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  • Yee Yeoman

Navigating Pelvic Health during Perimenopause and Menopause

Perimenopause and menopause mark significant transitional phases in a woman's life. Perimenopause, often referred to as the menopausal transition, is the stage leading up to menopause. It typically starts in a woman's 40s, but it can begin as early as the 30s or as late as the 50s. During perimenopause, hormonal fluctuations occur, leading to a range of physical and emotional changes.

Menopause, on the other hand, is the point at which a woman has not had a menstrual period for 12 consecutive months. It is a natural part of the ageing process and usually occurs around the age of 51, although it can happen earlier or later for some women. Menopause signifies the end of a woman's reproductive years and the cessation of ovulation and hormone production.

Both perimenopause and menopause can bring about various symptoms and challenges, including significant impacts on pelvic health. It's important for women to understand these stages and be proactive in managing their pelvic health during this transitional period.

Studies have revealed that a significant number of women in the postmenopausal stage, ranging from 45-63 percent, experience vulvovaginal symptoms. Surprisingly, this number escalates to a staggering 80 percent for women aged 65 and older. Unfortunately, these symptoms are rarely discussed openly among women, leading to a mere 7 percent of women seeking treatment for their discomfort. It's time to change the narrative and address the pelvic health challenges that come with perimenopause and menopause.

Understanding the Symptoms: Vulvovaginal dryness, burning, irritation, and sexual issues like lack of lubrication, discomfort, or pain are common symptoms associated with perimenopause and menopause. These changes can also affect urinary function, leading to increased urgency and recurrent urinary tract infections. Collectively, these symptoms are known as the intriguingly named "Genitourinary Syndrome of Menopause (GSM)."

The Impact on Pelvic Health: During this stage, you may experience reduced vaginal elasticity, changes in vaginal pH, alterations in vaginal flora, decreased lubrication, and heightened susceptibility to physical irritation. It's crucial to address these symptoms promptly since GSM is a permanent condition that tends to worsen over time. Delaying treatment can diminish the effectiveness of interventions, making early intervention imperative.

The Bladder Connection: Urinary symptoms often go hand in hand with vaginal symptoms during perimenopause and menopause. The sudden urge to urinate and the inability to wait even for a few minutes can be reminiscent of toddlerhood. Activities like coughing, sneezing, running, and jumping may become anxiety-inducing due to the risk of urine leakage. Studies have indicated that women reporting vaginal dryness are nearly twice as likely to experience incontinence. The impact of incontinence extends beyond physical discomfort, affecting work productivity, sexual satisfaction, mental well-being, and overall quality of life. Click on this link to find tips on how to conquer bladder leakage.

Exploring Treatment Options: In a British study published in Maturitas, non-hormonal therapy applied vaginally was found to be the most common treatment for GSM (31.8 percent). This was followed by hormonal therapy applied vaginally (11.6 percent) and systemic hormonal therapy (4.7 percent). It's essential to discuss these options with your GP to determine the most suitable approach for you.

If hormone therapy is not a preferred choice, there are other steps you can take to alleviate symptoms and support your pelvic health:

Prioritise Sleep: Getting adequate rest can positively impact your overall well-being and reduce symptoms associated with menopause.

Use Lubricants and Moisturisers: These products help rehydrate vulvar and vaginal tissues, lower pH levels, and promote vaginal health. Opt for paraben-free options with an osmolality below the WHO's ideal recommendation.

Engage in Regular Exercise: Exercise contributes to overall physical and mental well-being, which can help manage menopause symptoms, including those affecting pelvic health.

Stress Management: Implement stress-reducing techniques such as meditation, deep breathing exercises, or engaging in activities you enjoy to support your overall health.

Perimenopause and menopause can bring significant changes to your pelvic health, but it's crucial to break the silence surrounding these issues. Seeking appropriate treatment and taking proactive steps to maintain your pelvic health can enhance your overall well-being and quality of life. Remember, you're not alone in this journey, and there are resources available to support you along the way.

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