Pelvic Health & Menopause: Let’s Talk About Down There

The topic of pelvic health isn’t exactly a conversation starter over coffee. Most of us grew up pretending we didn’t even have a pelvic floor, let alone that it might need maintenance. But menopause has a way of reminding us that everything below the belt is still very much alive, just a little… different.

If you’ve ever sneezed, coughed, or laughed and felt it dribbling down your leg, well, welcome to the club

What’s Actually Going On

Estrogen doesn’t just look after your periods, it also keeps your vaginal tissues, bladder, and pelvic floor muscles strong and flexible. When estrogen levels drop, those tissues can become thinner, drier, and less elastic. In simpler terms, your pelvic floor (the muscles holding up your bladder, bowel, and bits) can get a little weaker. You might notice:

• Leaking a little when you cough, sneeze, or jump (the “oh shit, I've pissed my pants” moment).

• Vaginal dryness or discomfort during sex.

• More urgency when you need to pee (and less time to get there!)

• A heavy feeling down below, especially later in the day

Not glamorous, but totally common.

The Power of the Pelvic Floor

If you’ve ever rolled your eyes at the word Kegel, hear me out. Pelvic floor exercises actually work when done right. Think of them as strength training for your undercarriage.

Here’s the thing, most of us have been doing them wrong for years. It’s not about clenching your whole body like you’re bracing for impact it’s about short, controlled squeezes and full relaxations.

Tip: Try imagining you’re stopping the flow of wee and holding in wind at the same time (glamorous, I know). Hold for a few seconds, release, and repeat. A few rounds a day can make a huge difference over time. Try not to overdo it though. There is such thing as having a pelvic floor that is 'too tight'. Again, like most things Menopause related, it's all about balance

Let’s Talk Vaginal Dryness (Yes, We’re Going There)

Vaginal dryness is one of the most common (and least talked about) menopause symptoms. It’s physical and it can seriously affect comfort and intimacy.

The good news? You have options:

• Lubricants: For during sex — think silky, not sticky.

• Vaginal moisturisers: Used regularly to keep tissues hydrated.

• Local estrogen treatments: Creams, pessaries, or rings prescribed by your GP. Super effective, low dose, and totally safe for most women.

Don’t suffer in silence or just accept it. It’s part of being human and you deserve to feel good and comfortable in your body

When to Call in the Experts

If you’re leaking often, it's time to call in the plumbers. No but seriously, if you're feeling pressure or heaviness and things just generally don’t feel right, it might be time to see a pelvic health physio. They’re like personal trainers for your pelvic floor and can tailor exercises to your body.

No shame, no judgment just individualized results.

A Little Reminder

Your pelvic floor has carried you through coughing fits, maybe kids, workouts, and decades of life. It’s not failing you, it just needs a little TLC. Taking care of your pelvic health isn’t vanity, it’s self-respect. Because feeling strong, dry, and confident in your own body? That’s peak empowerment.