Pelvic Floor Function in Menopause: Symptoms, Solutions, and Support
Meta Description: Pelvic floor issues like incontinence or pain are common in menopause—but they’re not inevitable. Learn what’s happening and how to strengthen and protect this vital area.
What No One Talks About (But We Should): Your Pelvic Floor
Your pelvic floor muscles play a major role in your health—from bladder control to sexual comfort. And during midlife, these muscles often go through major changes.
Whether from childbirth, aging, surgery, or simply time, these muscles can weaken or become overactive. This can lead to symptoms like:
• Urinary or bowel incontinence
• A feeling of heaviness or pressure
• Pain during sex
• Pelvic organ prolapse (when organs shift downward)
• Changes in sexual sensation
But here’s the truth: these symptoms are common, but not normal—and they’re treatable.
Understanding Urinary Incontinence
Urinary incontinence is one of the most common pelvic floor issues. While not directly caused by menopause, it becomes more frequent with age.
The two main types are:
• Stress incontinence: urine leaks when you cough, sneeze, or lift something—usually due to weak pelvic muscles.
• Urge incontinence: sudden, strong urges to pee that can lead to accidents—often due to overactive bladder muscles.
Some women have mixed incontinence, experiencing both types.
Many factors increase your risk: childbirth, surgery, excess weight, diabetes, infections, smoking, and even certain medications.
Getting a Diagnosis
A healthcare professional may ask you to keep a “bladder diary” for a few days, review your medical history, test your urine, or perform a physical exam. They may also assess how well your bladder empties and if other organs are involved.
Treatment Options: What Helps and Why
Everyday Strategies:
• Limit fluids to around 64 oz/day
• Avoid caffeine if it worsens urgency
• Lose weight if needed
• Practice timed voiding (peeing at regular intervals)
For Stress Incontinence:
• Cough control: quit smoking and manage chronic cough
• Urethral inserts: tampon-like devices to prevent leaks during activity
• Pessaries: flexible rings inserted into the vagina to support organs
• Pelvic floor physical therapy: guided sessions to strengthen or relax the right muscles, sometimes with electrical stimulation or biofeedback
For Urge Incontinence:
• Bladder retraining
• Medications: like anticholinergics or antimuscarinics
• Nerve stimulation: devices to help retrain the bladder
• Botox: injected into the bladder wall if other treatments fail
In Some Cases: Surgery
If other strategies don’t work, there are minimally invasive surgical options that are highly effective.
Kegel Exercises: Your Daily Power Move
Kegels strengthen the pelvic floor and can prevent or improve incontinence.
How to do them:
1. Contract the muscles you’d use to stop urinating.
2. Hold for 3 seconds, then release.
3. Aim for 5 minutes, 3x a day.
4. Add a second each week, working up to 10–15 seconds.
Bonus tip: once you’ve mastered them, squeeze during a cough or sneeze to prevent leaks.
Pelvic floor dysfunction is treatable. Don’t suffer in silence—there’s help, there’s healing, and there’s hope.
