Jane Simpson is a continence nurse specialist

As oestrogen levels drop at the time of the perimenopause and menopause, this can affect your pelvic floor health.
Jane Simpson is a continence nurse specialist with special interest stress incontinence, overactive bladder and urge incontinence, vaginal prolapse, pregnancy and childbirth, the menopause, sex and the pelvic floor, bowels and pelvic floor. She has also written a book called The Pelvic Floor Bible.
As oestrogen levels drop at the time of the perimenopause and menopause, this can affect your pelvic floor health.
You may have had children and the pressures of raising a young family may have led to a certain albeit nonintentional neglect of your pelvic floor muscles! Then when you suddenly start having symptoms of the menopause your pelvic floor is telling you it needs your help.
The common symptoms that occur at this time are:
- Leaking urine when you cough, sneeze, run, jump or do vigorous exercise. This is stress incontinence
- Having frequency or urgency to pass urine, sometimes called “key in the door syndrome’ does this ring a bell? Or even urge incontinence. This is an overactive bladder/urge incontinence
- A heavy feeling in your vagina like you are sitting on an egg, or you have a feeling of heaviness that wasn’t there before. This is a Pelvic organ prolapse (POP)
- Pain during sex, urinary infections/cystitis or sometimes itching and soreness of the vulva. This is caused by vaginal dryness.
- Constipation, this can be caused by pelvic organ prolapse (faeces sitting or trapped in a prolapse of the back wall of your vagina- a rectocele), general aging and a drop in your hormones.
Your lifestyle at the time of the menopause is very important. It’s a good time to stand back and reflect on things that could affect your pelvic floor, and your bladder and bowel health, things like your weight, have a look at your exercise regime maybe more swimming cycling and yoga rather than high impact exercise, your fluid intake, try to cut down on caffeine, alcohol and fizzy drinks. Eating a good well-balanced diet. Caring for yourself, taking a step back from the frenetic life we all lead and having a bit more me time.
Pelvic floor rehabilitation and general pelvic floor health is so important. As our pelvic floor is neatly tucked away in our underwear, we often forget all about it unless it’s really bothersome, i.e., leaking urine or a prolapse.
Try to start doing a few pelvic floor exercises every day. For self-help try the squeezy app, there are all sorts of gadgets available to buy, vaginal weights, Elvie trainer, electrical stimulation devices. Some of these give very good biofeedback and can be very motivating. If you are not sure what to do or how to find your pelvic floor seek the help of a women’s health specialist.
Remember: The health of your pelvic floor is very important to your whole physical wellbeing. Pelvic floor dysfunction is often curable or at the very least made much more manageable with the right help. So, love your pelvic floor it needs you!