As women move through life, one of the most significant transitions they face is menopause. Typically occurring between the ages of 45 and 55, menopause marks the end of a woman’s reproductive years and is accompanied by a variety of physical and emotional changes. While many people focus on symptoms like hot flashes, mood swings, or weight changes, pelvic health is often overlooked—despite being deeply impacted by this stage of life.

At Auria Pelvic Health, we understand that pelvic floor health is crucial at every stage of life, but menopause brings specific challenges that can have a significant impact on your comfort, function, and overall well-being.
From urinary incontinence to pelvic pain, many women experience new or worsened pelvic health issues during menopause. Fortunately, with the right knowledge and care, it’s possible to navigate these changes with confidence.
In this blog post, we’ll explore the ways menopause affects pelvic health and share tips on how to manage these changes so you can feel your best as you embrace this new phase of life.
How Menopause Affects Pelvic Health
Menopause is defined by a decline in estrogen levels, the hormone responsible for regulating many aspects of reproductive and overall health. This hormonal shift can lead to several pelvic health issues, many of which may come as a surprise to women who previously had no pelvic floor concerns.
1. Vaginal Dryness and Discomfort
One of the most common symptoms of menopause is vaginal dryness. Estrogen helps maintain moisture and elasticity in vaginal tissues, and as its levels drop during menopause, women may experience dryness, itching, and discomfort. This can lead to painful intercourse and can make other activities, like exercise or even sitting for long periods, uncomfortable.
2. Urinary Incontinence
Estrogen also helps maintain the tone and strength of the pelvic floor muscles, which support the bladder and other pelvic organs.

As estrogen levels decline, many women experience urinary incontinence (leakage of urine) or an increased urgency to urinate. Coughing, sneezing, laughing, or exercise can often trigger involuntary leakage.
3. Pelvic Organ Prolapse
Pelvic organ prolapse occurs when the pelvic floor muscles weaken to the point where the pelvic organs (bladder, uterus, rectum) begin to drop or “prolapse” into the vaginal canal.
This condition can lead to a feeling of heaviness or pressure in the pelvic area, urinary incontinence, difficulty emptying the bladder, and pelvic pain. Estrogen loss can exacerbate prolapse by weakening the pelvic tissues and muscles.
4. Decreased Libido and Sexual Health
In addition to vaginal dryness, menopause can lead to a reduced libido due to hormonal changes and physical discomfort. The lack of estrogen can affect blood flow to the genital area, leading to a reduction in sensation and overall sexual health. These changes may impact intimacy and can cause emotional stress or frustration for some women.
5. Pelvic Floor Muscle Weakness
As we age, all muscles—including those of the pelvic floor—naturally lose strength and elasticity. During menopause, the pelvic floor muscles may become weaker or less coordinated, contributing to symptoms like incontinence, prolapse, and decreased support for internal organs. If pelvic floor muscles are already weakened during childbirth, menopause can exacerbate these issues.

6. Emotional and Mental Health Challenges
While not directly related to the physical pelvic floor, the emotional changes associated with menopause can indirectly affect pelvic health. Anxiety, depression, and stress can increase pelvic tension, leading to issues like pelvic pain or discomfort. Women may also feel less inclined to engage in physical activity, which can further weaken pelvic floor muscles and affect overall well-being.
How to Manage Pelvic Health During Menopause
While menopause brings many challenges, it’s important to know that pelvic health issues don’t have to be an inevitable part of the process. With the right tools, resources, and lifestyle changes, women can experience improved comfort and function during this time of life.

1. Pelvic Floor Exercises
Pelvic floor exercises—often referred to as Kegel exercises—are one of the most effective ways to maintain and restore pelvic health during menopause.
These exercises strengthen the muscles that support the bladder, uterus, and rectum, helping to improve bladder control, prevent prolapse, and reduce pelvic pain. A pelvic health therapist can first determine if exercises are appropriate for you, and if so, will teach you how to do these exercises correctly.
2. Vaginal Moisturizers and Lubricants
For vaginal dryness and discomfort, using vaginal moisturizers and lubricants can significantly improve comfort, especially during intercourse. Vaginal moisturizers help maintain hydration in the vaginal tissues, while lubricants can make sexual activity more comfortable. There are also estrogen-based creams, which may be recommended by your healthcare provider to restore vaginal health.
3. Bladder Training and Management
If you’re experiencing urinary incontinence or increased urgency, bladder training can help you regain control. This involves gradually extending the time between bathroom visits and learning techniques to prevent leakage. Additionally, avoiding bladder irritants like caffeine, alcohol, and spicy foods can help reduce urgency and frequency.

4. Pelvic Health Physical Therapy
Pelvic health physical therapy can be a game-changer for women experiencing pelvic floor issues during menopause. A trained pelvic therapist will assess your pelvic floor strength, address muscle imbalances, and teach you exercises to improve support and function.
Pelvic therapy is particularly helpful for managing prolapse, incontinence, and pelvic pain. Therapists may also provide guidance on posture, movement, and breathing to help reduce pelvic floor tension.
5. Engage in Low-Impact Exercise
Exercise is essential for maintaining pelvic health, but high-impact activities (like running or jumping) can sometimes exacerbate pelvic floor issues during menopause. Instead, focus on low-impact exercises like walking, swimming, Pilates, or yoga.
These activities help maintain core and pelvic floor strength without putting unnecessary pressure on the pelvic region. Aim for 30 minutes of low-impact exercise most days of the week to support pelvic health, muscle strength, and overall well-being.

6. Emotional Well-being and Stress Management
The emotional challenges of menopause, including stress, anxiety, and mood swings, can have a direct impact on pelvic health.
Mindfulness practices, meditation, deep breathing, and yoga can help reduce pelvic tension and improve emotional health.
Addressing the emotional side of menopause is just as important as managing the physical changes. Incorporate mindfulness and relaxation techniques into your daily routine. Consider therapy or support groups to help navigate the emotional aspects of menopause.
Final Thoughts: Empowering Yourself Through Menopause
Menopause doesn’t have to be synonymous with pelvic health struggles. By staying informed, prioritizing pelvic floor health, and seeking support from professionals, you can embrace this transition with confidence and vitality. The right care and attention can help you manage symptoms like incontinence, pelvic pain, and dryness, allowing you to enjoy life to its fullest.
At Auria Pelvic Health, we’re here to guide you through the challenges of menopause and help you optimize your pelvic health at every stage of life. Whether you’re experiencing vaginal dryness, incontinence, or pelvic pain, our team of experts can create a personalized plan to support your unique needs.
Let’s navigate menopause together and ensure that pelvic health remains a priority. You deserve to feel your best, no matter your age!
Auria Pelvic Health
8929 S Sepulveda Blvd., Ste. 412, Los Angeles, CA 90045 | Phone: 213-699-3996

Article Written By Dr. Sasha Speer, DPT
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