Thriving Through the Change: How Physiotherapy Supports You in Menopause

What Is Menopause — and What Actually Happens?

Menopause is the natural biological transition when the ovaries stop releasing eggs and menstrual periods end. It is typically diagnosed when you've had 12 months with no period, usually occurring between about 45–55 years of age (though it can happen earlier or later).

During this transition, the levels of hormones — especially oestrogen and progesterone — decline, which affects many body systems.

Because of these hormonal changes, women often experience:

Vasomotor symptoms — hot flashes, night sweats
Sleep disturbance
Mood changes — irritability, low mood, anxiety
Musculoskeletal changes — reduced muscle strength, bone density, joint stiffness
Pelvic floor and urogenital changes — urinary leakage, urgency, pelvic organ prolapse risk, sexual discomfort
Changes in body composition — less muscle mass, more fat retention

It's important to know: menopause is a natural life stage, not a disease — but it's also real in its physical and emotional effects.

Myth Busting: Let's Clear Up Some Misconceptions

Myth 1: "Menopause means you'll stop being active or you're too old to exercise."

On the contrary — exercise and movement remain extremely important, perhaps even more so during and after menopause. Research shows that physical activity is a potent tool for health promotion during the menopausal transition.

Myth 2: "Pelvic floor problems are just in younger women or only after childbirth."

Menopause brings physiological changes that affect the pelvic floor (e.g., reduced oestrogen makes tissues less elastic, muscles may thicken or lose flexibility) which increases the risk of urinary and pelvic floor issues.

Myth 3: "There's nothing I can do — symptoms are just inevitable."

While you cannot stop menopause, there are many effective strategies (including physiotherapy, targeted exercise, and lifestyle changes) that reduce the impact of symptoms, preserve function and improve quality of life.

Myth 4: "Physiotherapy is only for injuries or sports — not for menopause."

Actually, physiotherapists (especially women's health and pelvic health specialists) are very well-placed to support women through menopause with movement, strength, pelvic floor rehab, education and more.

The Role of Physiotherapy and Pelvic Floor Health Care During Menopause

Here's how your physiotherapy clinic can help — with evidence-based support behind it.

Pelvic Floor and Urogenital Support

Research shows that pelvic floor muscle training (PFMT) is effective in post-menopausal women for urinary incontinence. One analysis found approximately a 92% chance of significant improvement compared with controls.
A trial found that PFMT increased pelvic floor muscle strength in post-menopausal women not using hormone therapy more than those on hormone therapy.
As the pelvic floor and surrounding tissues respond to hormonal decline, physiotherapy can help with both strengthening and ensuring flexibility and relaxation of the pelvic floor.

Musculoskeletal Strength and Movement

Resistance or strength training has been shown to improve muscle strength, bone density and hormonal/metabolic markers in menopausal women.
Mind-body exercise (yoga, tai chi, etc.) has been shown to improve sleep quality, reduce anxiety and depression, and improve bone mineral density in perimenopausal and postmenopausal women.
Physiotherapists are movement specialists — helping with mobility and joint pain (which may increase at this stage) and overall function.

Education and Empowerment

A review of exercise interventions found improvements in physical and psychological quality of life in menopausal women — the takeaway is that active involvement helps.
Physiotherapy is not only about fixing problems but helping women build resilience, feel strong, remain active, reduce fear of leakage or prolapse, and support sexual and pelvic health empowerment.

Top Tips for Women Going Through Menopause

Here are some practical, physiotherapy-informed tips:

