic floor. They are the muscle group responsible for some pretty important functions like, bowel & bladder control, better sex as well as managing and preventing prolapse.

A study showed that women with continence issues often increases will wait for 6 years before they seek help. And only then will mention it to their doctor, if she is female, looks interested and is old enough.

I would recommend downloading the Squeezy App today and start your pelvic floor muscles exercises. If you are still not sure, book an appointment with a specialist Women’s Pelvic Health Physio.

2. Happy Bowel Movements

Bowel problems can cause misery in peoples lives. With changing hormone levels during the menopause bowel problems can increase whether it be constipation, incomplete emptying, faecal incontinence, problems with controlling wind, rectal prolapse, haemorrhoid’s, or pain from anal fissures– and sometimes quite a few of those symptoms can occur at the same time.

Here are a few tips how to achieve a regular happy bowel movement:

Position matters. Your knees need to be higher than your hips.
Have patience, you can’t just empty the tap, take your time
If you strain, it is like squeezing toothpaste from the top, it makes it more difficult to empty your bowels completely. Straining is also a risk factor in the development of prolapse, if you strain regularly, talk to your GP or Women’s Pelvic Health Physio.
3. Dealing with Vaginal Dryness

About half of menopausal women suffer from vaginal dryness and painful intercourse. Your vagina is very well oestrogenised, so reduced oestrogen might lead to itchiness, pain, you might not be able to wear your favourite pair of jeans and sex can be painful, which is miserable. Yet less than half of those women seek help.

If sex is painful or your sexual experience is changing, seek help from a Women’s Pelvic Health Physio and use a good vaginal lubricant or ask your GP for topical Oestrogen (this is not HRT).

AND FINALLY

Ask for support! Talk to your friends, mother, sisters and daughters; keep asking even if that is not your natural style. Women’s health needs to be talked about more, we are not simply men with boobs and tubes, we have different physiologies and need individualised treatment. As a women’s pelvic health specialist we have some great public health message to share, too often we keep it tucked behind the closed doors of clinics.

NWHP has links with Norfolk Menopause