A woman covering her private.

The Truth About Menopause and Pelvic Floor Dysfunction

Menopause is a natural physiological process that all women go through as they age. The word “menopause” can be used to describe the various changes you will experience immediately before or after you stop getting your monthly period. Menopause typically occurs in your late 40s or early 50s, with the average age of onset being 51 years. Your doctor will diagnose you with menopause if you have gone for a consecutive year without a period.

The start of menopause can weaken your pelvic floor muscles, which are responsible for supporting your pelvic organs. The weakening of these muscles can cause pelvic floor dysfunction. Other factors that can contribute to the weakening of pelvic floor muscles include weight gain during menopause, a less flexible bladder, anal strain during birth and serious medical conditions such as diabetes.

What is the Link Between Menopause and Pelvic Floor Dysfunction?

Once you hit menopause, your body’s ovaries end production of sex hormones including progesterone and estrogen. Estrogen plays an essential role in keeping the pelvic floor healthy and this is why you are likely to develop pelvic problems at this stage of your life.

Estrogen helps in keeping your pelvic floor ligaments strong and flexible. So, when the level of this sex hormone drops, the ligaments that keep your bowels, urinary bladder and womb in position get thinner, frailer and less flexible. The consequence is that your chances of developing pelvic floor dysfunction, such as prolapse or leaking from your bowels or bladder, increases – about 50% of all menopausal women develop either prolapse or leakage and, in some cases, both.

Prolapse refers to a situation where one of the three pelvic organs drops into the vagina. When the organ that has prolapsed is the bladder, it is called a cystocele. If it is the bowel that drops, it is called a rectocele. When the womb drops, it is called a uterine prolapse.

It is possible to have more than one organ prolapse at the same time. The prolapse may be slight and you may not even know whether they are there, or the drop may be more serious where a ball shape may be visible at the entry to or protruding past your vagina. Although these organs cannot fall out completely, they can be extremely uncomfortable, especially if they are bulging outside of your vagina.

Menopausal women may experience two kinds of bladder leakage: stress urinary incontinence (UI) and overactive bladder (OAB). UI occurs when your pelvic floor ligaments and muscles get overextended. This occurs when coughing, sneezing, or even laughing. It applies pressure to your bladder and cause urine to escape. OAB refers to a sudden urgency to pass urine and the inability to hold it in.

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Menopause Causes

Menopause occurs due to the following processes:

  • Natural reduction of reproductive hormones, including progesterone and estrogen.
  • Surgical removal of both the uterus and ovaries.
  • Chemotherapy and radiation treatment – these anticancer treatments can activate menopause, resulting in symptoms such as hot flashes, either during or just after the treatment period.
  • Primary Ovarian insufficiency – a condition where your ovaries cannot manufacture adequate levels of sex hormones.
  • Pelvic Floor Dysfunction Causes

    Although accurate causes of pelvic floor dysfunction are not known, researchers associate this disorder with conditions or procedures that lead to pelvic muscles weakening or it can lead to the tearing of connective tissue. They include:

    • Menopause
    • Childbirth
    • Pelvic surgery
    • Nerve damage
    • Severe injury to the pelvic floor area

    Pelvic Floor Dysfunction Symptoms

    Pelvic floor dysfunction has several symptoms, including:

    • The desire to have numerous bowel movements within a short duration
    • Stool or urine leakage
    • Painful urination
    • Incomplete bowel movements
    • A frequent urge to urinate
    • Pain during sexual intercourse
    • Constant pain in your pelvic floor area, rectum, or genitals
    • Excessive strain in the pelvic area or rectum
    • Muscle contractions in the pelvis

    Keep in mind that many of these symptoms may be related to other conditions, so it is important to have a thorough physical examination so that your doctor can accurately diagnose your symptoms.

    Menopausal Pelvic Floor Dysfunction Treatment

    Various treatments exist for pelvic floor dysfunction due to menopause. We will outline common therapies below.


    Biofeedback is one of the popular therapies for pelvic floor dysfunction. This low-risk, non-painful, non-surgical procedure is performed by a physical therapist. It offers much needed relief for over 75% of pelvic floor dysfunction patients. The physical therapist may employ different biofeedback strategies to rehabilitate the muscles. For instance, the therapist may use unique sensors and video to inspect the pelvic floor muscles and ligaments as the client tries to contract or relax them. Then, they offer feedback and work with the patient to boost muscle strength and flexibility.

    Self-Care and Relaxation Techniques

    To cut down stress on your pelvic floor muscles, avoid excessive pushing or straining while using the bathroom. Practicing relaxation techniques like meditation, stretching, and yoga can be a great way to relax and strengthen your pelvic floor muscles. Another valuable technique is taking warm baths – they enhance blood circulation and muscle relaxation.


    Your doctor may recommend a muscle relaxant to ease the symptoms of pelvic floor dysfunction. Relaxants are effective when it comes to preventing muscle spasms. Follow your doctor’s prescription carefully to get the most out of the prescribed muscle relaxant and minimize possible side effects.

    Kegel Exercises

    These exercises entail contracting and relaxing your pelvic muscles. The goal is to strengthen these muscles and help them provide firm support to your pelvic organs.


    If your doctor discovers your pelvic floor problems are a consequence of one or more of the pelvic organs dropping into the vagina, a surgical procedure may be necessary. The aim of surgery is to help the pelvic floor muscles relax and position the prolapsed pelvic organ(s) back in their proper place.

    In Conclusion

    Pelvic floor dysfunction can be an embarrassing and a sometimes painful condition. The good news is that there are effective treatment approaches that can strengthen your pelvic muscles and increase their capability to hold your pelvic organs in position. Discuss your symptoms with your doctor to help them arrive at an accurate diagnosis. If the condition is in its early stages, home remedies and relaxation techniques such as warm baths, meditation and yoga may be enough. If it is a bit advanced, medication and surgery may be necessary.