Menopausal changes
Condition Overview
Menopause marks the end of your reproductive cycle and has significant hormonal changes which can be accompanied by night sweats, hot flashes, body aches, fatigue, and irritability. On top of these very noticeable outward signs of menopause, it can also negatively impact your pelvic health, bone health, and myofascial system.
In the postpartum period, we are not going through menopause; however, the drastic hormonal changes women experience during this phase can mimic menopause or peri-menopausal symptoms so it is important to receive guidance and treatment on how to mitigate these responses.
What Do Menopausal Changes Do To Pelvic Health?
Low Estrogen Pelvic Floor Dysfunction:
We have a higher likelihood of developing this especially if breastfeeding or pumping but can occur while our hormones are still regulating themselves after delivering a baby.
With low estrogen comes delayed menstruation and reduced blood flow and lubrication to your vulva, vagina, and pelvic floor muscles. This can cause dryness and thinning of vaginal tissues also known as vaginal atrophy.
In addition, you may also notice a decrease in sexual libido or desire, urinary incontinence, vaginal dryness/burning, and changes in pelvic floor muscle strength.
Because of these changes with low estrogen, you may experience you may experience pain and bleeding during intercourse. Furthermore, if you have decreased pelvic floor strength due, you may experience urge or stress urinary incontinence/leaking or prolapse symptoms such as pressure and heaviness.
What can we do to combat these menopausal symptoms during postpartum and menopause?
First, having a good understanding that these symptoms are likely due to hormonal changes can clue you in to getting the help you need sooner rather than later so we can make positive lifestyle changes.
In physical therapy we will discuss all pelvic health symptoms including but not limited to bladder, bowel, sexual, and gynecological health.
With your consent we will perform an external and internal pelvic floor muscle assessment to determine tissue sensitivity, resting muscle tone, and muscle strength, endurance, and coordination. In your treatment, we may include manual therapy such as dry needling, cupping, and myofascial release, and use of vaginal tools such as pelvic wands or dilators.
If needed, we will teach you how to perform kegels and incorporate this into your daily life and exercise routine. We will provide advice and recommendations to improve tissue dryness and irritation. This can include vaginal moisturizer such as V-magic, coconut oil, or vitamin E oil used daily/nightly, or we may recommend seeking gynecological care if it is thought you need hormone replacement therapy such as estrogen cream.
Maintaining vaginal moisture will help keep the pelvic floor tissues “plump”, improve healing, and reduce sensitivity. We will also recommend using a water based soluble lubricant during sexual intercourse. With urinary incontinence, we will teach you pressure management strategies, urge control strategies, and pelvic floor strengthening and coordination exercises as needed. It takes about 6-8 weeks for muscles to demonstrate change, so keep putting forth effort!
If you are postpartum or experiencing peri-menopausal or menopausal symptoms, make an appointment today to get started on the care you need to improve your quality of life!