"I never had these problems before"
Many women come to us in their 40s and 50s surprised by new symptoms: leaking when they never leaked before, rushing to the bathroom, painful sex, or a feeling of pressure. Often they've been told it's just part of getting older.
These symptoms are common, but you don't have to accept them. They're very treatable.
What changes, and why
Estrogen helps keep the tissues of your vagina, vulva, urethra, and bladder thick, elastic, and well hydrated. As estrogen drops in perimenopause and menopause, those tissues can become thinner, drier, and more sensitive. Muscle mass also declines with age, including in the pelvic floor. Together, this can cause:
Leaking with coughing, sneezing, laughing, or exercise
Urgency and frequency, including waking up at night to pee
More frequent UTIs
Vaginal dryness, burning, or irritation
Pain with sex or a pelvic floor that tightens in response to pain
New or worsening prolapse symptoms, like heaviness or pressure
Doctors call the group of vaginal, vulvar, and urinary changes "genitourinary syndrome of menopause" (GSM). Unlike hot flashes, these symptoms often don't fade with time without treatment.
How pelvic floor PT helps
At Awake, every visit is a full hour, one-on-one with a Doctor of Physical Therapy. For midlife pelvic health, treatment often includes:
Pelvic floor strengthening to reduce leaking and support your organs, plus learning to relax muscles that have become tight or guarded
Bladder retraining to calm urgency and stretch out the time between bathroom trips
Help with painful sex, including hands-on care, education, and dilator or vibrator guidance when helpful
Strength training guidance to protect your bones and muscles, with a pelvic floor that can handle the load
Whole-body care for hip, back, and joint aches that often show up in this stage
A team approach
Pelvic PT works best alongside your medical provider. Vaginal estrogen, for example, is a low-dose treatment many women use for GSM symptoms, and it's worth asking your provider whether it's right for you. Vaginal moisturizers and lubricants can also help with dryness and comfort. We're happy to coordinate with your OB-GYN, midwife, or menopause specialist.
Small changes that help
Don't "just in case" pee. Going too often can train your bladder to hold less.
Stay hydrated and notice bladder irritants like caffeine, alcohol, and carbonation.
Lift weights. Strength training is one of the best things you can do for midlife health. Exhale on effort to protect your pelvic floor.
Use a good lubricant for sex and a vaginal moisturizer a few times a week if you're dry.
[patient story: a woman in perimenopause or menopause who stopped leaking or got back to comfortable sex]
This is a great time to start
Whether your symptoms are new or have been building for years, pelvic PT can help you feel strong and confident through this stage of life. Call (651) 432-0250 or request an appointment.
