Menopause, Pelvic Floor Health, and the Power of Strengthening with Physical Therapy

Menopause is a natural stage of life, but that doesn’t mean it’s always easy. Hormonal changes can bring shifts in your body—including how your muscles, joints, and pelvic floor function. The good news? With the right guidance and strengthening, you can move through this chapter feeling strong, supported, and empowered.

How Menopause Affects the Pelvic Floor

During and after menopause, the decrease in estrogen impacts muscle tone, connective tissue, and even how our bodies respond to exercise. For the pelvic floor, this may look like:

  • Increased risk of leakage with coughing, sneezing, or exercise

  • Vaginal dryness or discomfort

  • Heaviness or prolapse symptoms

  • Core weakness that impacts balance and stability

These changes are common, but they don’t have to be your “new normal.”

What’s Normal and What’s Not?

It’s important to understand the difference between what’s typical in menopause and what may signal something you can (and should) get help for:

Common, Normal Experiences:

  • Hot flashes, night sweats, and sleep changes

  • Vaginal dryness due to lower estrogen

  • Some shifts in metabolism and muscle recovery

👉 Even though these are “normal,” support is available. Many women benefit from lifestyle changes, and some may also choose to talk with their healthcare provider about hormone replacement therapy (HRT) or other options to manage symptoms and improve quality of life.

Not Normal (and worth seeking help for):

  • Bladder leakage with coughing, sneezing, or exercise

  • Pain with intercourse

  • A feeling of heaviness, bulging, or prolapse in the vagina

  • Chronic constipation or bowel leakage

  • Ongoing back, hip, or pelvic pain that limits activity

These symptoms are common, but they are not something you just have to live with. Pelvic health physical therapy offers proven strategies to restore strength, reduce symptoms, and help you feel more like yourself again.

Why Strengthening Matters

Building strength during menopause goes far beyond muscle tone. Strengthening helps:

  • Support bone density and joint health

  • Improve balance and reduce fall risk

  • Enhance core and pelvic floor function

  • Boost energy, confidence, and quality of life

When the pelvic floor and deep core are strong and well-coordinated, they work in harmony with the rest of your body—supporting your spine, hips, and posture.

How Physical Therapy Can Help

A pelvic health physical therapist takes a whole-body approach to strengthening during menopause. That might include:

  • Teaching proper 360 breathing to support the diaphragm and pelvic floor

  • Targeted pelvic floor and core strengthening

  • Resistance training for bones, joints, and muscle health

  • Strategies for posture and movement to reduce tension in the neck, back, and hips

  • Education on bladder, bowel, and sexual health changes during this stage of life

Instead of a one-size-fits-all workout, therapy provides a customized plan that fits your goals, lifestyle, and the unique changes your body is experiencing.

The Bottom Line

Menopause is a time of transition, but it can also be a time of strength. With the right tools and support, you can feel in control of your body, your pelvic floor, and your movement. Physical therapy helps you stay active, strong, and confident—through menopause and beyond.

👉 Want to learn more? Schedule a pelvic health screening this month and take the first step toward feeling stronger and more supported in your body.

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