Understanding perimenopause and the role of pelvic health physiotherapy
Perimenopause is a natural yet often complex phase in a woman’s life, marking the transition toward menopause. While it brings hormonal and physical changes, it also presents an opportunity to focus on health and well-being.
The term ‘perimenopause’ refers to the years leading up to menopause, when the body’s production of oestrogen and progesterone begins to fluctuate. This phase can last several years and typically starts in a woman’s 40s, though it can begin as early as the late 30s. Menopause itself is defined as the absence of menstruation for 12 consecutive months and usually occurs between the ages of 50 and 52 in Australia.
Hormonal changes and their impact on symptoms
During perimenopause, fluctuating levels of oestrogen and progesterone can affect multiple systems in the body, leading to a wide range of symptoms:
Oestrogen supports the health of vaginal and urinary tissues. Its decline can result in vaginal dryness, reduced elasticity, and discomfort during intercourse. Many women also experience a higher risk of urinary tract infections.
Oestrogen influences neurotransmitters like serotonin and dopamine, which regulate mood. Fluctuations can cause mood swings, increased anxiety, irritability, and sleep disturbances. Night sweats and changes in melatonin production may also affect sleep quality.
Oestrogen plays a crucial role in maintaining bone density. Its decline during perimenopause accelerates bone loss, increasing the risk of osteoporosis and fractures.
Hormonal shifts can contribute to a reduction in muscle mass and strength, leading to fatigue and decreased physical endurance. Joint stiffness and discomfort are also common complaints.
Oestrogen has protective effects on the cardiovascular system. Lower levels can influence cholesterol levels and increase the risk of heart disease.
Hormonal changes may affect metabolism, leading to weight gain, especially around the abdomen. These shifts can influence self-esteem and overall health.
Common challenges of perimenopause
Every woman experiences perimenopause differently, but some common challenges include:
Physical Symptoms: Hot flushes, night sweats, fatigue, sleep disturbances, and joint pain.
Emotional and Cognitive Symptoms: Mood swings, anxiety, and brain fog.
Pelvic Health Issues: Urinary incontinence, vaginal dryness, and increased risk of pelvic organ prolapse.
Bone and Muscle Changes: Decreased bone density, muscle mass, and strength.
How pelvic health physiotherapy can help
Its not all doom and gloom. As much as this period of time can present many challenges, there is many strategies and ideas that you can implement to help transition through this stage of your life. This is a great opportunity to prioritise your health and well being. Pelvic health physiotherapy offers practical, evidence-based solutions to help women manage the challenges of perimenopause. Here’s how it can make a difference:
Pelvic floor muscle health
Assessing and strengthening the pelvic floor muscles to address incontinence and prevent prolapse.
Providing techniques to alleviate vaginal discomfort and improve sexual health.
Bone and muscle strength
Designing personalised weight-bearing and resistance exercise programs to maintain bone density and muscle mass.
Including balance and coordination exercises to reduce the risk of falls.
Joint and muscle pain relief
Using manual therapy, stretching, and strengthening exercises to reduce stiffness and discomfort.
Developing routines to improve mobility and physical endurance.
Education and self-management
Offering guidance on posture, body mechanics, and lifestyle changes to minimise strain.
Sharing relaxation techniques for stress reduction and better sleep quality.
Supporting your journey through perimenopause
By understanding the changes your body is going through and seeking support, you can navigate this phase with greater ease. If you are struggling with perimenopause and the hormonal changes taking place, it may also be helpful to reach out to a GP that has a good understanding of menopause and how they can best support you. It is important to have a good team or care providers around you that can assist and support you.
