Pelvic Floor Physiotherapy During Menopause: What Every Woman Should Know
- Aug 18, 2025
- 3 min read
Updated: Jun 15
For many women, menopause arrives quietly. 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, support and evidence-based care. 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.
Many of the symptoms women experience during menopause are related to changes in hormones, muscle function, connective tissue health and bone density.
As oestrogen levels drop, the tissues of the pelvic floor which support your bladder, uterus and bowel can become thinner, weaker, and less elastic.
Common Pelvic Floor Symptoms During Menopause
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
Reduced strength, balance and coordination with movement
Sleep disturbances and fatigue
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 During Menopause?
Physiotherapy during menopause focuses on supporting the whole body, not just isolated symptoms. Treatment aims to help women maintain strength, pelvic floor function, mobility, confidence, and quality of life through this stage of life.
At Praxis Rehab Physiotherapy, treatment is tailored to your individual symptoms, goals, lifestyle, and stage of menopause.
1) Pelvic Floor Rehabilitation
Research supports pelvic floor muscle training (PFMT) as a first-line conservative treatment for urinary incontinence and pelvic floor dysfunction during midlife and menopause.
A pelvic floor assessment helps identify muscle weakness, poor coordination or overactivity, prolapse symptoms and bladder and bowel habits contributing to symptoms.
Treatment may include:
Individualized pelvic floor muscle training
Bladder retraining strategies
Urgency management techniques
Advice regarding safe return to exercise
Pelvic floor exercises are most effective when they are supervised, specific, and performed correctly rather than relying on generic “Kegel” exercises alone.
For women experiencing bothersome prolapse symptoms such as heaviness or bulging, a vaginal pessary may also be discussed as part of conservative management.
2) Strength, Movement and Bone Health
Menopause can affect muscle mass, bone density, balance, and overall physical resilience. Many women notice increased stiffness, reduced strength, or fear around exercise during this time.
Physiotherapy can help you:
Build strength safely and progressively
Improve balance and mobility
Improve posture and movement patterns
Return to exercise with confidence
Support long-term bone health
Importantly, movement remains one of the most powerful tools for healthy ageing, symptom management, and maintaining independence.
Menopause Is Not the End of Strength or Vitality
Menopause is a significant life transition, but it does not mean giving up exercise, confidence, intimacy, or comfort in your body.
With the right support, many women experience major improvements in pelvic floor symptoms, strength, mobility, and overall wellbeing.
Physiotherapy can provide the tools, education, and guidance to help you move through menopause feeling supported, capable, and empowered.
Ready to feel more like yourself again?
Looking for a physiotherapist in Adelaide's eastern suburbs? We’ve got you covered.
Let’s talk. Book an appointment with Sangeeta, our pelvic health physiotherapist.
You’ll find us at: Signal Health Tusmore, 350 Portrush Road, Adelaide, SA 5065, on Tuesdays between 9:30 am - 2:30 pm.
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