Pelvic Floor Physiotherapy During Menopause: What Every Woman Should Know

Sangeeta Sharda
Aug 18
3 min read

Updated: Aug 28

For many women, menopause arrives quietly but its effects can be anything but. It’s not just the end of periods. It’s a whole-body shift that can influence your sleep, mood, energy, memory, and, yes, even your pelvic health. And yet, we don’t talk about it nearly enough. At Praxis Rehab Physiotherapy, we believe that menopause deserves more than a quick mention in passing. It deserves understanding, compassion, and support. If you're approaching this stage of life or already in the thick of it, here’s what we want you to know. Let’s unpack what menopause does to your body, and how pelvic floor physiotherapy during menopause can support your wellbeing.

What Causes Pelvic Floor Changes During Menopause?

Menopause is officially defined as the point in time when you haven’t had a period for 12 consecutive months. But the changes often begin years earlier, during a phase called perimenopause. This is when hormone levels particularly oestrogen and progesterone start to fluctuate. Some women breeze through it with only minor changes. For others, it can feel like their body has become unfamiliar overnight. Hot flushes, mood swings, poor sleep, weight changes, and a foggy head are just a few of the symptoms women often report. There can also be changes in your skin, your libido, and the way your body holds onto strength and energy. And while these changes are natural, they can also be deeply unsettling.

As oestrogen levels drop, the tissues of the pelvic floor which support your bladder, uterus and bowel can become thinner, weaker, and less elastic. You might notice:

Urine leakage when laughing, sneezing, coughing or exercising
A sense of heaviness or pressure in the vagina (a possible sign of prolapse)
Needing to go to the toilet more often or urgently
Discomfort during sex due to vaginal dryness
Back or hip pain, and a weaker core
Constipation or slower bowel movements

These symptoms are common, yes but they’re not something you have to live with quietly or permanently. Fortunately, pelvic floor physiotherapy can make a big difference.

How can Pelvic Floor Physiotherapy Help?

This is where pelvic health physiotherapy for menopause makes a real difference. Our job isn’t just to treat symptoms, it's to help you understand what’s happening in your body, regain control, and feel confident again. We start by getting to know you, your history, your symptoms, your goals. A pelvic floor assessment helps us understand how your muscles are functioning and what kind of support your body might need. From there, we guide you through specific exercises to strengthen and coordinate your pelvic floor. These aren’t just generic “Kegels” they’re personalised, practical, and designed to fit into your life to improve your pelvic organ support as well as bladder control during menopause. We might prescribe a ‘vaginal pessary’ if heaviness or bulge is bothersome. We also look at the big picture. If your sleep is poor, your energy is low, or your joints are aching, that matters too. We can help you create gentle movement routines that build strength without draining your reserves. We also offer guidance around bladder habits, bowel health, intimacy, and hormonal changes because all of these things are connected.

At Praxis Rehab Physiotherapy, our specialist women’s pelvic floor physio, Sangeeta Sharda is personalised to guide, support and empower you.

It’s Not About “Getting Back to Normal”

Here’s the truth: menopause isn’t about returning to who you were before. It’s about moving forward with new knowledge, new tools, and a new respect for your body.

This chapter of life can absolutely be one of strength, vitality, and self-assurance especially when you’re supported. You don’t need to wait until symptoms are unbearable. And you definitely don’t need to go it alone. If you’re noticing changes and wondering whether pelvic physiotherapy could help, reach out. Whether it’s guidance, reassurance, or hands-on support, we’re here to walk beside you through it all.