Why You Should See A Women’s Health Physiotherapist During Perimenopause

- Maddison Cutmore (Specialist Pelvic Physiotherapist)

Perimenopause is a season of change. Your body is shifting, hormones are fluctuating, and sometimes it feels like your familiar self is rapidly evolving. But one thing many women don’t expect during this phase?

Pelvic floor issues.

You might start to notice new symptoms:

- leaking when you laugh,
- a sudden urge to go,
- pain during intimacy, or
- vaginal heaviness.

It’s easy to dismiss these changes as just part of getting older, but they’re actually signs that your pelvic floor might need some attention.

So, what is your pelvic floor?

Most of us have heard of the pelvic floor, we know it’s somewhere “down there,” and we’ve probably been told to do our Kegels at some point. But there’s a lot more to it.

Your pelvic floor is a complex network of muscles and connective tissue (fascia) that stretches like a sling from your pubic bone to your tailbone. It has a deep layer and a superficial one, and together, they help support your pelvic organs (bladder, uterus, and bowel), maintain continence, and play a key role in sexual function.

These muscles are just like any others in your body in that they can get weak, tight or uncoordinated, but thankfully, they are trainable.

Why hormones matter?

During perimenopause, declining estrogen levels can lead to a range of pelvic symptoms:

• Vaginal dryness, which can make sex uncomfortable or even painful

• Urinary urgency and frequency, or leaking when you sneeze, laugh, or exercise

• Pelvic organ prolapse, which can feel like pressure or heaviness in the vagina

• Changes in bowel habits, including constipation or incomplete emptying

What does a women’s health physio do?

We’re here to help you understand what’s happening in your body and to give you the tools to feel better, stronger, and more in control.

At your appointment, we take a full history and often perform a vaginal examination, which allows us to assess the pelvic floor muscles in detail. This includes checking:

• The strength, endurance and coordination of your muscle contractions, including whether these muscles can fully relax (yes, relaxation is just as important as strength, particularly for painful intercourse or hip/back pain)

• The tone in these muscles and whether this corresponds to any familiar or referred pain

• The position of the vaginal walls which helps us assess for any signs of prolapse

• The movement of your bladder and/or urethra to look for any mobility here which might

  be contributing to urinary incontinence.

This is a valuable assessment in perimenopause, because with hormonal changes, muscles and fascia are impacted and often stop functioning as well as they always have.

It’s never too early (or late) to check in

Many women come to see us postpartum, when they’re trying to recover and rebuild their pelvic floor. But perimenopause is just as important a time to pay attention to your pelvic floor. These years lay the foundation for how you’ll move, function, and feel in your 50s, 60s, and beyond.

Prevention is always better than cure.

We have a focus on preventative healthcare

The more you understand your anatomy and how it functions, the more empowered you are to address symptoms you’ve been ignoring or prevent issues from progressing.

 You deserve to feel strong, supported, and comfortable in your body, at every stage of life. If you're experiencing any of these symptoms, or simply want a check-up to make sure everything’s working well, a women’s health physiotherapist can be your best ally through the perimenopausal transition.

Looking to manage pelvic floor symptoms?

Let us help! At Ponti Health, alongside our team of women’s health GPs, we have a team of expert women’s health physiotherapists who can help you manage the symptoms of perimenopause through pelvic physiotherapy effectively. Book your first appointment with Ponti Health today!