The menopause, typically occurring between the ages of 49 and 52, marks the end of the menstrual cycle and the beginning of a new phase in every woman’s life. It represents an inevitable milestone characterized by profound changes. During this delicate transition, the body undergoes significant physiological and hormonal changes. Women face various challenges, among which the health of the pelvic floor stands out as crucial for overall well-being. One of the most significant changes during menopause is the marked decrease in estrogen, essential female hormones that play a key role in shaping the condition of the pelvic floor. This hormonal deficit can often result in a series of dysfunctions that require particular attention.
The impact of estrogens on the female body
Estrogens are the primary female sex hormones, and their impact extends far beyond what one might imagine. They not only influence fertility, sexual development, and libido but also play a fundamental role in cognitive function, mood regulation, and the health of the heart and bones. Additionally, they are responsible for regulating the menstrual cycle and directly influence the well-being of the pelvic floor. This crucial region of the body involves muscles, ligaments, and connective tissues that provide support to vital organs such as the bladder, uterus, and rectum. During menopause, the ovaries gradually cease functioning, leading to a continued decrease in estrogen levels until they stabilize at a low and steady stage.
Challenges of the pelvic floor during menopause
The decrease in estrogen during menopause is associated with the onset of various disorders and discomforts. In addition to menstrual irregularities preceding actual menopause, symptoms such as hot flashes, night sweats, insomnia, mood swings, and irritability emerge. Furthermore, significant pelvic floor discomforts may occur due to a loss of elasticity and type 1 collagen in all muscles of the body, including the pelvic muscles, which undergo progressive weakening. Let’s carefully examine some of the most common intimate disorders associated with this period:
- Urinary incontinence: Urinary incontinence often emerges as a disorder in menopausal women due to narrowing of the urinary tract and consequent weakening of the pelvic floor muscles. This can manifest through minor and sporadic urine leaks, but also through complete and constant bladder leakage. Several risk factors contribute to or exacerbate incontinence, such as obesity, consecutive pregnancies, natural childbirth, previous uro-genital surgeries, and, of course, an unbalanced diet.
- Pelvic organ prolapse: This condition occurs when pelvic organs (uterus, bladder, and/or rectum) descend from their normal position and protrude into the vaginal cavity. Hormonal changes can weaken supporting tissues and pelvic floor muscles, increasing the risk of prolapse. Symptoms may include a sensation of heaviness or pressure in the pelvic area, difficulty in controlling bladder or bowel movements, and sometimes, visible descent of organs through the vagina.
- Vaginal dryness and sexual dysfunctions: The reduction in estrogen levels can affect vaginal lubrication and elasticity. Menopause can cause vaginal dryness, making sexual intercourse difficult or even painful. This can significantly impact a woman’s sexual life and relational health with her partner.
- Recurrent cystitis: Cystitis occurs frequently during menopause, largely due to hormonal influences on the regulation of normal vaginal bacterial flora. Reduced vaginal acidity increases the risk of intestinal bacteria entering the urethra and bladder. Specifically, decreased beneficial lactobacilli and increased pH reduce the vagina’s acidic filtering effect, promoting the proliferation of pathogenic saprophytic flora and increasing the risk of infections both vaginally and urinarily.
Menopause presents multiple challenges to women entering this new phase of life. However, it is important to emphasize that the experience is individual and varies from person to person. Each woman experiences her menopause uniquely, with nuances and personal needs. Next month, we will explore advice and solutions for addressing challenges related to menopause. It will be an opportunity to delve into strategies and practices that can contribute to well-being during this transition period.
The contents of this page are for informational purposes only and should in no way replace the advice, diagnosis, or treatment prescribed by your physician. Responses to the same treatment may vary from patient to patient. Always consult your doctor regarding any information related to diagnoses and treatments, and meticulously follow their instructions.
