How Do Hormones Affect Your Pelvic Floor Health?
Navigating Postpartum and Menopause
Hormones play a pivotal role in our overall health and well-being, and when it comes to pelvic floor health, they are especially influential. Whether you’re navigating the postpartum period or entering menopause, understanding how hormonal fluctuations impact your pelvic floor can empower you to take proactive steps toward better health. In this blog, we’ll explore the connection between hormones and pelvic floor function, and offer practical tips for managing these changes in both the postpartum and menopausal stages.
What is the Pelvic Floor?
Before we dive into the impact of hormones, let’s quickly review what the pelvic floor is and why it’s so important. The pelvic floor is a group of muscles and connective tissues that support your bladder, bowel, and uterus. These muscles help control functions like urination, bowel movements, and sexual health, and they play a key role in stabilising your core.
A healthy pelvic floor is essential for quality of life. However, certain life stages, like pregnancy, childbirth, and menopause, can mean impact the function of these important muscles.
Hormones and the Pelvic Floor: The Link
Your hormones influence the strength and elasticity of all of your muscles – including your pelvic floor, and hormonal fluctuations can cause changes in their function. The two main hormones that affect the pelvic floor are oestrogen and progesterone.
These hormones are known for their role in regulating the menstrual cycle, but they do lots of other important jobs too. Oestrogen and progesterone support the elasticity and strength of tissues throughout the body, including the pelvic floor. During periods of low oestrogen—such as postnatally, during menopause and even during your period —the pelvic floor muscles can find it harder to engage and feel less elastic, leading to potential issues like incontinence or prolapse.
The Postpartum Period: A Time of Hormonal Shift
After childbirth, your body goes through a dramatic hormonal shift as it adjusts to life without pregnancy. One of the most significant changes is the decline in progesterone and oestrogen levels, which can impact your pelvic floor in a variety of ways.
Pelvic Floor Changes After Birth:
- Pelvic Floor Function: Pregnancy and childbirth can impact the function of the pelvic floor muscles. After delivery, these muscles may struggle to activate effectively, especially if you’ve experienced a vaginal birth, particularly one with a long pushing stage or an episiotomy but even post abdominal birth the function of the muscles is impacted by the pregnancy, the change in the tissues due to the incision and the hormonal changes.
- Urinary Incontinence: Reduced oestrogen levels post-birth can lead to vaginal dryness, which in turn affects the function of the pelvic tissues. This, as well as the other factors mentioned, can make women more prone to urinary incontinence—leaking urine when coughing, laughing, or exercising.
- Prolapse: In some cases, the pelvic organs (bladder, uterus, or rectum) can shift downward or protrude into the vaginal canal—a condition known as pelvic organ prolapse. This can occur due to increased abdominal pressure, the change in support of the pelvic floor and the rapid drop in oestrogen after childbirth.
- Abdominal Separation (Diastasis Recti): While not directly related to hormones, hormonal changes can contribute to the relaxation of connective tissues, which, combined with the physical stresses of pregnancy, can contribute to abdominal separation. The core acts like a cannister so when one part is out of balance, it affects everything else too. Diastasis Recti and pelvic floor dysfunction have a strong correlation.
How to Manage Postpartum Pelvic Floor Health:
- Pelvic Floor Exercises: Kegels (or lifting and squeezing the pelvic floor is a good way to ensure that the pelvic floor muscles are functioning. If you’re unsure where to start, a pelvic health specialist or physiotherapist can guide you. When you know they are working correctly, the best way to build strength is to take a global approach with Pilates based rehabilitation.
- Abdominal Recovery: If you’ve experienced abdominal separation, exercises that focus on deep core engagement and gradual strengthening can help restore function. Start slow and avoid exercises that put unnecessary pressure on your abdomen. You can learn how to do this in Centred Mums classes.
- Postpartum Care: The gold standard of postnatal care is to visit a women’s health specialist and have a full postnatal check.
Menopause: Do Hormones Affect Your Pelvic Floor
As you approach menopause, oestrogen levels begin to decline, which can have a significant impact on pelvic floor health. This natural part of the ageing process can be a time of concern for many women as they begin to experience changes in the pelvic muscles and tissues.
Pelvic Floor Changes During Menopause:
- Vaginal Atrophy (Genitourinary Syndrome of Menopause): One of the most common changes during menopause is vaginal atrophy, a condition caused by decreased oestrogen levels. Vaginal tissues can become thinner, drier, and less elastic, which can lead to discomfort, pain during sex, and urinary incontinence.
- Increased Risk of Prolapse: As oestrogen decreases, the vaginal walls and pelvic floor muscles lose some of their firmness, which can make you more prone to pelvic organ prolapse. This can result in sensations of heaviness or bulging in the pelvic area. This is often treated as simply a pelvic floor issue but should be addressed holistically.
- Pelvic Floor Muscle Changes: Without the supportive effects of oestrogen, the muscles of the pelvic floor (like all the muscles in your body) can lose strength over time, making it harder to control bladder function or maintain sexual health.
- Urinary Incontinence: Menopause can exacerbate urinary incontinence due to the combination of hormonal changes and changes in pelvic floor function. Many women experience more frequent urinary leakage, especially when sneezing, coughing, or during exercise. But it doesn’t have to be this way!!
How to Manage Pelvic Floor Health During Menopause:
- Pelvic Floor Strengthening: Just like during the postpartum period, strengthening the pelvic floor is essential (ideally before menopause kicks in so you have a head start!). A full body approach to pelvic floor health can be incredibly beneficial, but consider working with a pelvic health professional to ensure you’re performing them correctly.
- Vaginal Moisturisers and Lubricants: If vaginal dryness is an issue, using a good vaginal moisturiser or lubricant can improve comfort and reduce the risk of painful sex.
- Hormone Replacement Therapy (HRT): For some women, HRT may be an option to help balance hormone levels and address symptoms like vaginal dryness and urinary incontinence. However, always consult with a healthcare provider to determine what’s best for you.
- Pelvic Health Physiotherapy: A pelvic physiotherapist can assess your pelvic floor function and offer specialised treatments like biofeedback or manual therapy to address any pelvic floor dysfunction.
Taking Charge of Your Pelvic Floor Health
Hormonal changes during the postnatal period and menopause can have a significant impact on your pelvic floor, but understanding these changes is the first step in taking control of your health. Whether you’re recovering from childbirth or navigating the transitions of menopause, there are steps you can take to keep your pelvic floor strong, healthy, and functional.
Remember, it’s never too late to prioritise pelvic floor health. If you’re experiencing any symptoms or just want to optimise your pelvic health, don’t hesitate to seek support from a pelvic health specialist or get in touch to discuss how I can support you. With the right knowledge and tools, you can navigate these hormonal changes with confidence and grace.
Final Thoughts – Do Hormones Affect Your Pelvic Floor?
Hormones are powerful agents in our body, and their impact on the pelvic floor is undeniable. By being mindful of how hormones affect us at different life stages and proactively managing our pelvic health, we can enjoy better quality of life—free from discomfort and limitations. Whether it’s during the postpartum period or navigating menopause, understanding and caring for your pelvic floor will help ensure a healthy, active, and empowered life.
If you found this blog helpful, be sure to share it with others who may benefit from the information, and feel free to reach out with any questions or concerns. Your pelvic health matters—let’s take care of it together!
