How Hormonal Changes During Perimenopause and Menopause Affect Your Pelvic Health

Menopause and Pelvic Health

Perimenopause and menopause are big transitions in a woman’s life. They bring with

them many physical and emotional changes, and for some, that includes new pelvic health

symptoms. These can feel confusing, worrying, or even embarrassing — but you are not

alone. Understanding what’s happening inside your body can help you take steps to feel

more confident and supported.

How Hormonal Changes Affect the Pelvic Floor

During perimenopause and menopause, levels of oestrogen and progesterone fluctuate and then naturally

decline. These hormones don’t just influence your menstrual cycle — they also play a vital

role in maintaining the strength and elasticity of the pelvic tissues.

When oestrogen levels drop, you may notice:

• Weaker pelvic floor muscles – tissues become thinner and less resilient.

• Changes in bladder control – urgency or leakage when coughing, laughing, or exercising.

• Vaginal dryness or discomfort – blood flow is reduced, the tissues are less lubricated and more fragile.

• Pelvic organ support issues – the risk of prolapse (when the bladder, bowel, or uterus

bulges into the vaginal wall) increases.

Common Pelvic Symptoms Women May Notice

Every woman’s experience is unique, but some of the most common symptoms during

perimenopause and menopause include:

• Stress incontinence (leaking when you sneeze, laugh, or exercise).

• Urgency or frequency – needing to dash to the loo more often, sometimes with little

warning.

• Heaviness or dragging sensations in the vagina (possible signs of prolapse).

• Pain or discomfort with intimacy due to dryness or thinning tissues.

• A feeling of reduced strength or control in the pelvic muscles.

Practical Tips to Help

1. Stay active – Regular exercise improves circulation, muscle strength, and mood. Even

gentle walking or yoga can make a difference.

2. Prioritise hydration and diet – Drinking enough water and eating fibre-rich foods can

reduce constipation, which otherwise puts pressure on the pelvic floor.

3. Address vaginal dryness – Vaginal moisturisers or lubricants can help make intimacy

more comfortable. In some cases, your GP may recommend local oestrogen treatments.

4. Breathe and relax – The pelvic floor isn’t just about strength — it also needs to be able

to relax. Stress and tension can contribute to symptoms.

5. Do your pelvic floor exercises daily – Pelvic floor training is one of the most powerful

tools you have to protect bladder control, support your organs, and restore confidence.

Why Pelvic Floor Exercises Are Essential

Think of your pelvic floor as a hammock of muscles supporting your bladder, bowel, and

uterus. Just like any other muscle group, it needs regular training to stay strong and

responsive — especially during times of hormonal change.

The right exercises, done correctly, can:

• Reduce or stop bladder leaks.

• Ease feelings of heaviness.

• Improve sexual wellbeing.

• Boost overall core stability and confidence.

Get Expert Support with the Pelvic Floor Masterclass

If you’re unsure whether you’re doing your pelvic floor exercises correctly, or if you’re

already experiencing symptoms, you don’t have to struggle alone.

The Pelvic Floor Masterclass is my 12-week guided programme designed to help women

strengthen, heal, and regain confidence in their pelvic health. It’s tailored for women at all

stages, including perimenopause and menopause, and will give you the knowledge and

practical tools you need to take back control.

■ Join the Pelvic Floor Masterclass today and give your pelvic health the care it deserves.

■ Remember: Perimenopause and menopause are natural life stages, but that doesn’t

mean you have to live with unwanted pelvic symptoms. With the right support, you can

continue to feel strong, comfortable, and confident.

Chantal