Perimenopause and the Pelvic Floor
What is perimenopause? It is something all women will go through at one point or another with their reproductive health. During this transitional period, you may notice changes in your body, and in your pelvic floor.
What is Perimenopause?
Perimenopause is a transitional period in a woman’s menstrual cycle, between premenopause (your “regular” cycle) and menopause. Your body produces less estrogen and progesterone, causing your periods to become irregular. In addition to irregular periods, you may also experience difficulty sleeping, hot flashes, decreased libido, and vaginal dryness.
This stage typically begins in a woman’s 40’s, but can happen as early as your 30’s or as late as your 50’s. This period can last up to 10 years for some women! You remain in the perimenopause stage until you have been without a period for 12 consecutive months, at which point you are considered to have hit menopause. After reaching this point, you are considered to be in postmenopause, where you stay for the rest of your life.
How Does Perimenopause Impact the Body?
The fluctuation of progesterone and estrogen levels during perimenopause can impact the body in many different ways. Some changes are more noticeable than others, with the most common impact being irregular periods. Your cycle will start to vary in length, and your flow may become lighter or heavier.
Some other noticeable changes involve sleep. You may have difficulty falling or staying asleep, as well as experiencing night sweats. You may also experience hot flashes, which can vary in intensity and duration.
Perimenopause doesn’t only affect you physically, but can also affect you mentally. You may have mood swings, feel more irritable, feel more anxious or depressed, or feel “brain fog” or effects of cognitive decline.
How Does Perimenopause Impact the Pelvic Floor?
Other physical impacts of perimenopause show up in the pelvic region, often directly impacting the pelvic floor. Your pelvic floor is a group of muscles located at the base of your pelvis, connecting your public bone, tail bone, and sit bones, and supporting the bladder, rectum, urethra, bowels, and uterus or prostate.
Perimenopause can cause vaginal and bladder issues. As your hormones change, you may lose elasticity in your tissue, have thinning of the vaginal walls, decreased lubrication, and decreased urethral function. This can show up as pelvic organ prolapse, pain with sex, and incontinence.
How Can Pelvic Floor Physical Therapy Help?
Pelvic floor physical therapy can help treat and manage a variety of conditions, not just ones caused by perimenopause. It can help strengthen the pelvic floor muscles to prevent prolapses, relax the muscles to ease pain with penetration, and can help strengthen or relax the muscles to help manage incontinence.
Pelvic floor physical therapy can also help with other symptoms like constipation, back pain, and hip pain. When you work with a physical therapist, they can give you a holistic approach to addressing your symptoms, and help you reach and maintain your goals.
Read more about V Strong Physical Therapy, and learn how pelvic floor physical therapy can benefit you. Book a consult call with our team to get started on your pelvic health journey today!
Works Cited
“Perimenopause.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 18 Dec. 2025, www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666
“The Effect of Perimenopause on Pelvic Floor Health.” MUTU System, 17 June 2025, mutusystem.com/en-us/pelvic-floor/the-effect-of-perimenopause-on-pelvic-floor-health/
“What Is Perimenopause?” Cleveland Clinic, 4 June 2025, my.clevelandclinic.org/health/diseases/21608-perimenopause