Optimizing Pelvic Floor Health & Sexual Well-Being in Perimenopause

By Kristen Parise, BSc, MSc, BHSc PT

Navigating through perimenopause and the changes it brings can be quite a journey for many women. One of the common challenges faced during this stage is maintaining sexual health due to the effects of perimenopause on the body. But here’s some good news: there are actionable steps you can take to improve your pelvic floor function and, as a result, enhance your sexual health. Let’s dive into the rejuvenating world of pelvic floor exercises and education.

Understanding the Pelvic Floor’s Role

The pelvic floor, a hammock-like set of muscles, stretches from the pubic bone to the tailbone and supports the pelvic organs. These muscles are crucial not only for bladder and bowel control, but also for sexual function. A strong pelvic floor enhances blood flow and sensation, thereby improving arousal and orgasm.

Kegel exercises, named after Dr. Arnold Kegel, are designed to strengthen these muscles. They’re straightforward, require no equipment, and can be done almost anywhere. By engaging and holding the pelvic floor muscles as if you’re trying to stop the flow of urine, you’re on your way to firmer support and improved sexual function.

Making sure your pelvic floor muscles are able to lengthen and totally let go is equally important. Muscles that hold too much tension can contribute to pain with penetration making sex uncomfortable.

Research Backs It Up

Recent studies have thrown light on how pelvic floor muscle training positively influences the sexual health of menopausal women. For instance, a randomized clinical trial involving 145 menopausal women highlighted improvements in arousal, orgasms, and satisfaction for those engaging in pelvic floor exercises compared to those receiving standard postmenopausal care. These exercises, coupled with formal sex education, were found to significantly boost several aspects of sexual function.

Another study focused on women aged 40 to 60 found similar results. Participants who regularly practiced pelvic floor exercises showed marked improvements in arousal and satisfaction. The simple act of dedicating a few minutes a day to these exercises contributed to a more fulfilling sexual experience and a more positive outlook on sexual health.

Why Education Matters

In addition to exercises, education plays a crucial role. Understanding the changes your body is going through and learning how to manage them can empower you to take control of your sexual health. Educational programs focusing on the physiological and psychological aspects of perimenopause can reshape attitudes towards sex and provide practical tools to address discomforts, such as vaginal dryness, which can be common after menopause.

Empowering yourself with knowledge can transform your experience. Knowing that decreased estrogen levels are a primary cause of genitourinary syndrome of menopause (GSM) allows you to seek appropriate treatments, whether they be exercises, lifestyle changes, or pelvic health physiotherapy.

Making the Change

Implementing these strategies doesn’t require a complete lifestyle overhaul. Begin by incorporating strengthening and pelvic floor lengthening exercises into your daily routine. Aim for a few sets of short holds, gradually working up to longer contractions. As with any exercise, consistency is key. Easy lengthening exercises include deep squats, and yoga exercises like happy baby and child’s pose. While it might take a few weeks to notice changes, the improvements in pelvic muscle strength will contribute to better bladder control and enhanced sexual satisfaction.

Seek out educational resources—books, workshops, online courses—that focus on sexual health during perimenopause. Not only will these help you understand the changes occurring in your body, but they’ll also provide guidance on navigating these changes with confidence and grace.

The Way Forward

Perimenopause is not the end of your sexual health journey; rather, it’s a transformative phase that can bring about a renewed understanding and appreciation of your body. Embracing pelvic floor exercises and prioritizing education can open the doors to a more satisfying and fulfilling sexual experience.

Every woman’s journey through perimenopause is unique, with its own set of challenges and triumphs. But by taking proactive steps like these, you can shift from simply enduring perimenopause to thriving through it. And remember, you’re not alone on this journey. Countless women are discovering the benefits of improved pelvic function and reclaiming their sexual health with positive, empowering results.

Get Help Today

Pelvic Health Physiotherapists can help you along your journey to sexual wellness. A thorough pelvic health assessment not only assists you in understanding how your body is working, but it will also teach you how to contract and relax your pelvic floor muscles. During the visit you will learn all about pelvic floor muscle function, pelvic organ prolapse, and how to reduce and eliminate pain with intercourse. I encourage you to connect with your local pelvic health physiotherapist. If you’re in the Hamilton/Dundas area in Ontario, reach out to us at Blueberry Therapy.

If you are a healthcare professional (OB/GYN, Primary Care Physician, Nurse Practitioner, Naturopathic Doctor, Pelvic Health Physiotherapist, Psychotherapist, Researcher, etc.) and want to learn more about women’s sexual health, I encourage you to join me at The Pleasure Principle Conference on May 30^th 2025. This one-day conference promises to be an enriching experience, bringing together a diverse pool of experts and practitioners who share a passion for enhancing women’s sexual health and well-being. This gathering is a must-attend for those devoted to advancing clinical best practices in the field.