Understanding Pelvic Health at Every Life Stage

Just as we prioritize caring for our hearts, muscles, bones, and joints, it’s crucial to take care of our pelvic health. In a recent Menopause Mastery Podcast episode, Dr. Betty Murray sat down with Dr. Kim, a physical therapist who specializes in pelvic floor therapy, to talk about this essential but often overlooked aspect of women’s health.

The Foundation: Your Pelvic Floor and Core

Your pelvic floor isn’t just a simple muscle group—it’s actually key to many body functions, from keeping you stable to helping with digestion. It’s a common mistake to assume that pelvic floor dysfunction always requires strengthening exercises like Kegels. However, Dr. Kim emphasizes that sometimes the muscles are too tight and must be lengthened. A specialized evaluation can help determine the best approach for each individual.

Think of your core as a container with four main parts: your diaphragm, abdominal muscles, pelvic floor, and multifidus (back muscles). When these work together properly, they help you breathe and move effectively. This is especially important during activities like weightlifting—using the wrong technique can actually weaken these muscles over time.

How Hormones Change Everything

Hormones play a major role in pelvic health throughout our lives. During pregnancy, a hormone called relaxin helps prepare the body for childbirth, but it can also cause pain in the SI joint. Later in life, during perimenopause and menopause, dropping estrogen levels can make pelvic floor muscles less flexible, which might lead to bladder leaks or pain during sex.

The good news is there are solutions for these changes. While lubricants can help temporarily with vaginal dryness, products containing hyaluronic acid provide longer-lasting relief. Vaginal estrogen can also help make muscles more supple and reduce UTI risks without affecting the rest of your body.

Taking Care of Your Pelvic Health

Many women avoid exercise because they’re worried about bladder leaks, but this can impact their overall health. Understanding how to care for your pelvic health can help you stay active and confident. This includes paying attention to your body’s signals, like when you need to use the bathroom, and not ignoring them.

Dr. Kim’s passion for this field comes from her own experiences with childbirth injuries while going through perimenopause. She now focuses on teaching women about safe labor positions and pelvic health to prevent long-term problems.

Beyond the Basics: Surgery, Sex, and Solutions

For women who’ve had a hysterectomy, concerns about organ prolapse are common. Dr. Kim emphasizes trying non-surgical options first, like pelvic physical therapy and pessaries, and learning proper breathing techniques before and after surgery.

When it comes to sex and aging, both doctors encourage women to stay sexually active, noting the health benefits of regular orgasms. They want women to feel comfortable enjoying their sexuality at any age.

Practical Tips for Better Pelvic Health

Here are some ways to maintain good pelvic health:

• Practice breathing exercises like 4-7-8 or box breathing
• Use pelvic wands when recommended by a professional
• Pay attention to how often you urinate (and avoid going “just in case”)
• Get evaluated by a pelvic floor specialist to understand your specific needs
• Learn proper breathing techniques for exercise and daily activities