Menopause & The Pelvic Floor: What’s the Connection?

Ladies, it sometimes seems that we have been dealt something of a rough deal. From periods throughout life to menopause.

There always seem to be additional problems to deal with. Unfortunately, this means that there can be a link between pelvic floor health and menopause.

However, all is not lost, and there are certainly many ways to improve any problems. You may discover this as you hit your perimenopausal and menopausal years. 

Can Menopause Cause Pelvic Pain?
Can Menopause Cause Pelvic Pain?

Yes, menopause can cause pelvic pain and discomfort.

The most simple explanation is the estrogen levels.

As we get older and closer to perimenopause age, our estrogen levels start to decline.

Without estrogen, the vaginal tissues have a harder time and become more irritated easily. There is also an increased risk of urinary tract infection, because without estrogen, these tissues get a lot thinner, and the urethra stops sealing properly.

Vagina infections go up because of changes to the pH levels, which in turn creates dryness and can lead to painful and irritated sex, which nobody wants!

Finally, as if that little lot isn't enough, low estrogen also leads to muscle mass reduction and can cause pelvic organ prolapse. Constipation can also be an issue, and if you are straining to empty your bowels, any existing symptoms of prolapse can be made worse. 

What Can Cause Pelvic Pain After Menopause? 

Pelvic pain after menopause could be due to an underlying condition, such as endometriosis or constipation. They can also be down to the strength or lack of strength in your pelvic floor. However, following all of the advice for menopause and pelvic pain treatment and keeping it going even once you are part of the menopause can certainly make a positive difference to any pain in the pelvic region.

Menopause & Pelvic Pain Treatment  

To better manage pelvic pain during or after menopause, you can:

  • Talk to your GP about HRT (Hormone Replacement Therapy) and estrogen
  • Use lubrication
  • Cut down potential irritations
  • Stop smoking
  • Practice pelvic floor exercises regularly


Talk to your GP about HRT and Estrogen

manage your menopause symptoms

Over the last few years, the conversation about menopause and hormone replacement therapy has really opened up. With several celebrities sharing their menopause stories in public, the stigma has been reduced.

So, you should find your GP is very open to discussing the possibility of hormone replacement therapy or estrogen cream/pessary that can be used topically. The aim of this cream is to help improve the health of vagina tissues and their elasticity. It isn't a quick fix, as normally it would take about six weeks before you notice any changes, but when established, you may also find the irritation factor is reduced, and you become less susceptible to urinary tract infections. 

Use Lubrication 

Pelvic pain during menopause can be made worse by discomfort during sexual intercourse. So it's always a good idea to introduce a lubricant or moisturiser. Ensure that it is specifically designed for vaginal use and is either hyaluronic or silicone-based, as these are the best for reducing dryness in the area.

Cut Down Potential Irritations 

Irritation to the pelvic region can come from many different sources and add to the amount of pelvic pain women suffer during menopause.

Some of the problems are caused by things we take for granted. For example, a washing powder or fabric conditioner could cause irritation to the skin, so try and find something designed to be very gentle. The same can also be said for intimate cleansing wipes; ironically, being sold for the purposes of helping, they can actually do more damage, and we recommend avoiding them.

If you are suffering from leakage, be sure to use an incontinence pad, not a sanitary towel, as they have a different design and sanitary towels could cause irritation.

When shopping for toilet rolls, be sure to choose, unperfumed, natural brands. Try not to wear thongs and tight clothing, and when you are exercising, be sure to select materials that are designed to be breathable for athletics.

Finally, it may well be time to stop removing any pubic hair, as this can also become a really big source of irritation, even if it has been fine for years.

Stop Smoking

If you happen to be a smoker, it could well be time to try and quit. When you smoke a cigarette, the circulation of blood is affected, and this includes how well it flows to the vagina, providing it with oxygenated fresh blood. Cigarette smoke also dulls the effects of any oestrogen at a time when you are producing less naturally.


Practice Pelvic Floor Exercise Regularly 

pelvic floor exercises in menopause

Starting pelvic floor exercises is something you can never leave too late. The Pelvic floor is always going to become weaker once women pass the age of 40, so really, you should be starting pelvic floor exercises around this time, if not sooner.

However, if you didn't get around to it, don't panic. Starting them at any time can only help the health of your pelvic floor region and hopefully reduce any pain you are having in the area.

Pelvic floor health can be negatively affected by carrying children and childbirth, irrespective of whether you have a Caesarean or vaginal birth.

The Kegel is the best-known pelvic floor exercise, and we really cannot recommend it enough. Everything in the region, including control of your bowel and bladder, will benefit from pelvic floor exercises, so you should aim to start doing them and try to do them every single day.

The best thing about pelvic floor exercises is, that they are completely discreet, and you can do them anywhere, on the bus, in a queue or in the safety of your own home.


The Takeaway

No matter whether you are perimenopausal, menopausal or out the other side taking steps to look after your pelvic region can help reduce any irritation or pain you may be suffering.

We always recommend seeing a pelvic floor physio.

Pelvic floor exercises are your best friend, and it is never too late to start practicing them.


Have a go with our Kegel weights, or maybe sign up for one of our 30 Day Pelvic Floor Challenge, to get you into a good habit. Starts Monday 5th June 2023. ⬇️⬇️⬇️

30 day pelvic floor challenge


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Watch Astrid Talk About Secret Whispers Kegel Weights

Astrid and pelvic floor weights

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If you have any concerns please talk to your healthcare provider to get the proper diagnosis so you can get treatment as soon as possible and get on with your life.

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