Navigating Menopause with Pelvic Floor Physical Therapy: Insights from Dr. Rachel Rubin
Twice a month, the Lady Birds participate in continuing clinical education to stay up to date with the latest research, and to discuss diagnoses we are seeing most often in clinic. In June, we watched a lecture by Dr. Rachel Rubin, a board-certified urologist and fellowship-trained sexual medicine specialist. She shed light on how pelvic floor physical therapists play a crucial role in helping folks navigate menopause. Menopause is a significant transition in life, marking the end of reproductive years. While it is a natural process, it does bring about a variety of physical and emotional changes that may affect quality of life. Too often, effective symptom management ends up being a guessing game between patient and provider. With less than 7% of gynecologists reporting confidence in caring for folks in this phase of life, pelvic floor PTs can help to fill that care gap as specialists in the musculature most impacted by menopause.
Dr. Rubin’s insights had us buzzing, both from frustration at the lack of support that so many people face during this time, but also from excitement to share what we know with our patients and to work to improve their experience during this change! Read on to learn more about our key takeaways from this important lecture.
Understanding Menopause and Its Impact
Menopause typically occurs between the ages of 45 and 55, but it can happen earlier or later for some people. It is defined as the time when an individual has not had a menstrual period for 12 consecutive months. Perimenopause refers to the years surrounding menopause on either side, but is most often used to discuss the time just before menopause happens. We see patients at Lady Bird who are just beginning to see signs of perimenopause all the way through to post-menopause and beyond. The hormonal changes that occur during this period, particularly the decline in estrogen levels, can lead to various symptoms, including:
Hot flashes
Night sweats
Vaginal dryness
Mood swings
Sleep disturbances
Urinary incontinence
Decreased libido
These symptoms can vary in intensity and duration, affecting each person differently. Dr. Rubin emphasized that understanding these changes is the first step towards managing them effectively.
The Role of Pelvic Floor Physical Therapists
“My whole job is getting folks to the right pelvic floor physical therapist” — Dr. Rachel Rubin, joking but not joking
Our specialized training as pelvic health practitioners focuses on the pelvic floor muscles — those integral in bladder and bowel control, as well as sexual function. During menopause, the pelvic floor muscles are no longer receiving the hormones they need which can lead to weakness, resulting in symptoms such as urinary incontinence, pelvic pain, and sexual dysfunction. These symptoms are known as GSM, or genitourinary symptoms of menopause. Pelvic floor physical therapy is an evidence-based, low-intervention way to help treat GSM.
Dr. Rubin highlighted several ways in which pelvic floor PTs can assist folks during menopause:
Education and Awareness: We provide valuable education about the pelvic floor and its functions. Understanding how these muscles work and how menopause impacts them can empower folks to take proactive steps in managing their symptoms.
Individualized Assessment: Every person’s experience of menopause is unique. We conduct thorough assessments to understand each patient's specific symptoms and challenges. This personalized approach ensures that the treatment plan is tailored to meet individual needs.
Pelvic Floor Exercises: Strengthening and/or lengthening the pelvic floor muscles through targeted exercises can alleviate many menopausal symptoms. Your pelvic floor PT will spend time teaching you these exercises, ensuring proper technique and progression to maximize benefits.
Manual Therapy: Hands-on techniques, such as myofascial release and trigger point therapy, can help relieve pelvic pain and improve muscle function. We are skilled in these techniques and can provide significant relief from discomfort.
Lifestyle and Behavioral Modifications: We offer guidance on lifestyle changes that can support pelvic health. This may include dietary recommendations, bladder training, and strategies to manage stress and anxiety.
Support and Encouragement: Navigating menopause can be physically and emotionally challenging, and is often fraught with confusion and frustration. We offer ongoing support and encouragement, helping folks stay motivated and positive throughout their journey.
Key Takeaways from Dr. Rubin's Lecture
Holistic Approach: Dr. Rubin emphasized the importance of a holistic, whole-person approach to managing menopausal symptoms. This includes not only physical therapy, but also addressing emotional well-being, nutrition, and overall lifestyle.
Collaboration with Healthcare Providers: Effective management of menopause often requires a multidisciplinary approach. We work closely with other healthcare providers, such as gynecologists, endocrinologists, and mental health professionals, to ensure comprehensive care.
Proactive Management: Early intervention can significantly improve outcomes. Dr. Rubin encourages folks to seek help as soon as they notice symptoms, rather than waiting until they become severe. There is no need to suffer in silence!
Patient Empowerment: Knowledge is power!!! Unfortunately, there is so much misinformation out there about menopause symptom management. Proper education about what is happening in people’s bodies and the changes they are experiencing is SO important so that they may be empowered to take control of their health and well-being.
Conclusion
Menopause is a natural phase of life that brings about significant changes. While it can be challenging, it is also an opportunity for growth and self-care. Pelvic floor PTs play a vital role in helping folks navigate this transition, providing education, support, and effective treatments to manage symptoms and improve quality of life. Contact us to schedule an evaluation if you’re experiencing any of the symptoms mentioned in this article and learn how we can help!
This post was written by Dr. Samantha Yorke, PT, DPT. Samantha received her Bachelors of Science in Biology from Lewis and Clark College in Portland, OR. She went on to receive her Doctorate in Physical Therapy from West Coast University, where she graduated top of her class, earning awards for outstanding leadership and academic excellence.
She found her passion for pelvic floor physical therapy during her clinical rotations. Sam strives to educate and empower women to be their healthiest, most whole self. She applies manual therapy techniques in combination with exercise to treat individuals best.
Sam has completed pelvic floor physical therapy training through Herman and Wallace and plans to continue taking courses to expand her knowledge in pelvic floor dysfunction, prenatal, and postpartum care.
