Menopause and the Pelvic Floor: Understanding the Impact and How Osteopathy Can Help

Menopause is a natural stage in a woman’s life, marking the end of her reproductive years. While it is often thought of simply as the cessation of menstrual cycles, menopause comes with a wide range of physical and emotional changes. One of the most significant areas affected by menopause is the pelvic floor, and this can result in discomfort, incontinence, and other pelvic health issues. Understanding the role of hormones, particularly oestrogen, and how osteopathy can help in managing these changes is key to maintaining pelvic health during this life stage.

What Is Menopause?

Menopause typically occurs between the ages of 45 and 55, when a woman’s ovaries stop producing eggs, and the production of hormones such as oestrogen and progesterone declines. This leads to the end of menstrual periods and a variety of symptoms including hot flashes, mood changes, night sweats, and sleep disturbances. While these are the most well-known effects, menopause can also have a profound impact on the muscles, ligaments, and tissues of the pelvic floor.

The Role of Oestrogen in Pelvic Floor Health

Oestrogen plays a crucial role in maintaining the strength, elasticity, and hydration of tissues throughout the body, including the pelvic floor muscles. During the reproductive years, these muscles are typically supported by sufficient oestrogen levels, helping them stay strong and functional. However, as oestrogen production declines during menopause, women may begin to experience a weakening of the pelvic floor muscles, which can have a range of effects.

1. Muscle Weakness: Oestrogen helps maintain muscle tone, and its decrease can cause the pelvic floor muscles to weaken. This can lead to difficulty controlling bladder and bowel function, as well as reduced support for the organs in the pelvic region.

2. Dryness: Oestrogen also helps to keep the vaginal tissues moist and lubricated. A drop in oestrogen can lead to vaginal dryness, irritation, and discomfort during sexual activity. It can also make tissues more prone to tearing or injury.

3. Urinary Leakage: One of the most common pelvic health issues during menopause is urinary incontinence. Weakened pelvic floor muscles may struggle to properly support the bladder, leading to leaks during coughing, sneezing, or physical activity.

4. Prolapse: In more severe cases, a weakened pelvic floor can lead to pelvic organ prolapse, where the bladder, uterus, or rectum may start to drop into the vaginal canal.
   

How Osteopathy Can Help

Osteopathy is a holistic approach to healthcare that focuses on the body's musculoskeletal system. It aims to improve function, reduce pain, and enhance overall health through manual techniques that target muscles, joints, ligaments, and fascia. Osteopathic treatment can be particularly beneficial for women experiencing pelvic floor issues due to menopause.

1. Pelvic Floor Rehabilitation: Osteopathic practitioners can assess and treat pelvic floor dysfunction. By using specific manual techniques, they can help release tension in the pelvic muscles, restore balance, and improve muscle tone. Pelvic floor rehabilitation can also be in the form of exercise prescription, whether its stretches, strengthening or use of pelvic floor equipment.

2. Posture and Alignment: Osteopaths focus on the alignment of the pelvis and spine. Poor posture or misalignment can exacerbate pelvic floor issues, and osteopathic treatment can help improve posture, which in turn supports the pelvic region.

3. Breathing Techniques: Osteopathy also incorporates breathing exercises, which can be especially helpful for women experiencing pelvic floor dysfunction. Correct breathing techniques help activate and support the pelvic floor muscles, improving control and strength.

4. Soft Tissue Manipulation: Osteopathic manipulation can relieve tension in the muscles and connective tissues around the pelvis. This can improve circulation and flexibility, supporting the natural healing and restoration of pelvic floor function.
   

Managing Menopause and Pelvic Floor Health

While osteopathy is a valuable tool in managing pelvic floor health during menopause, there are several other strategies women can use to alleviate symptoms and support their pelvic muscles.

1. Pelvic Floor Exercises: Regular pelvic floor exercises are essential for strengthening these muscles and improving bladder control. Kegel exercises, which involve contracting and relaxing the pelvic floor muscles, are a simple and effective way to build strength and endurance in the pelvic region. These exercises can be done anywhere and are often recommended by healthcare providers.

2. Exercise: General physical activity is beneficial for overall health and pelvic floor strength. Exercises like yoga, pilates, and swimming can help improve muscle tone and flexibility, while also supporting bone health. Weight-bearing exercises, such as walking and strength training, are also important to maintain bone density, which can be affected by lower oestrogen levels.

3. Topical Oestrogen Creams: For women experiencing vaginal dryness and irritation, topical oestrogen creams can be helpful. These creams are applied directly to the vaginal tissues to provide localised relief from dryness, discomfort, and irritation, helping to restore moisture and elasticity to the vaginal walls. This is something you would need to chat to your GP about as it is not suited to everyone.

4. Lubricants and Moisturisers: Over-the-counter lubricants and vaginal moisturisers can also help alleviate the discomfort of vaginal dryness, especially during sexual activity. These products can provide temporary relief and improve comfort.

5. Diet and Hydration: Eating a balanced diet rich in vitamins and minerals is essential for maintaining healthy tissues and muscles. Staying hydrated is equally important, as it helps maintain the elasticity of the tissues and prevents further dryness.
   

Menopause is a natural transition, but its effects on the pelvic floor can be challenging. The drop in oestrogen levels can weaken muscles, cause dryness, and increase the risk of urinary leakage and pelvic organ prolapse. However, with the right management strategies, including osteopathy, pelvic floor exercises, topical treatments, and lifestyle changes, women can maintain pelvic health and enjoy better quality of life during this stage.

If you're experiencing any pelvic health issues related to menopause, don't hesitate to seek help from an osteopath or other healthcare professional. By addressing these concerns early and with a holistic approach, you can support your body through this transition and beyond.