Menopause and Its Effect on the Body

What is Menopause?

Menopause happens when menstruation has not taken place for 1 year or more. The years leading up to that point (generally between the ages of 45 and 55) where symptoms can also arise is called perimenopause. During this period, the hormones oestrogen and progesterone levels fluctuate, and can cause symptoms such as hot flashes, disturbed sleep and changes to menstruation cycles. Once a woman has not had a period for over 12 months, she is post-menopausal. This can be a big transition for some women, and while some will experience very few to no symptoms, for others, injuries and conditions can arise.

The Effect of Menopause on Bones and Tendons

The decrease in oestrogen levels following menopause results in a reduction in collagen production, which means that tendons can become weaker and more prone to injury. This reduction in collagen production means tendons are slower to repair and have reduced elasticity (increased stiffness in tendons). Muscle mass tends to shrink during this period also, meaning that strength and exercise tolerance can reduce.

Bones also lose density, resulting in some women developing osteopenia and osteoporosis.

The best things you can do to maintain bone, muscle and tendon health is resistance training, and to manage tendon injuries under the guidance of a physiotherapist or exercise physiologist.

The Effect of Menopause on the Pelvis and Bladder

The menopausal process can also lead to vaginal, vulvar, and or vaginal symptoms. As oestrogen levels decrease, this increases the likelihood of women experiencing symptoms such as:

• Vaginal dryness
• Urinary frequency and urgency
• Recurrent UTIs
• Pain during sex and decrease in libido
• Reduced vaginal wall and vulvar elasticity
• Thinning of the inner labia
• Pelvic organ prolapse
• Reduced muscle mass

Prolapse, urinary symptoms, sexual pain symptoms and other pelvic concerns can be addressed with a pelvic floor physiotherapist, where they may recommend exercises to strengthen or reduce tightness in the muscles. There are products such as vaginal moisturisers or lubricants that can be bought online or at chemists to improve symptoms of vaginal dryness and pain during sex. There are also medically prescribed oestrogen treatments available which can also improve symptoms. A pelvic floor physiotherapist can assess you and recommend that you talk to your doctor about oestrogen treatments, or recommend non-prescription products to address these symptoms.

While there’s a lot of doom and gloom around the process of menopause, it is important to know that you can live a wonderful life after menopause. There are many options available to address any symptoms that you have, and generally keeping strong and active will help you to live well. For guidance on pelvic symptoms, bone health, tendon health, and exercising in an optimal way, come and see one of our physios!

Grace is a physiotherapist with a special interest in the menopausal period and has experience treating urinary, prolapse, sexual pain, bone, and tendon conditions.