Menopause and Your Pelvic Floor: What the Heck is Going On Down There?!
If you’re reading this, chances are you’ve hit that phase in life. You know, the one where hot flashes sneak up like ninjas, your body starts seriously changing, and, oh yeah, your pelvic floor decides to join the party, too! (or, more accurately, the pelvic floor bails, throws a tantrum or both!)
Menopause brings a host of changes to our bodies, and while the common ones like hot flashes and night sweats get all the attention, it’s time we talk about something less glamorous but just as important—our pelvic floor.
In this post, we’ll explore what happens to your pelvic floor during menopause, why you should start paying attention to it sooner rather than later, and what you can do to keep things strong, happy, and leak-free, including yoga for the pelvic floor (my specialty!).
What Happens Hormonally During Menopause? (And The Impact This Has on The Pelvic Floor)
So, here’s the lowdown: during menopause, our bodies go through big hormonal changes. Estrogen and progesterone, which have been our loyal sidekicks throughout life, start to drop off. Estrogen, in particular, plays a crucial role in keeping our tissues healthy, including the pelvic floor.
The pelvic floor is a group of muscles, ligaments, and connective tissues that support your bladder, uterus, and rectum. It’s like the bouncer for your internal organs, keeping everything in place. But when estrogen dips, those muscles can weaken and become less elastic, which can lead to issues like urinary incontinence, pelvic organ prolapse, and even painful sex.
The Hormonal Cascade: From Perimenopause to Menopause
Menopause doesn’t just happen overnight; it usually creeps in as perimenopause, which can last several years. During this time, estrogen levels fluctuate like a roller coaster, which is why you might notice things going a bit haywire with your cycle. Once menopause officially hits—meaning you’ve gone a full year without a period—those hormones settle into a new, lower normal.
So, what’s the impact of all this on the pelvic floor?
Loss of muscle tone: Estrogen helps keep the pelvic floor muscles strong and resilient, so less estrogen means less tone. This can lead to a feeling of “heaviness” in your pelvis or a frequent need to pee.
Thinning tissues: The tissues in your vagina and urinary tract thin out without estrogen, making them more vulnerable to irritation and infection.
Dryness and discomfort: Vaginal dryness becomes a real thing during menopause, which can affect your pelvic floor and lead to discomfort during sex or exercise.
Why It’s Important to Care for Your Pelvic Floor Before Menopause
Here’s the thing: your pelvic floor has been working hard your whole life. Every sneeze, laugh, heavy lift, and childbirth, has put it to the test. But by strengthening and taking care of it before you reach menopause, you can prevent or reduce the severity of issues once menopause comes knocking.
Think of your pelvic floor as a garden. If you neglect it, things start to wither, but with a little TLC, it can thrive! Prepping your pelvic floor now can lead to better bladder control, a stronger core, and more confidence as you move through menopause. Plus, a healthy pelvic floor can lead to more enjoyable intimacy and fewer issues with pelvic organ prolapse, yes, please!
3 Top Reasons to Start Taking Your Pelvic Floor Health Seriously Early:
Prevent urinary incontinence: A strong pelvic floor helps you control your bladder, reducing the chance of unexpected leaks.
Avoid pelvic organ prolapse: Keeping these muscles strong can prevent organs from shifting downwards, which can be uncomfortable and require medical intervention.
Reduce discomfort: With better tone and elasticity, you’ll experience less pain, dryness, and discomfort during physical activities.
Treatment Options for Pelvic Floor Health During Menopause
If you've already reached menopause without taking action to maintain pelvic floor health, don't fret!! There are still plenty of things you can do yourself and with the help of modern medicine. Let’s explore some of the most effective methods.
1. Pelvic Floor Physical Therapy
Pelvic floor physical therapists are like personal trainers for your pelvic muscles. They can teach you exercises that strengthen these muscles, improve your posture, and even use tools like biofeedback to help you better connect with your body. You can consult with your doctor to find a referral for a pelvic floor specialist in your area.
2. Hormone Replacement Therapy (HRT)
Some women find that HRT helps reduce the symptoms of menopause, including those pesky pelvic floor issues. HRT can involve estrogen therapy, which may come in the form of creams, patches, or pills. Consult with your doctor about HRT.
3. Lifestyle Changes
Staying active and maintaining a healthy weight can make a big difference for your pelvic floor. Avoid constipation by drinking plenty of water, eating fiber-rich foods, making sure your posture is top notch and staying away from heavy lifting.
4. Kegel Exercises
Yes, I know you’ve heard of these! But Kegels are like the foundation of pelvic floor exercises. The key is to do them right. A lot of us clench our butts or thighs, but a proper Kegel focuses on lifting the pelvic floor muscles up and in. Kegel exercises are, however, not the only answer to your pelvic floor woes.
5. Yoga for the Pelvic Floor (More on This Below!)
Yoga can strengthen the pelvic floor, improve posture, and help you connect with your body in a way that’s both gentle and effective. Plus, it’s a great way to reduce stress, which can have a positive impact on overall hormonal balance.
Yoga for Pelvic Floor Health During Menopause
Yoga is one of the best ways to support your pelvic floor health, especially during menopause. I am so passionate about sharing yoga for the pelvic floor with women, I have seen firsthand in myself and my students how effective and empowering it is.
Not only does it strengthen those muscles, but it also encourages relaxation and flexibility, which are crucial as our bodies change. Plus it doesn't just target the pelvic floor muscles (looking at you Kegels!!) it targets the entire core, spine and hips which all play a crucial role in our pelvic floor health.
