Menopause Pelvic Health Assessment

As we reach perimenopause most of us have experienced some of these risk factors that can lead to pelvic floor issues like:

• Childbirth
• Gynae Surgery
• Respiratory illnesses
• Constipation
• Weight gain

A menopause warrant of fitness check will assess your pelvic floor function now in light of these risk factors and your current hormonal changes/symptoms. You will go away with personalised pelvic floor exercise prescription, pelvic health lifestyle advice and a follow up appointment to assess your progress. You’ll notice changes within 4 weeks but it may take 3-6 months to regain full strength depending on what you wish to achieve.

Diagnosis

I’ll assess you and find out on external and internal examination what the problem is. In most cases I’ll be able to provide treatment for you. Sometimes I may need to refer you back to your GP where appropriate, especially if medications are needed.

You will feel comfortable in a private environment where you can speak freely and feel relaxed in open discussions about your pelvic health.

Management

We’ll create a management plan that helps you not only understand what’s going with your pelvic health, but also introduces you to a variety of options and tools you can use to manage your symptoms.

Treatment

As Registered Pelvic Health Professional, Registered Nurse and Personal trainer I am trained to assist you with achieving greater pelvic health.

You can say, ‘Goodbye’ to painful sex, vulval pain, infections, and/or reduced bladder control. A clear examination and diagnosis of your symptoms and sound advice for management and treatment will be your next step.

Sexual Function

Sexuality is an important part of our wellbeing. Issues in this area become easy to discuss when you speak privately to an experienced Registered Nurse in a consultation that is unhurried and where you feel comfortable to open up about changes you may be experiencing.

Problems

Typical sexual problems in menopause:

• It is sore during sex. It hurts and I can’t wait for it to be over. Sometimes the pain is at the entrance or higher up near my cervix.
• I have no libido, I don’t really care if I ever have sex. I don’t feel turned on anymore, I don’t masturbate or orgasm as much as I’d like to. This is affecting my relationship.

Benefits

• Internal assessment allows us to see where the problem is. Treatment differs based on where the problem is.
• As a healthcare professional I realise that some women may feel uncomfortable about a vaginal examination. I explain carefully what happens and obtain patient consent before proceeding. Most women feel very comfortable and find they understand their body a lot more from having the exam.

Problems

• Sometimes I feel such a strong urge to pee. It makes me feel anxious because I worry that I can’t get to the loo in time.
• When I sneeze the wee just comes out. Sometimes I need to wear a pad, especially during exercise.
• I have frequent urination, I seem to be peeing more than usual and I’m up in the night, sometimes more than once.
• I’ve heard that urinary incontinence can get worse with age. I’ve noticed a few changes, I really don’t want to be that smelly old lady in a rest home when I get older.

Benefits

• Increase your confidence to know that you are doing your pelvic floor exercises right.
• Nip those leaks in the bud by strengthening your pelvic floor with personalised exercise prescription by assessing the pelvic floor muscles and organs with a quick vaginal examination.
• The process is easy and interesting as you are involved in it by contracting your muscles. This provides you with instant feedback.

Prolapse

Prolapse means “falling out of place.” One, two or three of the pelvic organs can fall out of place usually because excess pressure has been placed on them during episodes of coughing, childbirth, lifting heavy weights, menopause hormone changes or constipation. 

Problems

• I feel a heaviness or dragging sensation between my legs. This happens after exercise, or lifting heavy objects or at the end of the day. 
• My Mum had prolapse. I am wondering if I could have this too. I have seen her struggle although she doesn’t say much. Can I see you to see if I have prolapse too?
• I’ve had 3 vaginal births, I’ve heard this is a risk factor for prolapse. Now that I am in Menopause I feel like I should get things checked. I’ve never seen a pelvic health professional before. 

Benefits

• When you have a vaginal examination I can palpate the vaginal walls to feel if your bladder or bowel is pressing against the vaginal walls. A simple test such as cough can detect if the pelvic organ moves more with increases in pressure. 

Problems

• I can’t exercise. I am so worried that I’ll put pressure on my prolapse and that will make it worse. 
• I am over the peeing during exercise. Wearing a pad and always black pants makes me feel yuk. I am worried someone will see the pad or I will smell. 
• I’ve given up on exercise as I am so embarrassed about peeing and prolapse symptoms. I do not know who to talk to about this. I worry that my health will be affected from not moving. 

Benefits

• It important to keep exercising and moving in a way that uses your core muscles to support you. Doing this will take pressure off your pelvic organs and prevent leaking of urine or prolapse symptoms becoming worse. You will be able to sue this knowledge and apply it to everyday activities at home, like lifting heavy objects.