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Managing menopause

Navigating the changes in our body during Perimenopause…

long term health Apr 29, 2024

Things are changing, you’re noticing things with your body aren’t what they were before you hit your 40’s – but fear not, we have the power to take control and make this transition smoother.

Let’s talk today about pelvic health and why things are suddenly feeling a little different.

Just like any other symptom of perimenopause (that’s the 10 years prior to actual menopause, which starts on average at 52) – the changes in our hormones are driving the symptoms that we notice.

The reducing Oestrogen can be particularly troublesome when it comes to pelvic health – here’s what you might notice…

  • Leaking and sudden urges that you didn’t have before when you cough, sneeze or jump

  • Dryness (vaginal) or skin irritation

  • Bladder sensitivity – sudden urges or needing to go more often

  • Weight gain around your middle – you’re eating and moving the same as before.


Oestrogen has a big impact on the make up of our soft tissues, and we notice a reduction in muscle mass and increase laxity in the tissues as it reduces.  With less muscle mass, we also have less to metabolise – because muscles are really active and need lots of energy, which is where all the talk about ‘fixing your metabolism’ comes in.

We often work with women who have suffered with a nasty, prolonged cough around this phase, and found that their pelvic floor just isn’t doing its job anymore.

Of course, I always recommend you see a specialist women’s heath physio, and your GP for any changes in any stage, but there’s also a few things which can really help.

Empowering yourself…

Understanding what’s going on and what you can do about it is so empowering for women – this stuff really isn’t talked about enough.

Keeping your digestion in check with a healthy balanced diet, including variety of plant foods for fibre is important.

Using a step (or alternative) to put your feet on when opening your bowels, is great for optimising the pelvic alignment and reducing pressure on the pelvic floor muscles can have a big impact.

Keeping an eye on caffeine and alcohol consumption might also be needed to reduce bladder sensitivity – tak a look at some bladder re-training if you find you are needing to wee very often, especially when you’re trying to stay super-hydrated.

And finally, we can counteract the effect of reducing oestrogen levels on our muscles by completing some exercise, particularly whole body strength training and a focused core and pelvic floor programme – and as a bonus this can help other symptoms of the perimenopause too.

You can take a look at the Complete Pelvic Floor Masterclass for guidance on what to do and how to do it – it’s not quite as simple as just imagining you’re stopping the flow of wee, but there are some very simple and effective exercises that can be done at home, without the need to wear Lycra, that will strengthen these muscles and overcome the dwindling muscle mass caused by those bothersome hormones!  And when you work on your pelvic floor strength, you actually work on your core and whole body strength too – so you’ll feel much better for it.

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