Mrs Jane E Simpson
Mrs Simpson is the Continence specialist at The London Clinic, and the author of The Pelvic Floor Bible.
Friday 18 October is World Menopause Day which raises awareness of the impact menopause can have on women’s health and everyday lives, including the pelvic floor.
Jane Simpson Continence Specialist and author of The Pelvic Floor Bible talks about pelvic floor health during the menopause and what to do about it.
The muscles of the pelvic floor support the bladder and keep us dry. Stress incontinence happens when these muscles become weak and the neck of your bladder does not always stay closed under stress, for example with a sneeze or a cough. Stress incontinence commonly occurs after childbirth or during the menopause.
Research indicates that between 25 and 45 per cent of women around the world suffer from stress incontinence. The large statistical variance is almost certainly due to many people being too embarrassed to be completely honest about their symptoms.
You may have had a bit of stress incontinence over the last twenty or so years, but if it wasn’t bad enough to be wearing a pad I suspect you never got around to doing anything about it. Suddenly it’s the menopause and things are much worse
Frequency, Urgency and Urge Incontinence
The symptoms of frequency and urgency can be harder to deal with when your oestrogen levels are starting to drop, but don’t panic; there are still things you can do to improve the situation
Due to the decrease in your oestrogen levels you can suddenly start having to run to the toilet. You tell yourself it’s ridiculous, you only went an hour ago, but your bladder is having none of it.
Pelvic Organ Prolapse
It is thought that about 50 per cent of women over fifty have some degree or symptoms of prolapse. It may feel like a heavy feeling in your vagina, like you are sitting on an egg or a ball or a general feeling that ‘things’ are falling out.
Atrophic Vaginitis and Vaginal Dryness
Atrophic vaginitis means that the walls of your vagina start to thin and lose some of their elasticity. It can be accompanied by vaginal dryness, pain during sex, urinary infections and itching and soreness of the vulva. This is due to your body having less oestrogen.
This problem can often be solved or helped by the use of vaginal oestrogen and pelvic floor rehabilitation.
Quick Tips for Great Pelvic Floor Muscles
- We should all be doing pelvic floor exercises. It’s an absolutely vital part of our physical wellbeing, and is incredibly easy to do
- Sit on the arm of a chair, or any hard surface with your feet flat on the floor. Lean slightly forward with your vulval area in contact with the hard surface. With your hands on your thighs try to lift the area around your vagina and anus away from whatever it is you are sitting on.
- Draw up all the muscles at the same time, squeeze, lift and hold for a count of five – build up to ten over time, if you can. Let go gently and count to five, then repeat five times. Try to do the exercises three times a day at least twice maybe, while cleaning your teeth then you will never forget. Once a day, do ten short, sharp contractions. Done in a rhythmic pattern of squeeze, let go, squeeze, let go.
- If this is not working please don’t give up whatever you do, you may be helped by a tool or gadget. For example vaginal weights, the Elvie trainer, or electrical stimulation (checking first with the manufactures instructions that these are ok for you to use). If in doubt seek help from a women’s health physiotherapist or a continence specialist.
For more treatments regarding pelvic floor problems caused by the menopause, please read our feature: 12 things you need to know about your pelvic floor. Most problems are very curable, or certainly better managed.
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