The Two Most Common Pelvic Issues In Menopause

For women who have gone through menopause there are two most common pelvic issues I see in this group of people.

1. Pelvic pain/pain with sex

2. Incontinence

There are ways to help these two issues. Some involving pelvic floor therapy and some medical interventions.

Pelvic Pain Causes and Treatments For Menopause

A common reason women have pelvic pain after menopause, and more specifically, pain with intercourse, is due to vaginal dryness.

Vaginal Dryness

After a woman goes through the menopause transition her body stops producing estrogen. The vaginal tissues have estrogen receptors. Now scientists are discovering there are estrogen receptors all over the body, including the brain, which may explain brain fog in menopause.

Since the body stopped producing estrogen, the vaginal tissues become thinner and drier which can actually lead to both symptoms of pelvic pain and can be a contributing factor in incontinence. We will address incontinence later.

Often using lubrication with sex is not enough to prevent the pain. It is certainly helpful, but for many women, not enough.

I recommend every woman speak to her doctor about starting vaginal estrogen. This is a localized cream or suppository that helps restore thickness and moisture to the vaginal tissues. It can also help prevent UTIs (urinary tract infections) because it is thickening the outer vaginal tissues and keeping out bacteria.

How Pelvic Floor Therapy Helps With Pelvic Pain

Pelvic floor therapy can also help with pelvic pain if vaginal estrogen is not enough. Often there are tight muscles in the pelvic floor that create pain with intercourse or inserting something in the vagina. If the muscles are tight, they cannot relax and expand as they are supposed to with arousal and this can cause pain with sex. A pelvic floor therapist can work directly on these muscles to relieve tension and give you specific stretches to help.

Two Tools To Help With Pelvic Pain

There are two tools I like to recommend to my clients to help with pelvic pain, or pain with intercourse.

1. Vaginal dilators.

   1. Vaginal dilators give a general stretch all around the pelvic floor muscles.

   2. These are good for people who have pain with insertion or can't tolerate insertion.

   3. These dilators pictured are from Soul Source and you can use my code 04181b for a discount. (affiliate)

1. Pelvic wand

   1. The pelvic wand is for more specific tight spots in the muscle. This is meant more for people who have pain with certain positions or perhaps deep penetration.

   2. The wand pictured is from Intimate Rose and you can use my name Carri for a discount. (affiliate)

Incontinence Causes and Treatments In Menopause

There are a few different categories of incontinence

1. Stress incontinence--leaking with coughing, sneezing, laughing, exercise

2. Urge incontinence--leaking on the way to the toilet or not being able to hold urine when you feel the urge to go

3. Overflow incontinence--leaking urine when the bladder is too full

For women after menopause urge and overflow incontinence are the two types I see the most with my patients. Stress incontinence is not as common in this population.

This population, women who have gone through menopause, is one population that might benefit solely from doing kegels.

I also have these women make sure they have good bladder habits such as:

• going to the bathroom at regular intervals

• not going too often and shrinking the bladder capacity

• drinking water or their beverages slowly throughout the day rather than a large amount at once

• ruling out any bladder irritants such as caffeine, carbonation or citrus.

If those things have been optimized, then often this population needs stronger pelvic floor muscles in order to make it to the toilet on time.

As we age we start to lose muscle mass if we aren't actively working to prevent that through exercise and lifting weights.

For most of my younger patients general exercise is enough to improve their bladder symptoms because every time you walk, move or exercise your pelvic floor muscles are activated, but in my older folks they often need to do kegels to specifically strengthen their pelvic floor muscles.

For these patients they like using a device like the Perifit to do their kegel exercises.

(I have no affiliation with Perifit). I always recommend working with a pelvic therapist first to make sure you can do kegels correctly and that you need to do kegels to help your problem.

If you want to learn more about optimizing your bladder habits and bladder function, which is also a huge reason for incontinence in this age group, then sign up for my free bladder masterclass here.