Written By: Lisa Charron, PT, DPT, on October 06, 2023
When people think about menopause, the first thing that comes to mind is hot flashes and a hormone rollercoaster. However, there are many symptoms associated with menopause including anxiety, difficulty sleeping, skin conditions, and mood swings.
Then there are lesser-known symptoms – like Genitourinary Syndrome of Menopause (GSM). This is a term used to describe urinary, genital, and sexual symptoms common in individuals undergoing the menopause transition. Many of these changes were previously diagnosed as vulvar/vaginal atrophy, but the more comprehensive name, GSM, better reflects the wide range of symptoms that individuals may experience.
A visit with a pelvic rehabilitation provider may help provide more guidance on these strategies. A pelvic floor muscle evaluation may also assist in assessing the role of your pelvic floor muscles in your bladder symptoms, and what types of stretches and exercises may help.
2. Sexual Symptoms
The decrease in estrogen in the vulvar tissues that occurs with menopause often leads to vulvar and vaginal dryness. In turn, this can cause pain with vaginal penetrative intercourse. Although vaginal moisturizers or lubricants are often an effective first step in addressing vaginal dryness, sometimes the pain continues despite these treatments. This is because penetrative vaginal sex requires pelvic floor muscles that can lengthen and relax to allow for vaginal penetration, as well as pelvic floor muscles that can contract and contribute to arousal. BOTH contraction and relaxation are essential for sexual function.
Pelvic floor therapy can improve your pelvic floor muscles’ ability to do both! In addition to addressing the role of the pelvic floor muscles in sexual function, a pelvic health rehabilitation provider may also be able to provide guidance on other aspects of sexual health, such as positioning, lubrication, and education regarding sexual function. They may also help to refer you to the appropriate provider for further medical or behavioral health treatment, such as a vulvar health specialist, a menopause specialist, or a sex therapist.
While POP is not always visualized or felt at the vaginal opening, some individuals report a feeling of heaviness, dullness, or pressure. POP is graded in severity by stages (0-4), with a higher stage representing a greater level of pelvic organ descent in the vaginal canal. POP can also be present without symptoms.
There are several surgical and non-surgical options for treating POP. Lesser-known, non-surgical options include pessaries or pelvic health rehabilitation.
GSM is highly prevalent as an effect of the menopause transition, but just because it is common does not mean it is not treatable! Contact your healthcare provider to learn more about how specialists in gynecology, urogynecology, and pelvic health rehabilitation can help. The Spaulding Pelvic Health Rehab Team at Care New England has training to evaluate your needs and develop a comprehensive and individualized treatment plan to help improve your quality of life at all ages.
Disclaimer: The content in this blog is for informational and educational purposes only and should not serve as medical advice, consultation, or diagnosis. If you have a medical concern, please consult your healthcare provider, or seek immediate medical treatment.
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