Disclaimer: Not everyone who goes through menopause identifies as a woman and not all people who identify as women go through menopause. At Jayla, our core audience is people who identify as women, so we primarily use the word “women.” However, we’re working on specific content for people going through menopause who might not identify as women. Inclusivity is a key value of ours, so bear with us!
Take back control of your bladder and sexual pleasure
No longer able to hold it in? Struggling to enjoy sex because it has suddenly become painful?
Your pelvic floor muscles are likely the culprit. During perimenopause and menopause, they get weaker. But don’t worry, it’s not irreversible.
We’ll equip you with the right knowledge and exercises to reverse urinary incontinence (aka bladder leakage) and sexual pain.
Why am I having bladder control issues in menopause?
Twenty to 30% of women going through perimenopause and menopause have genitourinary symptoms (1). It’s not as scary as it sounds! Genitourinary is the medical term used to describe things related to both the genital and urinary systems in the body. In simple terms, it covers everything from your bladder and kidneys to your reproductive organs.
During perimenopause and menopause, our estrogen levels decline, which leads to our collagen levels declining as well. This causes our muscles and connective tissues to become weaker and less flexible, including the muscles that enable you to control your bladder. Those muscles are called the pelvic floor muscles!
What are pelvic floor muscles? How do they relate to my bladder?
Maybe you peed yourself a tiny bit when laughing or during sudden intense exercise when you were in your 30s. Now, it’s happening more and more regularly. That’s probably because your pelvic floor muscles are no longer as effective in supporting, contracting, and relaxing your bladder as they once were.
A key group of muscles! These muscles are often forgotten about because we don’t see them, but it’s just as important to keep them toned and strong.
When our pelvic floor muscles weaken during menopause, we may experience symptoms, such as bladder issues, pain during sex and feelings of vaginal pressure, internal soreness, and sensitivity.
But don’t worry, we’ve got solutions for you!
Does urinary incontinence go away after menopause?
Your natural estrogen levels, and therefore your collagen levels, will not increase on their own after menopause. As a result, your pelvic floor muscles are unlikely to strengthen, and the symptoms associated with pelvic floor weakness are unlikely to improve unless action is taken.
Fortunately, symptoms such as urinary incontinence and pain during sex can be significantly reduced by actively working towards re-strengthening your pelvic floor muscles.
How is painful sex related to my pelvic floor muscles?
Being able to tighten and relax your pelvic floor muscles usually makes sex comfortable, improves blood flow for better orgasms, and increases natural lubrication (3). Conversely, weaker pelvic floor muscles can lead to painful sex. It’s like trying to run with a sore muscle—it just doesn’t work as smoothly, and it can hurt.
On top of this, sex has many psychological elements to it. Once we experience pain during sex, our libido may drop and our body may naturally get stressed during sex in response. This can lead to less lubrication, which may in turn make sex painful once more (3). You see how it can quickly become a self-reinforcing spiral.
Again, don’t worry, by re-strengthening your pelvic floor muscles, you can work towards better, pain-free sex.
How can I strengthen my pelvic floor muscles during menopause?
You can strengthen your pelvic floor muscles at any age. Exercises may be more difficult once you reach perimenopause and later postmenopause, as collagen levels begin to decline, but the best time to start is now!
What are the top pelvic floor exercises during menopause?
Pelvic floor exercises, also called Kegel exercises, are an effective way to increase bladder control and reduce pain during sex. A study involving over 2,000 women aged 40+ with bladder issues found that most felt their quality of life improved after doing pelvic floor muscle exercises (4). That’s a pretty epic success rate!
So how are they done?
1. Get yourself ready
Pelvic floor muscle exercises can be done standing up, sitting, or lying down, but it’s important to relax. Therefore, we recommend finding somewhere that is calm and comfortable. Aim to do the exercises with an empty bladder. Give yourself a minute or two to release any tension, and then begin.
2. Let’s go
Suck your anus muscles in, exactly like when you’re trying to avoid passing gas. At the same time, pretend that you’re tightening the opening of your vagina around a marble. Squeeze!
While you’re still holding tight, pull up towards your belly button.
Are you trying as you read? We love that!
Contract your pelvic floor muscles for 3 to 5 seconds, then relax them for another 3 to 5 seconds. Repeat this cycle of contraction and relaxation up to 10 times (5).
