Menopause And Physiotherapy

Some of you may be aware that October is World Menopause Month, so I though I’d write a piece today to cheer all the female readers up  and hopefully provide a little insight for the men too.

When the word menopause is mentioned, people typically think of hot flushes and mood swings. But there is so much more to menopause and the ways it affects the body are far reaching and vary from person to person.

Menopause by definition, is when a woman has not had a menstrual period for 12 consecutive months. The average age of menopause is 51 but the perimenopause (the period leading up to the cessation of periods) can last anywhere from 6 months to 10 years! It is caused by a change in the body’s production of the reproductive hormones (oestrogen and progesterone primarily, but also testosterone and a couple of other hormones). Once a woman’s periods have stopped she will have much lower levels of both progesterone and oestrogen.

It is during the perimenopause that symptoms are experienced. Treatment is not essential as the menopause is a natural part of aging, but any treatment that is given is to treat the symptoms rather than the process itself.

Here are just some of the symptoms experienced during the perimenopause:

  • Irregular menstrual cycles
  • Heavy bleeding might occur for a day or two
  • Excessive sweating during night
  • Hot flushes
  • Vaginal dryness, itching and pain during sexual intercourse
  • Frequent urinary tract infections
  • Mood swings
  • “Brain fog” – difficulty concentrating and with memory
  • Fatigue
  • Weight gain due to uneven fat distribution
  • Headaches
  • Dizziness
  • Joint and muscle pain
  • Difficulty sleeping

What a delight for the women out there! It must be said that not every woman will experience all of the symptoms, and everyone’s experience will be different.

From a Physiotherapist’s perspective, the joint and muscle pain will, in part, be attributed to a loss of muscle mass, termed Sarcopenia. This happens to all of the muscles in the body (including the pelvic floor) which will result in weakness of those muscles and therefore less support for the surrounding joints. In relation to the pelvic floor, this can result in incontinence – either in terms of the frequency in which one requires the toilet, or in terms of urgency.

It is thought that muscle mass is lost at a rate of 1-2% a year in post-menopausal women, but thankfully exercise can be a great help to build and maintain muscle mass and strength.

Weight bearing exercise, in particular, can provide added benefit as this helps improve bone density (in the five to seven years post menopause, women lose up to one fifth of their bone density, increasing the chance of osteoporosis).

The topic of HRT (hormone replacement therapy) goes beyond the scope of this article (and my qualification to impart such information!), but the purpose of it is to increase the hormone levels again to manage the symptoms of the perimenopause.

Good ways to prepare for and manage the effects of the menopause:

– Eat a well balanced diet containing plenty of calcium and vitamin D to help bone density and health.

– Regular exercise, including some weight bearing elements. Exercise that focuses on building strength (using body weight or external weights) are particularly useful to overcome the muscle mass loss. (Pilates is excellent for this….).

SO there you have it! An insight to the perimenopause and beyond. It sounds very daunting but there is lots of support and awareness building “out there” nowadays, but as always, be careful when researching via “Dr Google”. If you have specific questions or conc