On top of all of that yoga incorporates breathwork, mindfulness and relaxation. Healthy breathing patterns that sync up the movement of our pelvic floor and diaphragm correctly help us to maintain a healthy pelvic floor and also allow us to become sensitive and aware of what is going on down there.
In turn, this helps us to self-identify weaknesses and tightness so we can create a targeted approach to our own pelvic floor health (instead of mindlessly doing Kegels which may be making things worse!!). Here are some of my favorite yoga poses that target the pelvic floor.
If you have been cleared for exercise by your clinician, try these out, and discontinue if you experience any pain, increased pressure, or other worrisome symptoms. PROCEED at your OWN RISK. These exercises are only beneficial for women who are ready for them.
Cat-Cow with pelvic floor breath
During this exercise, we activate the pelvic floor while moving the spine with the breath.
Come onto all fours, making sure hips are aligned with knees and shoulders aligned with wrists. Fingers are spread and the spine is neutral. You may like to place a folded blanket under the knees.
As you inhale lift the head and tailbone, arch the spine, and gaze up. Maintain a slight contraction in the core muscles. Feel the abdomen stretch and release and relax the pelvic floor. This is the cow.
As you exhale tilt the pelvis down and tuck the tailbone, round the back and hollow the belly. Feel the abdomen lifting up into the body, lifting the pelvic floor as the spine stretches out. This is the cat.
Repeat 10 – 15 rounds of cat-cow.
Supported Bridge Pose
This pose is a pelvic floor powerhouse!
Lie on your back, bend your knees, and place your feet flat on the ground, hip-width apart.
Lift your hips toward the ceiling, squeezing your glutes and pelvic floor muscles.
Hold for a few breaths, then release. This pose strengthens the pelvic floor, glutes, and hamstrings all in one go.
Supine Pelvic Tilts
Pelvic tilts are a gentle way to reintroduce movement into the pelvic floor and lower back.
Lie on your back with your knees bent and feet flat on the floor. As you inhale, tilt your pelvis forward, arch your lower back slightly, and open and relax the pelvic floor.
On the exhale, tilt your pelvis back, pressing your lower back into the floor and gently engaging and lift your pelvic floor.
This simple movement helps to mobilize the pelvic area and strengthen the deep core muscles.
Malasana (Yogi Squat)
This deep squat opens up your hips and engages the pelvic floor.
Stand with your feet a little wider than hip-width apart, toes pointing slightly out.
Squat down, bringing your hands together in front of your chest, and press your elbows against your knees.
Hold for a few breaths, breathing deeply into your lower abdomen.
Take it to the next level by making it dynamic, coming up to standing and then back down to malasana.
You may find that you need the support of a rolled-up blanket under the heels and/or a block under the hips.
Navasana (Boat Pose)
Navasana is a fantastic pose for strengthening the entire core, including the deep abdominal muscles that support your pelvic floor.
Start by sitting on your mat with your knees bent and feet flat on the floor.
Lean back slightly, keeping your spine straight, and lift your feet off the ground until your shins are parallel to the floor.
You can keep your hands on the ground for balance, or, for an extra challenge, extend them straight out in front of you.
Engage your core as you hold the pose, imagining that you’re pulling your belly button towards your spine. Hold for a few breaths, then release.
This pose not only tones your abs but also helps stabilize the pelvis, which is crucial for pelvic floor support.
Child’s Pose
Child’s pose is a restorative pose that allows the pelvic floor and lower back to relax fully. Relaxation of the pelvic floor muscles is just as crucial to their stability and health.
Begin in a kneeling position, then sit back on your heels and extend your arms forward, lowering your torso towards the floor.
Rest your forehead on the mat and breathe deeply, allowing your belly to expand and your pelvic floor to release with each inhale.
This pose promotes relaxation and can help relieve tension in the pelvic area.
Embrace the Change and Love Your Pelvic Floor
Menopause may come with a few surprises (and maybe a few unplanned trips to the bathroom!), but taking care of your pelvic floor can make the journey smoother. By incorporating pelvic floor exercises, staying active, and adding a little yoga into your routine, you can keep things strong, supported, and ready for whatever life throws your way.
Practice Yoga for the pelvic floor with me!
Every week I offer online gentle and chair yoga classes. All of which are suitable for postpartum recovery. I also offer monthly yoga for the pelvic floor classes and workshops specifically to guide you through yoga for the pelvic floor.
Join us and Flourish! Find movement, creativity, and serenity, and blossom into your highest self. Because you are amazing, and you deserve to be well as you recover from giving birth!
NOTE: Use the code FLOURISHFREEYOGA to get your first class with me on the house.
Are you serious about your Pelvic Floor Health? Join my Pelvic Floor Membership!
Ready to ditch the Kegel focus and dive deeper into pelvic floor health? The Beyond the Kegel Membership is your all-access pass to a stronger core, happier pelvic floor, and a community of supportive women.
Here's what sets us apart:
Exclusive Access to the Core & Floor Foundations Course (value $275).
Live & On-Demand Classes: Get access to at least 2 LIVE dedicated pelvic floor yoga classes per month, plus a library of recorded classes covering a variety of topics. We'll cover what YOU want! Just let us know!
Continuous Learning: Membership includes access to upcoming workshops like Chair Yoga for the Pelvic Floor, further expanding your knowledge and practice options.
Supportive Community: Connect and share experiences with other women on their pelvic floor journeys in our private member community.
