Menopausal changes
Condition Overview
Menopause marks the end of your reproductive cycle and has significant hormonal changes which are 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 floor health, bone health, and the 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?
During the postpartum phase, especially if you are breastfeeding, there is a decrease in production of estrogen. This reduces likelihood of starting your menstrual cycle and reduces blood flow and lubrication to your vulva, vagina, and pelvic floor muscles which can cause drying and thinning of these tissues.
Due to this there can be a decrease in sexual libido or desire, urinary incontinence, vaginal dryness/burning, and changes in pelvic floor muscle strength. In addition, we also see irritability/mood swings, hair loss, depression/anxiety, and weight gain.
During intercourse, you may experience pain and bleeding - this could be due to thinning and drying of tissues leading to tearing and itching/irritation. If you have decreased pelvic floor strength due to decreased estrogen, you may experience urge or stress urinary incontinence. This can make it more difficult to make it to the bathroom without leaking or have leakage with coughing, sneezing, and/or exercise.
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!