KCP Pelvic Floor Physical Therapist Ashley Williams recently had the honor of serving on a panel discussion about menopause at a recent screening of the short film, The M Factor. Designed to foster conversations around the topic of menopause, the event drew a sold out crowd. After the film, the audience was encouraged to ask questions to the panel of women’s health experts.
Many audience members had questions regarding the pelvic floor, which Ashley was able to address. For those who missed the event, we thought we’d share some of the questions and Ashley’s answers regarding her area of expertise.
Q: How can menopause impact pelvic floor health, and what are some strategies or exercises women can do to maintain their pelvic floor health during this stage of life?
A: As the film mentioned, estrogen plays such a big role in every system in your body, and that includes your musculoskeletal system. It doesn’t just stop at your pec muscles or your quads, it also includes your pelvic floor. Women who go through menopause tend to have a “weaker pelvic floor” or experience more urinary incontinence or pelvic organ prolapse. I see women all the time who come in and ask, ‘What can I be doing to stop this from happening to me or prevent it before going through menopause?’
It sounds really boring and generic, but taking care of your overall physical health and adding in more strengthening and physical activity is so crucial for your aging and development. It plays a role in your pelvic floor as well. I remind people all the time – your hip muscles are your pelvic floor muscles. So, if you’re not taking care of your hip mobility or you’re not strengthening your hips, you can’t be strengthening your pelvic floor. It goes beyond just doing kegels day in and day out – and if you are doing that, please stop unless you’ve been instructed to do so!
Q: If you have pelvic floor therapy postpartum, will you still need more pelvic floor therapy in menopause? And how important is pelvic floor therapy for not just your sexual health, but for your overall health and abilities?
A: I just had a discussion like this with a client the other day. The client is also a healthcare provider, and she’s super well educated in her field. That was really the only way she had learned about pelvic floor therapy postpartum to stop her peeing. Everyone else in her life had just told her, ‘That’s normal, you just had a baby, it’s normal for you to pee your pants.’ It’s not.
Common does not equal normal. And not normal does not mean it’s not fixable.
Thankfully she came in not long after the problem began. It wasn’t something she had been living with for a very long time, and we got her better quickly. Sometimes when we get people better so quickly, they show some anxiety – they are afraid to leave pelvic floor therapy, thinking What if it comes back?
This same postpartum client had brought up menopause to me. She told me, ‘My provider said that I am going to pee my pants when I go through menopause. Is all of this work that we just did for nothing? Is it going to come back?
I told her that menopause does come with challenges. But there is also a difference among women who went to pelvic therapy postpartum when they were peeing themselves and those who have just been living with it. The women who never addressed their issues are now going through menopause and peeing their pants significantly more.
Addressing the problems earlier is going to make your outcomes so much better. And that goes beyond just the pelvic floor. Let’s bring up a joint, like the knee. I love to talk about orthopedics, because they go hand in hand. It does the body a disservice to just look at the pelvic floor. We operate in so many different systems.
With the joint –let’s say you were having knee pain every time you tried to squat down to hand your kid something or help them put a shoe on, and you continue to ignore it and ignore it. Years go by, and now you go through menopause and now this knee is bone on bone, and you have to have a knee replacement. You’re going to be questioning yourself, thinking ‘Should I have just gotten this knee taken care of and looked at earlier? What could I have been doing earlier to strengthen and /or support this system?’ I encourage people all the time to make the time to address little issues before they get the chance to become bigger issues.
If you don’t know if something is ‘normal,’ it’s good to ask your providers. Ask your PCP even before coming to pelvic floor therapy. You can share with your provider and say, ‘Well, I’m having this issue, and I don’t like where my life is at right now. I don’t want it get worse. What should I do?’ Don’t ever feel awkward asking your provider any question; that’s what we are here for. Especially in the pelvic therapy world, where people can be hesitant to bring up certain concerns – I tell people there is nothing that you can say that will shock me or that I probably haven’t heard before. It’s okay to share! We are there to help, educate, and get you on the path to better health.
If you’re having pelvic floor challenges at any stage of life (such as urinary or fecal incontinence, painful intercourse, low back pain, or pelvic prolapse), we invite you to schedule an appointment with Dr. Williams at our office near Ballantyne.
