When Menopause Gets Personal: How to Tackle the ‘Unmentionables’

Menopause is a natural phase that occurs as our ovaries run out of eggs. By the age of 40, it is estimated that only 3-5% of a woman’s eggs remain. This results in a decline in hormones which can wreak havoc on every system in our bodies. For our genitourinary systems, over 80% of women will experience genitourinary syndrome of menopause (GSM). This is a collective term for symptoms related to the urinary, vaginal, and pelvic health changes caused by reduced estrogen. Unlike many other symptoms of menopause, GSM does not resolve with time and can get progressively worse if not treated.

While this may sound overwhelming, the good news is that with the right approach, you can alleviate symptoms, improve your comfort, and even enhance your overall pelvic health.

Here’s a closer look at GSM, pelvic floor health, and how proactive steps can support your well-being during menopause.

What is Genitourinary Syndrome of Menopause (GSM)?

An umbrella term that includes changes in the vaginal and urinary tract often caused by estrogen loss during menopause. This natural hormone decline can affect many areas of your body, but the vaginal and urinary tissues are especially impacted because estrogen helps keep these tissues thick, elastic, and well-lubricated.

When estrogen levels decrease, some of the common GSM symptoms may include:

• Vaginal dryness: Lower estrogen can reduce natural lubrication, leading to discomfort during daily activities or intimacy
• Urinary symptoms: Frequent urination, urgency, or even incontinence can occur as the urinary tract tissues thin and become less resilient. Increased urinary tract infections are also common for women in menopause
• Vaginal or vulvar irritation: A lack of moisture and elasticity can cause discomfort, itching, and even pain

The combination of these and other GSM symptoms can significantly impact your quality of life, including your sexual health and libido. This is a critical area of health that cannot be ignored!

The Role of Pelvic Floor Health in GSM

The pelvic floor is a group of muscles and tissues that form a supportive “hammock” at the base of your pelvis, keeping the bladder, bowel, and uterus in place. These muscles play a crucial role in bladder control, bowel function, and sexual health. However, the hormonal shifts during menopause, compounded by the natural aging process, can lead to pelvic floor weakening, further intensifying GSM symptoms.

A weakened pelvic floor can contribute to:

• Urinary leakage or incontinence: This is especially common when you laugh, cough, sneeze, or exercise
• Prolapse: When pelvic organs drop from their normal position, thus causing discomfort or even visible bulging
• Reduced sexual sensation: Muscle tone in the pelvic floor is essential for sexual response and pleasure

The good news is that pelvic floor health can be greatly improved with targeted exercises, lifestyle adjustments and professional therapies (when needed). Strengthening these muscles not only alleviates GSM symptoms, but also empowers you to feel more confident and in control of your body.

Steps to Manage GSM and Strengthen Your Pelvic Floor

The effects of GSM and pelvic floor issues can feel isolating, but they’re surprisingly common and highly treatable with a well-rounded approach. Vaginal estrogen is the gold standard treatment for GSM and has been shown to prevent 50% of UTIs. Vaginal estrogen is localized and does not impact other areas of the body.  Here are some additional ways PAUZ Health can support you:

1. Targeted Pelvic Floor Exercises: Specialized exercises like Kegels, squats, and yoga for pelvic health can strengthen the muscles that support your pelvic organs. We guide you through these exercises safely and effectively, ensuring you’re making progress without added strain
2. Hydration and Lubrication Strategies: Staying hydrated helps the health of tissues. In addition to vaginal estrogen, moisturizers and lubricants help reduce vaginal dryness and make sexual activity more comfortable
3. Stress Management Techniques: Stress exacerbates pelvic floor dysfunction and can contribute to urinary issues by increasing muscle tension. Techniques like meditation, guided breathing, and mindfulness not only help you stay calm but also encourage pelvic floor relaxation, which is essential for preventing over-tightening
4. Bladder Health Habits: We help you develop routines to improve bladder health and avoid unnecessary urinary urgency or frequency. This includes understanding fluid intake, avoiding bladder irritants and adhering to mindful bathroom habits
5. Nutrition: Working with a dietitian to ensure you are purposeful in consuming foods that support health

Seeking Professional Guidance for Lasting Relief

While lifestyle and self-care practices can alleviate many GSM and pelvic floor symptoms, some women may benefit from professional interventions. Here’s how we can support you:

• Pelvic Floor Therapy: Our team connects you with certified specialists who use techniques like biofeedback, manual therapy, and personalized exercise plans to strengthen and balance your pelvic muscles
• Hormonal and Non-Hormonal Options: For those struggling with severe GSM symptoms, we can help you explore options with your healthcare provider including low-dose vaginal estrogen treatments, laser therapies, or other innovative solutions tailored to your needs
• Personalized Wellness Coaching: You’ll have a partner every step of the way to ensure you succeed with the lifestyle enhancements you wish to make

GSM and pelvic floor issues are common, but they don’t have to define this stage of your life. With the right guidance and proactive steps, you can regain control, relieve discomfort, and enhance your quality of life. Let us help support you through every phase of menopause with empathy, expertise, and empowerment.

Start your journey to relief and strength here!