Perimenopause & Menopause

Perimenopause usually starts in the 40s, and by the early 50s, most women are in menopause. During this time, women often face not just common menopause symptoms but also problems related to their urinary and reproductive systems. These can include painful sex, urinary problems, and vaginal dryness, which are part of what's called the Genitourinary Syndrome of Menopause (GSM). This affects about half of women in their 50s. While systemic hormonal therapy helps with some menopausal symptoms, it may not address GSM adequately. Vaginal estrogen is recommended by the North American Menopause Society for managing GSM symptoms in menopausal women.

Symptoms

• Urinary urgency, frequent urination, burning, nighttime urination

• Sensations of bladder or pelvic pressure

• Pain during sexual intercourse

• Reduced or absent orgasms

• Challenges with bowel movements

• Vulvovaginal pain and burning

• Discomfort while sitting

How we can help

Pelvic floor physical therapists can check for GSM and pelvic floor problems, as they have similar symptoms like urgent or frequent peeing, burning, pelvic pressure, painful sex, less sexual pleasure, pooping issues, and pain in the vulva, vagina, or when sitting. They'll look at both muscle and hormone issues to help relieve discomfort and improve sexual and urinary functions.

What to expect

At your initial appointment, we will start by taking your medical history, followed by a comprehensive musculoskeletal examination of your pelvic area. This will include assessing your posture, joint alignment, any muscle restrictions or trigger points, the health of your connective tissue, and muscular strength. An internal examination is often part of this process, but it's entirely optional and will only be conducted if you feel completely comfortable with it. This exam is much more relaxed and comfortable compared to a typical ob/gyn visit, and it provides essential information about your pelvic muscle tone, strength, and coordination. If impairments are found during the exam, the physical therapist can treat the problems with manual therapy techniques resulting in pain relief and improved function. Following the exam, we'll discuss our findings with you and outline a personalized treatment plan aimed at achieving the best results. Most patients start feeling better after their first session and see significant improvement by their third visit.