The symptoms we are all likely to experience during perimenopause and menopause, but no one wants to talk about.
There are a number of genitourinary symptoms that can become particularly bothersome in this stage of our lives.
Why this occurs
Typically, these symptoms are because of declining oestrogen particularly in and around the vulva and vagina. There are a high level of oestrogen receptors in the vagina and when that declines there is a decline in the quality of tissue and muscle.
Reduced oestrogen production results in a drying of the tissues which can cause itching, discomfort, even bleeding if the tissues become cracked.
As oestrogen declines the muscles cause atrophy of the pelvic floor muscles this then gives rise to an increase in urinary leakage, weakness and potentially pain. As the muscles weaken the pelvic organs become at risk of prolapse as there is less support.
Treatment and how a woman’s health physio can help
A women’s health physio can spend time assessing the tissues and muscles around the vulva and vagina. We can spot atrophy and changes in skin tone easily. We can also identify is there is muscular weakness and prescribe the correct exercise to help build some strength. Often when there has been vaginal discomfort there is surrounding muscle tension which will contribute to pain.
We can then recommend the appropriate products to help with dryness and sexual wellbeing (we use ILO wellness in our clinic). We will often recommend using products (such as the balm) to help keep the tissues moisturised.
We will then request that your GP provide you with topical oestrogen in the form or a cream or pessary to help replace the declining oestrogen. This then helps aid some building of muscle tissue in conjunction with exercise.
Some women find that oestrogen and a good moisturiser rectifies the majority of their symptoms, some women will require greater input to help build their muscle strength or relieve muscle tension.
Women’s health Physiotherapists have any tools to help ease the symptoms and manage genitourinary symptoms of menopause so consider reaching out to your local specialist today.
Blog Post – Rebekah Taylor Senior Women’s Health Physio (Physio 73)