3. Frequency and time to see results
Do the exercise three times a day. You’ll start to see the effects within six to eight weeks. Improved core stability, improved bladder and bowel control, and increased sexual pleasure are just a few of the results you can expect to see!
If you’re having trouble doing this exercise three times a day, consider doing it twice a day with twenty reps each time. You’ll still be putting in the work and will see results within a few weeks!
4. Who shouldn’t do pelvic floor exercises?
Pelvic floor exercises don’t solve all pelvic floor issues and may worsen some (6). This means you should speak with a clinician if you experience pain or extreme genitourinary symptoms (6). Remember, pelvic floor exercises should not hurt.
What is pelvic floor therapy? Does pelvic floor therapy help with menopause?
As you can imagine, pelvic floor therapy is not quite the same as other types of physical therapy.
Typically, you begin with a consultation with a physical therapist. They’ll review your medical history and perform a physical exam. The exam may include assessments of your hips, spine, bony pelvis, and pelvic floor muscles. After this, the physical therapist will help you create an individualized plan for your pelvic health needs (6).
Sessions often also include biofeedback. The physical therapist places biofeedback sensors on the vaginal wall to measure muscle tone and strength of muscle contractions. This helps directly see the improvement following the plan.
The number of sessions needed will vary, and each session is customized to address your specific needs and symptoms (6).
What types of sports help strengthen our pelvic floor in menopause?
Yoga has been shown to help strengthen our pelvic floor muscles (7). Poses like bridges, squats, and specific breathing techniques help activate and strengthen the pelvic floor muscles, improving their support and function. Moreover, yoga promotes overall body awareness and relaxation, which can further benefit pelvic floor health.
A recent study indicated that 75% of women aged 45+ reported that their sex lives improved after completing a yoga program (7). Now, there wasn’t a control group, however, the results suggest that practicing yoga is linked to pelvic floor muscle strengthening!
Does Hormone Replacement Therapy help strengthen our pelvic floor in menopause?
As HRT replenishes diminishing estrogen levels, it can reduce the decline in collagen levels associated with pelvic floor weakness. This means your pelvic floor muscles will likely be less impacted by perimenopause and menopause.That’s a good thing!
Genitourinary symptoms can also be relieved by applying topical estrogen to the vagina twice a week.
Don’t suffer in silence
A study found that it can take up to seven years for women to seek relief for pelvic floor symptoms by speaking to their physician (8). We’re here to tell you: it’s not worth it! There are proactive steps you can take today to address these symptoms and improve your quality of life.
Try pelvic floor muscle training or, if you’re open to it, give yoga a try. But if you’re still having pain or symptoms, speak with a clinician. They’ll be able to recommend pelvic floor therapy or HRT. Remember, you’re not alone: nearly 1 in 3 women experience this menopause symptom (1).
References
- Baker, F.C. et al. (2018) Sleep and sleep disorders in the menopausal transition, Sleep medicine clinics. Available at: Source (Accessed: 19 June 2024).
- (2022) Pelvic floor muscles: Anatomy, function & conditions, Cleveland Clinic. Available at: Source (Accessed: 25 June 2024).
- Zhuo, Z. et al. (2021) The relationship between pelvic floor function and sexual function in perimenopausal women, Sexual medicine. Available at: Source (Accessed: 26 June 2024).
- Radzimińska, A. et al. (2018) The impact of pelvic floor muscle training on the quality of life of women with urinary incontinence: A systematic literature review, Clinical interventions in aging. Available at: Source (Accessed: 26 June 2024).
- (2023) Kegel exercises: How to do them & benefits, Cleveland Clinic. Available at: Source (Accessed: 26 June 2024).
- Kelly Feddema, P.T. (2023) Benefits of pelvic floor P.T., Mayo Clinic Health System. Available at: Source (Accessed: 26 June 2024).
- For better sex: 3 ways to strengthen your pelvic floor (no date a) Pelvic Floor & Sexual Health, Menopause Information & Articles | The North American Menopause Society, NAMS. Available at: Source (Accessed: 25 June 2024).
- Shaw, C. et al. (2001b) ‘Barriers to help seeking in people with urinary symptoms’, Family Practice, 18(1), pp. 48–52. doi:10.1093/fampra/18.1.48.
