What To Expect Post Menopause

What To Expect Post Menopause - common ailments

So, you’ve made it through menopause – now what? While many of the symptoms that came along with menopause will go away, because of some of the changes that happened during menopause, you still need to be on your A-game to remain healthy.

Here are some of the common things to watch out for

Vaginal Bleeding

As your estrogen levels drop during menopause, the vaginal lining becomes very thin and, as a result, may be easily irritated, resulting in bleeding. Polyps (usually non-cancerous growths) can also occur. Bleeding after menopause is not normal, so if you experience this, be sure to see your doctor right away to get checked out to ensure it’s nothing serious.

Risk of Osteoporosis

After menopause, a woman’s bone breakdown overtakes bone buildup, resulting in a loss of bone mass. Overtime, this can develop into osteoporosis. Prevention is key here – be sure to exercise on a regular basis (weight bearing exercises done regularly are great at making bones stronger). Eat high calcium foods, such as low-fat milk and dairy products, canned fish, dark leafy greens, and calcium fortified foods. Vitamin D is also essential, as it helps the body better absorb the calcium you’ll be taking in. You can get Vitamin D naturally by exposing your skin to sun for about 20 minutes daily, but you may also get it from foods like eggs, fatty fish, cereal and milk. If you feel you are at a risk for not getting the calcium or vitamin D you need, talk to your doctor about taking supplements.

Risk of Heart Disease

While menopause doesn’t cause heart disease, women are at an increased risk for heart disease after menopause has occurred. Some believe that lack of estrogen may again be to blame, but other changes are in effect too – increased blood pressure, increased LDL cholesterol (this is the “bad” one) and higher levels of fat in the blood can also increase after menopause.  Diet and exercise are as important as ever (to keep your heart healthy and prevent other conditions). Just 30 minutes of physical activity - walking, dancing, and swimming are all great options – 5 days per week can give you a good aerobic workout. And be sure to eat a healthy diet while avoiding too much red meat, or high sugar foods and drinks.

Vaginal Dryness

Because of low estrogen levels, you may still experience some vaginal dryness. Over the counter vaginal lubricants and moisturizers can help ease these symptoms, but if that doesn’t work, talk with your doctor about using some type of estrogen treatment – there are many available, and in different forms (tablets, rings, creams).

Life after menopause can be a wonderful time provided you take the time for self care and work to maintain a healthy lifestyle.

The Pelvic Floor As We Age. A look at how it changes through the different phases of life (pregnancy, menopause, etc.).

The Pelvic Floor As We Age, Pregnancy, Menopause.

A Guest Post By Michelle Herbst, PT

As women age, their birthing history and overall muscle weakness may catch up with them.  A healthy pelvic floor can be achieved as we age but often little attention is paid to the pelvic floor until it starts to fail. It can be difficult for women to seek medical attention due to feelings of embarrassment and despair. But, advances in health care and knowledge of the aging process allows today’s women to seek effective treatments.

Let’s step back and take a closer look at the pelvic floor as we age.

The pelvic floor is a sling supporting our abdominal and pelvic organs. It is made up of our muscles and connective tissues which I like to think of as our active and passive pelvic support structures. The pelvic floor muscles, or active pelvic support structures, create a muscular sling whereas our passive pelvic support structures are made of connective tissue called fascia. Fascia is a spider-web like material traveling through and covering the pelvic floor.

The active and passive pelvic support system are one in the same. They are knitted together interlacing creating a dynamic basin of support. Healthy pelvic support system work together controlling our sphincters, limit the downward descent of the pelvic organs and aide in sexual appreciation. Damage or weakness to the pelvic support system may result in symptoms of pelvic floor dysfunctions resulting in leakage and pelvic organ prolapse.

The pelvic floor over time.     

Pregnancy, child birth and the post-partum period is a time of great change. The interlacing nature of the active and passive pelvic floor support systems protect the mother and baby as they both grown. Child birth calls on the pelvic support system to push and slide the baby out into the world. The pelvic floor muscles can heal in as quickly as 6 weeks after delivery. But, the physical strain of living and creating new life can be taxing on the pelvic support system leaving it overstretched and weak.

The prescription is often kegels and post-partum kegels can be hard to do. The muscles are lengthened, very weak and trying to ‘reconnect’ to their nerve supply. In an attempt to ‘get it all done’, the post-partum mom is often multi-tasking while doing kegels. Their brain is preoccupied, sleep deprived and foggy. Despite good intentions, many new mothers ‘muscle their way through’ relying on other muscle groups to assist or do the job of the pelvic floor. Overtime with due diligence and a sleeping baby – the brain fog lifts, kegels are consistent and pelvic floor muscles recover allowing the new mom to return to and enjoy life’s pleasures and adventures.

Life continues to click at a fast pace.  The biological process of aging ticks away. The passage of time can be bittersweet. In the 3rd through 5th decades of a woman’s life, she will begin to experience a gradual loss in overall muscle strength and tensile strength of their connective tissue. In their 4th and 5th decades, peri-menopause ushers in a decrease in circulating estrogen and progesterone. The conclusion of these gradual changes are marked by menopause which is typically complete during the 5th decade. Life starts to catch up with you. The birthing of children, past injuries, the development of chronic health conditions and your family history may predispose the active and passive support system to overall weakening and loss of integrity resulting in leakage, organ prolapse and decline in sexual function.

What Can you do To Strengthen The Pelvic Floor?

1.     Protect and strengthen your active pelvic support system by engaging in a strength program and doing your kegels. Peak muscle strength occurs in twenties or thirties. And, unless a woman is engaging in a strength program she will begin lose muscle mass and strength.

