Looking after your hearts, bones & pelvic floors pre & post-menopause
How a women's health physio can solve your post-menopause health problems!
From treatment to prevention
‘Women aren’t men with boobs & tubes – we’ve got different physiologies and hormone profiles that need individualised treatment especially for the pelvic floor’.
This is what Christien Bird, a women’s health physiotherapist, says about women’s specific health needs in menopause - from our weakened pelvic floors to hearts and bones that need extra attention!
Women’s health physiotherapists treat the highly personal and too common conditions impacting on the pelvic floor and pelvis; from urinary and bowel incontinence to prolapse, vaginal atrophy and painful sex to constipation and pelvic pain, that as many as one in two women face when perimenopause and menopause hit.
Women are poorly educated about their health, particularly pelvic floor health, and we see it as our service to introduce you to the experts who can turn many of your health problems around. In a 2023 campaign the Royal College of Obstetricians and Gynaecologists (RCOG) called for improved information and education about pelvic floor health throughout women’s lives. Women’s health physios can join all the dots for women’s longterm health. Learn how…
You can take care of your pelvic health, hearts and bones!
How a women’s health physio can solve your post-menopause health problems
Telltale signs your pelvic floor needs attention
If you leak when you cough, sneeze, laugh, or when exercising it may be a sign of urinary stress incontinence – your pelvic floor can’t give the support it needs – although it’s very common it’s not normal, even a little leakage is a sign of some form of pelvic floor weakness that may need medical attention to strengthen and reverse leakage.
An eye-watering urge to pee that comes on suddenly, maybe when putting the key in the door and you don’t make it, may be a sign of urge incontinence.
Constipation – very common in menopause and our vlog with Christien will give you some great info!
Wind when you don’t expect it, including vaginal flatulence.
Bowel urgency or leakage.
Vaginal atrophy
Vaginal dryness and pain during sex
Vaginal delivery*
*Evidence shows vaginal delivery is a risk factor for incontinence & prolapse. Clearly we can’t change our obstetric history but, on a positive note, Christien said that it is absolutely never too late to start looking after your pelvic floor with exercise or treatment.
What happens in an assessment with a women’s health physio?
At the initial assessment, the WHP will take a full health history including gynaecological, medical and surgical history, find out how your bowels and bladder are working, if there are any issues with sex and how active you are in your daily life, all to build up a picture of how your body is functioning. You’ll spend time talking about those intimate areas of your life you normally don’t talk about, usually with a pelvic floor examination if you are comfortable with this.
The WHP will come up with a treatment plan which will vary in length dependent on individual issues identified – this could include prescription of pelvic floor muscles exercises, bladder retraining, fitting of supportive pessaries, recommendation of appropriate devices, lubricants, vaginal moisturisers or prescription of topical oestrogen.
It may take time to find the right solution for some conditions, but perseverance will pay off - with the right support in up to 85 per cent of cases there should be an improvement or reversal of the underlying weakness.
How do I find a menopause trained WHP?
There are over seven hundred registered WHPs in the UK, some working in the NHS and many working in private practice and their expertise is something that Christien feels is hidden behind clinic doors.
It’s a post code lottery in terms of NHS provision but you can check for an NHS or private practitioner somewhere near you, by entering your postcode on the Squeezy Directory, an NHS -backed website but not all a menopause trained.
To find a menopause trained WHP, look no further than the highly regarded Menopause Movement Directory. Search the list of women’s health and fitness professionals all have been trained to a high standard to treat, teach and train menopausal women.
Exercise prescription!
Women’s health physiotherapists want to keep women as active as possible and to help them continue, or return to, activities that they love, but where pelvic issues may be stopping them taking part.
Exercise is a non-negotiable for Christien - strengthening the core, helping with cardio-vascular health, strengthening bones, improving overall health and reducing certain cancer risks. She’s concerned that only 25 per cent of women in the UK meet the recommended exercise, she explains:
World Health Organisation recommends 300 minutes of exercise per week 2.5 hours of moderate to vigorous exercise and 2.5 hours moving (walking, gardening, stretching)
Research shows that women fear doing themselves harm as they don’t know how to exercise and therefore will hurt themselves, but she says very few of us will actually harm ourselves through exercise.
Keep moving – being sedentary, impacts on heart disease and is linked to urge incontinence in women who sit down for too long. Get up, stretch, move, two to three times an hour.
Muscles are your best friend in menopause - Strength training increases muscle mass, helps balance your hormones, increases metabolism that can help deal with weight gain.
Menopause MOT?
Perimenopause or menopause is a time to take stock, get your ducks in a row in preparation for the next phase of your life, a pelvic health check menopause ‘MOT’ can help clarify:
Solutions for pelvic floor, bladder, bowel and sexual function
If your exercise routines are on track for your bone, hormonal and cardiac health.
The status of your general and hormonal health
Whether you need a referral to other women’s health services -gynaecologist, nutritionist or women’s health fitness pro.
With too few women seeking help for issues that can rectified, do get support to remove barriers to a healthy and happy life, now and in the future!
January 2020
Christien Bird is a chartered physiotherapist and practice owner of the White Hart Clinic, London Christien specialises in women’s health physiotherapy. Her clinic is running women’s health services, including Menopause MOTs, online, email for more information.