Keep moving regularly — Aim for a mix of strength and resistance training (2–3 times a week ideally), aerobic movement (walking, swimming, cycling) and flexibility/mobility work. These help muscle strength, bone health, mood, sleep and general wellbeing.
Pelvic floor awareness — Learn to contract and relax the pelvic floor. Don't assume "more contraction is always better" — sometimes over-tightness is part of the problem. A pelvic health physio can help you get the right coordination.
Address posture and core strength — As hormone changes influence muscle/tissue integrity and bone health, posture and trunk control matter. Strong glutes, hips and back can protect from lower-back pain and improve everyday movement.
Focus on sleep and stress — Hot flashes, night sweats and mood changes can disrupt sleep — which then impacts movement, recovery and mood. Mind-body approaches (yoga, meditation, breathing) help.
Hydrate, nourish, and support bone health — Physiotherapists emphasise the importance of calcium and vitamin D (via medical advice), plus weight-bearing movement to support bone density.
Seek help early — Don't wait until symptoms become severe. If you notice urinary leakage, pelvic heaviness, prolapse sensation, sharp pains, sexual discomfort, or you're just feeling less able to move like you used to — book in for an assessment. The earlier you intervene, the more options you have.
Lifestyle factors — Smoking, excessive alcohol, very sedentary behaviour, lack of protein or very low body weight can all influence muscle, bone and pelvic health negatively. A movement plan goes hand in hand with lifestyle.
Mind the pelvic floor and whole-body link — Hip, abdominal and back strength influences pelvic floor behaviour. A whole-body view is helpful rather than just separate pelvic floor exercises.

A Section for Partners — How Can You Help?

Menopause doesn't just affect the person going through it — it has ripple effects in relationships, home life, intimacy and mood. Here are ways partners can help:

Be informed — Learn about menopause — its physical, emotional and sexual effects. Understanding helps empathy.
Talk openly — Encourage and maintain open communication about changes in mood, body, intimacy or function. Don't assume "it's just normal, she'll deal with it."
Support movement together — Invite her to join you for a walk, a gym session, a yoga class, or even a home stretch routine. Shared movement can strengthen relationships and show you care.
Be patient with pelvic health and intimacy issues — You may notice changes in sexual comfort, pelvic pain, dryness or urinary leakage. These are common. Acknowledge them, don't judge, and support seeking help (e.g., from a pelvic health physiotherapist or GP).
Assist with lifestyle modifications — Limiting alcohol, encouraging healthy meals, helping with sleep hygiene (cool room, less caffeine late, managing hot-flash triggers) shows you're in this together.
Help with rest and recovery — Night sweats and sleep disruption affect mood and energy. Offer help — staying quiet when she needs to get up, helping with kids or tasks so she can rest.
Celebrate the positives — Menopause is not just "ending reproductive years" — it can be a time of new freedom, focus on self, and new priorities. Encouraging this mindset can make all the difference.

Why Now — and Why It Matters

This October, as we mark World Menopause Month, it's a good time to shine a light on how many women are navigating this life stage — often silently or without the support they deserve. Studies show only a small proportion of women feel well-informed about menopause, and there is concern about misinformation and under-supported care.

At Bodytherapy, we believe that women's health and pelvic health are lifelong priorities — and menopause is just a key phase where proactive support makes a real difference. It's not "just something to suffer through" — it's a phase you can move through with strength, confidence and support.

Final Thoughts

Menopause is a significant change — but with the right support (especially movement, pelvic health, education and lifestyle), it does not need to mean loss of vitality or function. Your body is still capable of strength, flexibility, joy, and control — regardless of age or stage.

Let's use this World Menopause Month to talk openly, support each other, and move through change with intention rather than retreat. You deserve to feel empowered, comfortable and strong.

References

Menopause. (2018). Physical performance in relation to menopause. LWW Menopause Journal, 25(12).
UPMC HealthBeat. (2024). Menopause and the pelvic floor.
BMC Women's Health. (2023). Body composition changes across menopause: A systematic review.
APTA Magazine. (2019). Menopause: PTs help to ease the change.
PubMed. (2024). Pelvic floor muscle training efficacy in postmenopausal women with urinary incontinence: A systematic review and meta-analysis. PMID: 39615241.
PubMed. (2018). Effect of PFMT on postmenopausal women not using hormone therapy. PMID: 29914808.
PubMed Central. (2020). Exercise and menopause: Evidence for symptom improvement and quality of life benefits. PMC7579592.
PubMed Central. (2023). Resistance training and hormonal/metabolic responses in menopausal women. PMID: 36675477.
Menopause Journal. (2024). Effects of mind-body exercise on perimenopausal/postmenopausal women. LWW, 29(5).
Loyola Medicine. (2023). Menopause-related musculoskeletal pain.
The Guardian. (2025). Experts warn of misinformation in menopause care.