Menopause, Perimenopause & Pelvic Floor Health
Menopause and perimenopause are natural life transitions, but that doesn’t mean the changes feel easy. Hormonal shifts during this stage of life can affect everything from sleep and mood to pelvic floor function, bladder health, strength, energy, and overall well-being.
At Root To Rise Physical Therapy & Pelvic Health in Scarborough, Maine, we often work with individuals navigating symptoms related to perimenopause and menopause who are looking for answers, support, and a path forward. The good news? Many of these symptoms are treatable, and you don’t have to simply “live with them.”
Understanding what’s happening in the body can help you feel more empowered, informed, and supported through these transitions.
What Are Perimenopause and Menopause?
Menopause is officially defined as the point 12 months after a person’s last menstrual period. Perimenopause is the transitional phase leading up to menopause, when hormone levels begin to fluctuate and gradually decline.
These hormonal changes can impact multiple systems in the body, including:
Pelvic floor health
Musculoskeletal health
Cardiovascular health
Sleep and nervous system regulation
Bladder and bowel function
Many people are surprised to learn that perimenopause symptoms can begin as early as the mid-30s and may last for 10–15 years before menopause occurs.
Because these changes happen gradually, symptoms are often dismissed, misunderstood, or attributed to stress and aging alone. Working with supportive healthcare providers (including pelvic floor physical therapists) can help you better understand your body and manage symptoms proactively.
Understanding the Menstrual Cycle During Perimenopause
To better understand perimenopause and menopause, it helps to first understand how the menstrual cycle normally functions.
The menstrual cycle is a monthly sequence of hormonal changes that prepares the body for a possible pregnancy. It includes four phases:
Follicular Phase
Menstrual bleeding begins (cycle day 1), and estrogen levels start to rise.
Ovulation
An egg is released from the ovary.
Luteal Phase
Progesterone rises along with continued estrogen production. The uterine lining thickens in preparation for pregnancy.
Menstruation
If pregnancy does not occur, hormone levels drop and the menstrual cycle begins again.
During perimenopause, ovulation becomes less consistent. In the earlier stages, estrogen may continue to rise without the balancing effect of progesterone, leading to hormonal fluctuations that can contribute to symptoms such as:
Anxiety or depression
Insomnia and disrupted sleep
Breast tenderness
Heart palpitations
Hot flashes and night sweats
Headaches
Heavy, irregular, or painful cycles
As menopause approaches, both estrogen and progesterone levels decline further. This can contribute to:
Brain fog
Urinary and bowel symptoms
Increased abdominal fat
Insulin resistance
Tendon and joint pain
Arterial stiffening
Changes in muscle strength and recovery
How Menopause Affects Pelvic Floor Health
Hormonal changes during perimenopause and menopause can significantly impact the pelvic floor and surrounding tissues.
Estrogen plays an important role in:
Supporting bladder and vaginal tissue health
Maintaining healthy tissue elasticity and blood flow
Supporting pelvic floor muscle function
Regulating inflammation and vaginal pH
As estrogen declines, many people notice symptoms such as:
Urinary leakage or incontinence
Increased urinary urgency or frequency
Constipation
Pain with intercourse
Pelvic pain or pressure
Tendon pain and musculoskeletal discomfort
These symptoms are incredibly common, but they are not something you simply have to accept as a normal part of aging.
How Pelvic Floor Physical Therapy Can Help During Perimenopause & Menopause
At Root To Rise Physical Therapy & Pelvic Health, we take a whole-person approach to pelvic health during perimenopause and menopause. Pelvic floor therapy can help improve bladder, bowel, sexual health, mobility, strength, and overall quality of life.
A pelvic floor physical therapist can help you:
Improve urinary leakage, urgency, and bowel symptoms through pelvic floor muscle training
Address muscle tension and pelvic pain, including pain with intercourse
Support strength, mobility, and tendon health through individualized exercise programming
Improve breathing mechanics, core function, and pressure management
Provide education and guidance around lifestyle, movement, and symptom management
Collaborate within a holistic care team approach during this life transition
Our goal is to help you feel strong, informed, and supported—not limited by your symptoms.
You Don’t Have to Navigate Menopause Alone
Perimenopause and menopause can bring real physical and emotional changes, but support is available. With the right care team and individualized treatment approach, many symptoms can improve significantly.
At Root To Rise Physical Therapy & Pelvic Health in Scarborough, Maine, we’re passionate about helping individuals navigate these transitions with education, compassionate care, and evidence-based treatment.
If you’re experiencing pelvic floor symptoms, bladder changes, pain, or musculoskeletal concerns during perimenopause or menopause, we’d love to support you.
Reach out to schedule an appointment with one of our pelvic floor physical therapists and learn how pelvic floor therapy can help you feel more like yourself again.