A weakened pelvic floor, which is often associated with incontinence, is anything but rare during menopause – and women are now also talking about it, exchanging ideas and helping one another. Luckily. But what do experts advise when it comes to treating the unpleasant problems “down there”?
They are among the most common menopausal symptoms, but nobody likes to talk about them: Side effects of the weakness of the pelvic floor caused by menopause, including incontinence, are an enormous burden on women. Laughing, coughing, sneezing – every spontaneous, jerky and uncontrolled movement becomes a stress test with a weakened pelvic floor. And that for the psyche too. Because urine leakage is not only uncomfortable, but also embarrassing. But what can we do about it?
Speaking of menopause: Here you can find out whether you could already be through menopause …
Am I already through menopause?
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Kim is a state-certified physiotherapist and course instructor at pelvina, an app that enables a pelvic floor course via smartphone.
Kim knows the answer – and can give hope: The state-certified physiotherapist, who is an expert and course leader for the pelvina training app (the pelvic floor course is paid for by more than 100 health insurance companies), is there to give you advice and assistance With her training advice, many women going through the menopause gain new zest for life. Because with constant, targeted training of the pelvic floor, annoying complaints such as incontinence and the like can definitely be treated – and combated. Before the next spontaneous laugh, cough or sneeze, women no longer have to worry …
Marians Welt: What physical changes mean that women in particular have more problems with the pelvic floor during menopause?
Kim: Menopausal women often suffer from pelvic floor weakness due to hormonal changes. The changed hormone status leads to a thinning of the tissue. This can cause a lowering of the internal organs, which additionally stresses the pelvic floor. Regardless of hormonal changes during menopause, the firmness of the pelvic floor naturally diminishes over the years. This can be caused by certain types of sport, long periods of standing, being overweight, chronic coughing, heavy lifting or poor posture.
In which situations is it particularly common to see that the pelvic floor is weakened? And what are the most common descriptions in everyday practice on this topic?
A weak pelvic floor can generally be shown by drawing pain in the abdomen or by dropping urine in droplets. Back pain is also possible. Affected women often describe a weak bladder and uncontrolled loss of urine, for example when coughing, sneezing or laughing. That can be very uncomfortable in everyday life. Even when jumping or carrying heavy loads, it is possible that the pelvic floor can no longer reflexively counteract and a few droplets go into your pants.
How has awareness of the relevance of a strengthened pelvic floor changed in recent years? Is it being discussed more impartially and more today?
A change has taken place in recent years. The media, among other things, have contributed to a better awareness and understanding of the pelvic floor. In addition, women have developed a strong awareness of their bodies in recent years. 20 to 30 years ago women hardly talked about sexuality or problems related to the pelvic floor, such as bladder weakness. Problem solving was more likely to take place in a quiet little room. The Internet and digital communication options have also changed the way we deal with this complex of topics, because they allow an exchange about it while at the same time preserving anonymity. When some women start talking about it, more and more dare to do the same. And so it becomes clear that bladder weakness is widespread and that you are not alone with your problem. We see in our community on Instagram or in our app that women feel the need to talk to others about their problems.
Which sport is good for the pelvic floor during menopause? And which one not at all?
Here it depends on the measure. Little or no exercise can cause the pelvic floor to sag and become weak. Too much exercise, on the other hand, can overload the muscles and also damage the pelvic floor. Good sports include Pilates, Yoga and Qui Gong. The focus here is on strengthening the entire body, especially the core of the body. Swimming, cycling and Nordic walking are also suitable. With Nordic walking, the body does not have to absorb shocks like jogging. In the cold season, cross-country skiing and downhill skiing are good alternatives. Sports should be avoided in which the body and therefore the pelvic floor constantly has to absorb shocks. Tennis or squash are part of it, but also trampoline jumping and jogging.
What should menopausal women in particular consider when strengthening the pelvic floor? Are there certain exercises / loads that are rather unfavorable?
Basically, menopausal women can do any exercise. Menopausal women are often very fit – sometimes even fitter than younger women. The decisive factor is not so much age but rather general health. Correct breathing is important for pelvic floor training. Many hold their breath and press breathing occurs. This is not good because it leads to an increase in pressure in the abdomen, which has a rather counterproductive effect on the pelvic floor. I know from practice: Those who start training later often need a little longer time to develop a feeling for the pelvic floor or to feel it. Training under professional guidance helps here.