2.     Protect the passive pelvic support system by avoiding straining during bowel movements and avoid holding your breath while lifting, pushing and pulling. The passive pelvic support system can not ‘fix itself’ and will need to rely strength of the active pelvic support system. So, revisit number 1 again and again and again …

3.     Stay healthy and seek out your doctor’s advice when you are sick or notice your first sign of leakage or prolapse. The treatment often times isn’t as bad as you think it will be.

 
Michelle Herbst, PT

Michelle Herbst, PT

 

Staying Strong And Preventing Bladder Leakage During Menopause

preventing #bladderleakage during menopause

It’s estimated that a whopping 6,000 women reach menopause each day in the US. Menopause happens to every woman, and is the shift in hormonal changes that result in the cessation of menstruation.

While many women know about the common symptoms of menopause (Hot flashes! Insomnia!), there are certain changes that come about in menopause that are often surprising to women. One of these is loss of bladder or bowel control

A number of things occur during menopause that can contribute to you suddenly experiencing a bit of leakage

Weakening Of Pelvic Floor Muscles

Your pelvic floor muscles play a huge role in controlling your bladder and bowel. As the muscles weaken, it can lead to more urgent needs to use the restroom, and more leaks. Weakened muscles can also lead to an increased risk for pelvic organ prolapse.

A Less Elastic Bladder

Changes that occur during menopause can cause the bladder to lose it’s elasticity and the ability to stretch. This can cause increased irritation in the bladder when it fills with urine, and can impact the nerves that regulate bladder function, which can sometimes cause overactive bladder (OAB).

Vaginal Dryness

During and after menopause, the body produces much less estrogen, which results in an increase of vaginal dryness. This dryness has a number of consequences, which can include an increase in the amount of urinary tract infections.

Anal Trauma

While anal trauma is usually the result of childbirth, many women may not see the results of it until menopause, when that, combined with a weakened pelvic floor can increase the risk of fecal incontinence.

It’s important to know that while these changes can lead to bladder or bowel leakage, the symptoms can also be avoided or eliminated by taking proper care of the pelvic floor. It’s never too late to start strengthening things up.

Here are some ways to increase the strength of your pelvic floor as you go through this period

Get Active

As simple as it sounds, simply staying active is great to keep your weight, and overall health in check.  Gentle exercises, like walking, that don’t place too much pressure on the pelvic floor are best.

Try Squats

Squats are a great way to build up your glute and core muscles. To perform one, stand with feet shoulder with apart. Keeping your knees over your feet (don’t let them move past your toes), lower your bottom down as if you are sitting in a chair, being careful not to lean too far forward. Raise back up to starting position.  Aim for 10 reps per day. (Note, if these feel too difficult for you, try wall squats, which use the same movement, but are performed with your back to the wall for extra support.)

Kegel

When done correctly, kegels can do wonders for helping women with incontinence.  They help strengthen the muscles that prevent bladder leakage and also help to avoid or reduce the symptoms of pelvic organ prolapse.  Remember that when performing a kegal, learning how to relax the pelvic floor is just as important as learning how to tighten it. In some cases, women have pelvic floors that are too tight and cannot relax, and if this is the case, kegels can end up aggravating your condition. If you’re concerned about your pelvic floor, or just can’t get the hang of how to do a kegel, visit a pelvic floor physical therapist for help.

Hormones! They Are A Changin'. Top 3 Myths About Menopause - Debunked!

Top 3 myths about menopause - Debunked!

Menopause will affect every woman at some point in her life. Menopause occurs when hormonal changes cause the menstrual cycle to stop. Whether you are on the verge of this life change or right in the middle of it, there are things you can do to manage the side-effects. But first, it helps to know what is and isn’t true.

Here are some common myths about menopause and the reality behind them

MYTH #1: MENOPAUSE BEGINS AT A CERTAIN AGE.

Fact: While the average age for menopause to start is 52, this is not a steadfast rule.

Women can begin menopause as early as their 30s and as late as their 60s! Technically, menopause begins when you have stopped having a menstrual cycle for 12 months. But symptoms can start even before this begins – perimenopausal symptoms can last anywhere from a few months to several years before actual menopause starts.

MYTH #2: HOT FLASHES ARE THE BIGGEST SYMPTOM I NEED TO WORRY ABOUT.

Fact: While hot flashes are a commonly talked about symptom of perimenopause and menopause, there are many symptoms that can occur (although not all women experience all symptoms). Irritability, fatigue, anxiety, mood swings, low libido, forgetfulness, weight gain and vaginal dryness are just a few of the symptoms that women may experience during this stage of life.

MYTH #3: INCONTINENCE THAT COMES AS WE AGE IS JUST A RESULT OF GETTING OLDER AND THERE’S NOTHING I CAN DO ABOUT IT.

Fact: It’s true that menopause can increase the risk of urinary incontinence. During menopause, estrogen levels decline, causing a number of changes to the body. Without proper care, pelvic floor muscles can become weaker, increasing the possibility of leakage, or even pelvic organ prolapse. Vaginal dryness can occur as the lining of the vagina produces less mucus. And a decline in bladder elasticity can increase bladder irritation and impact bladder function, which can cause overactive bladder (OAB). But while hormonal changes that come with age can influence symptoms, there are many things that can be done to prevent or manage incontinence, starting with taking proper care of your pelvic floor. If you are experiencing any of the above symptoms, talk with a licensed physical therapist who specializes in women’s health as soon as possible so that they can evaluate your symptoms and set you up on a proper treatment plan.