Navigating Genitourinary Changes in Perimenopause and Menopause

As you move through the stages of perimenopause and menopause, you may face a variety of physical changes that can feel surprising and uncomfortable. Among these, genitourinary symptoms like urinary leakage, urgency, frequency, dryness, and painful sex are common but often go unspoken. Acknowledging these experiences can be empowering, as they are shared by many women. In this guide, I will break down the causes of these symptoms, share relevant statistics, and discuss how pelvic physical therapy can offer relief.

Understanding Genitourinary Symptoms

Perimenopause can start as early as your 30s or 40s. During this time, hormonal fluctuations can cause various genitourinary symptoms. For instance, a decrease in estrogen can lead to dryness, irritation, and changes in urinary function.

Research indicates that over 50% of women experience urinary incontinence during menopause. This condition may show up as stress incontinence, where leakage occurs during actions like sneezing or exercising, or as urge incontinence, characterized by a sudden, strong urge to urinate that can lead to accidental leakage.

The Impact of Hormonal Changes

The hormonal shifts during perimenopause and menopause can also result in painful sex, medically referred to as dyspareunia. A study in the Journal of Sexual Medicine showed that about 60% of postmenopausal women report experiencing pain during intercourse. This discomfort often arises from vaginal dryness, thinning vaginal walls, and reduced elasticity tied to lower estrogen levels.

Recognizing that these symptoms are a typical aspect of aging can help you approach them with a sense of acceptance. Importantly, seeking effective solutions can greatly enhance your quality of life.

Talk to a Gynecologist

It's important to openly discussing these issues with your healthcare provider. Effective treatments are available, so there’s no need to endure discomfort in silence. However, not all gynecologists are the same--many are not trained in how to manage the symptoms of perimenopause and menopause effectively. If you feel dismissed or not heard, it's time to find a different doctor.

The Menopause Society is a valuable resource and allows you to search for a practitioner near you who is trained. I've also really appreciated Dr. Mary Claire Haver's book The New Menopause: Navigating Your Path Through Hormonal Change with Purpose, Power, and Facts

The Role of Pelvic Physical Therapy

Pelvic physical therapy (PT) can be an invaluable resource for women facing genitourinary symptoms. A pelvic PT specializes in the pelvic floor's muscles and tissues, which can be impacted during perimenopause and menopause.

Research suggests that pelvic PT can lead to significant improvements in urinary leakage and painful sex. A study published in Female Pelvic Medicine & Reconstructive Surgery revealed that women participating in pelvic PT experienced up to a 70% improvement in urinary incontinence symptoms after just a few sessions.

How Pelvic PT Works

During your sessions, a pelvic PT will evaluate your pelvic floor muscles and create a personalized exercise plan aimed at strengthening and/or relaxing these muscles. Techniques may include biofeedback, manual therapy, breathwork, recommendations for and education on lubricants, moisturizing products, and correct body mechanics.

Many women discover that pelvic PT not only helps with urinary leakage but also improves their sexual experiences by addressing pain and discomfort. Therapy empowers women to manage their health and reclaim their bodies.

Practical Tips for Managing Symptoms

While professional help is crucial, there are also practical steps you can initiate at home to manage your symptoms effectively:

• Stay Hydrated: Drinking enough water supports urinary tract health and minimizes irritation.

• Use Lubricants: Over-the-counter water-based vaginal lubricants can ease dryness during sex, enhancing comfort

• Practice Kegel Exercises--IF your pelvic floor muscles are weak! Strengthening your pelvic floor muscles may reduce urinary leakage. A pelvic PT like me can help determine if your pelvic floor muscles are indeed weak and guide you on the correct way to do these exercises.

• Practice Relaxing the Pelvic floor--IF your pelvic floor muscles are tight! A pelvic PT like me can help you with strategies for relaxing the pelvic floor

• Maintain a Healthy Lifestyle: Regular physical activity and a nutritious diet can promote overall well-being, which might alleviate some symptoms.

• Communicate with Your Partner: Honest conversations about your experiences can foster support and understanding, making intimacy more enjoyable.

  
  

Embracing Change for Better Health

Navigating the genitourinary changes of perimenopause and menopause can be daunting, but you do not have to face it alone. By understanding these symptoms, seeking expert advice, and considering options like pelvic physical therapy, you can find relief from urinary leakage and painful sex. Remember, these experiences are a natural part of life, and addressing them is crucial for regaining comfort and confidence.

If you are experiencing these symptoms, contact me at Queen City Pelvic PT for guidance. You deserve to feel your best at every stage of life.