It's Menopause Awareness Month! Let's Talk About It.

I had a patient several years ago who I’ll always remember. Susan (not her real name) was a retired nurse who lived her absolute best life. She was always out doing some social event or gentle yoga class, having Long Island Ice Teas at lunch on Tuesday with the girls – that sort of thing. She had this shirt she would wear often that said: “They’re not hot flashes. They’re POWER SURGES!!!” That shirt made my day every time I saw it. I was struck by the way that she was very open about and owned the changes her body went through during menopause.

Though the tide is changing, menopause was and often is an overlooked aspect of women’s health. Decades of misconceptions and misinformation have created a stigma and shame around this perfectly natural part of the aging process. Since October is Menopause Awareness Month, let’s take some time to talk about it, what it is, how the pelvic floor is involved and how pelvic floor PT can help.

Menopause is defined as 12 months without a period. The ovaries, which hold all the follicles and egg cells, are the primary source of estrogen and progesterone in the body. Over time the ovaries stop releasing eggs every month and hormone production winds down until these processes stop. 1.3 million women in the US enter menopause every year. That’s roughly 6,000 every single day! On average, women in the US enter menopause around age 51 but there is a substantial variance.

The perception I grew up with was that women woke up one day and suddenly – boom – you’re in menopause. That’s simply not how it works. Your ovaries don’t just suddenly give up the ghost overnight. Perimenopause is the transition phase where hormones can fluctuate wildly from normal one day to very not normal the next which can make identifying and treating it very difficult. Perimenopause can last up to 10 years, during which effects that are associated with menopause can come and go with little predictability. Some women experience no effects at all.

Many of the effects of menopause are well-known: night sweats, power surges (hot flashes), and mood changes. Perhaps less well known are vaginal dryness, skin and body composition changes. But estrogen has a vital role in many of the body’s systems beyond reproduction. Estrogen is the most important regular of bone metabolism in men and women. This means menopausal women are much more at risk of developing osteoporosis which increases the risk of fractures, particularly of the femur near the hip joint. Estrogen is also responsible for the lining of the urethra and bladder, the thinning of which can lead to urinary incontinence and overactive bladder. This is labeled genitourinary syndrome of menopause (GSM). Menopausal women are also much more at risk of heart disease due to the changes that occur throughout the body. They are also more at risk of developing Alzheimer’s disease, autoimmune disorders, and sleep apnea. We’ll dive more into these topics in another blog post but it’s important to understand the widespread changes that occur in the body with menopause. It’s not just power surges and night sweats.

It is an unfortunate reality that many healthcare providers have little education around menopause. Providers may not connect the dots if a patient complains about one or more of these issues. This is why awareness of menopause and effects is so important. Even our language around menopause can be challenging. Just writing this blog post I went back and forth on whether to refer to things as “effects,” issues,” or “symptoms.” It’s important that we recognize and are aware of this perfectly normal part of life in order to normalize it. But we should also recognize that the changes of menopause are difficult to deal with and can be extremely disruptive to peoples’ lives without pathologizing it.

How can pelvic PT help? There are several ways. Urinary dysfunction and overactive bladder are things pelvic PTs deal with on a daily basis. Depending on your presentation and what drives your symptoms, specific exercises, lifestyle and functional changes, manual therapy, and neuromuscular reeducation are a lot of the tools we use to address these concerns. Vaginal dryness can be addressed with over the counter or prescription vaginal moisturizers hormone therapy. Bone health can be improved with resistance exercise which PTs are very good at prescribing and guiding people through. We are also great resources for getting further information and support on your journey through this next phase of life.

The difficulties that come with menopause and perimenopause can be improved and you don’t need to deal with this alone. Call us for a free consultation or book an appointment today. Happy Menopause Awareness Month!

Unbound Physio PLLC provides one-on-one pelvic health, balance, and orthopedic physical therapy in West Hartford and the Greater Hartford area.