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Easy Squeezy

Pelvic health is one of the areas of Women’s health which is affected by the perimenopause and menopause and simply doing Kegels (pelvic floor exercises) everyday will not make these issues magically disappear.

Good health in the pelvic area requires a multifaceted approach.

Mental stress from women's demanding lives (juggling a career, caring for ageing parents, navigating relationships, and parenting for some) also creates body stress. The more mental stress we experience, the lower our sex hormones impacting on libido but also pelvic health. Exercise can be another cause for pelvic health issues such as doing too little exercise or too much of the wrong type of exercise. This can put strain on the pelvic floor. And don't underestimate the importance of diet. Not keeping hydrated, a diet low in fibre or eating processed foods, all can create constipation which is a major cause for incontinence. In addition, eating a low fat diet coupled with fluctuating hormone levels spikes levels of stress which may exacerbate symptoms. Previous pelvic health issues such as post childbirth injuries, 3rd degree tears, prolapse and faecal incontinence can also be exacerbated. No surprise then that 60% women will experience pelvic health issues post menopause.

Early warning signs

Symptoms may begin with fluctuating hormones in perimenopause (2 to 10 years before menopause), such as a relative reduction in progesterone, resulting in poor sleep, anxiety and aches and pains or oestrogen dominance resulting in hot flushes, breast tenderness, anxiety, and weight gain. This can be followed by oestrogen depletion as menopause ( ie 365 days after your last period) comes closer, causing vaginal dryness, atrophy ( thinning of the tissues), bladder irritation and incontinence, as well as a reduction in testosterone affecting libido and comfort during sex amongst other symptoms such as energy, bone density and muscle mass.

Good pelvic health requires attention, not only to your pelvic floor muscles but also to your sleep habits, mental health and stress management. It requires joyful connection with nature, friends and family. The good news is that through lifestyle choices, we can influence the health of our pelvis - healthy eating including protein, fibre, good fat, good carbohydrates, and supportive supplements plus exercise/build up to exercise as appropriate.

Seeking help

Many women put up with leaking urine when they sneeze or cough or deal with it by popping a pad in their knickers but issues now will likely worsen in our senior years. With specialist support, such as a women's health physiotherapist, available on NHS or privately, in many cases, we can improve our pelvic health - in both the now and for our later years.

An integrative Pelvic Health physio will evaluate all of the above plus check for symptoms of pelvic organ prolapse, urinary frequency and urgency incontinence, cystitis, bladder or pelvic pain, stress urinary incontinence, prolapse pain with intercourse (dyspareunia) , constipation and faecal incontinence. A pelvic physio will evaluate your pelvic floor and teach breath coordination and pelvic floor training, including down-training if you have an overactive pelvic floor. You will be taught pressure management strategies, correct lifting techniques, as well as sleep hygiene, stress management, healthy eating and movement to complement your exercise needs and hormone balance.

Invictus Pelvic Health

Hi I am Nicky Travlos, founder of Invictus Pelvic Health. I use my expertise to work with Women who are struggling to juggle family, work and health and who are suffering from bladder and bowel and hormone issues, such as constipation, incontinence, prolapse, pain with intercourse and body aches and pains. I enjoy working with women to restore confidence in themselves, their bodies and their pelvic floor and use an integrative and holistic approach to improve their self care, lifestyles , energy levels, exercise regimes and bladder and bowel health. To sign up to an online course by Nicky, visit

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