Understanding perimenopause and menopause
Menopause is the time when your menstrual periods stop permanently, and you can no longer get pregnant. “Meno” comes from the Greek word relating to menstruation, while “pause” means a comparatively brief stop or delay. Menopause is a normal part of a woman's life, sometimes called “the change of life”, and the transition usually begins during perimenopause, which normally occurs in a woman's mid- to late-40s.
Perimenopause is the cycle where a natural decline in reproductive hormones happens, and each person's experience of it is different. Because of these hormonal fluctuations, people may notice periods becoming less frequent, as they're ovulating less often; longer and heavier, as the uterine lining has more time to grow thicker; lighter, when estrogen levels are low; or irregular, along with changes in menstrual cramps and other symptoms. On average, women are in perimenopause for about four years before their periods stop, and menopause itself is signaled by 12 months since the last menstruation.
Most women experience menopausal symptoms such as hot flashes, night sweats, vaginal dryness and discomfort during sex, difficulty sleeping, low mood or anxiety, reduced sex drive, and problems with memory and concentration. Some of these can be quite severe and have a significant impact on everyday activities.
The benefits of staying active
If you're starting to experience symptoms of menopause, the most important, simple thing you can do is exercise. Done regularly, exercise increases cardiorespiratory function and reduces the metabolic risks associated with declining estrogen, increasing HDL while reducing LDL, triglycerides, and fibrinogen, with the added benefit of a reduced risk of high blood pressure, heart attacks, and strokes.
Exercise can also help create a calorie deficit and minimize midlife weight gain. It increases bone mass, too, strength training and impact activities like walking or running help offset the decline in bone mineral density and prevent osteoporosis. It also reduces low back pain, helps reduce stress and improve mood, and may help reduce hot flashes, minimizing what's sometimes called the “domino effect.”
What physical therapy can address
We can customize treatment to address the areas most important to your current and future health. For bone density, strength, and balance, using free weights, weight machines, or exercise bands helps strengthen muscles and maintain bone density, balance, and flexibility to reduce the risk of falls and of serious fracture if you do fall, and building muscle also increases your metabolism, the rate at which you burn calories, even at rest.
For hot flashes and weight gain, which have some association with reduced hormone levels, research indicates that regular aerobic exercise can help keep them in check. If you don't have a favorite sport like biking or tennis that promotes aerobic conditioning, we can help you design a low-impact walking or swimming plan to become more physically fit and less susceptible to these symptoms. For insomnia, therapeutic massage is effective for menopause-related sleep trouble, and can also help alleviate other difficulties sometimes associated with menopause, such as anxiety and depression.
Painful intercourse and urinary incontinence
Dyspareunia, experiencing pain before, during, or after sexual intercourse, affects millions of women. When the root cause rests with pelvic tissues and muscles that need to be relaxed or strengthened, several months of pelvic floor physical therapy can make a significant difference. We can teach you specific exercises you can perform yourself, along with how biofeedback can help you track your progress, and special soft tissue techniques may also help alleviate dyspareunia.
Pelvic floor physical therapy can help with urinary incontinence, too. We can teach you the proper way to do classic Kegel exercises, the repeated contraction and release of the pelvic muscles, including those that surround the bladder and affect urinary flow.
Do not be embarrassed about consulting us at Tribeca Physical Therapy. We are trained to help patients at all stages and phases of life, including menopause. Early intervention is key to keeping everything under control and helping you feel comfortable during this period of your life. Tribeca Physical Therapy is officially reopened for in-person physical therapy sessions and continues to offer Telehealth PT, or Virtual PT. Call us at (212) 406-8080 or message us to schedule your first session.