Understanding the Menopausal Transition
Menopause is a natural biological process marking the end of a woman’s reproductive years. It is officially defined as 12 consecutive months without a menstrual period, typically occurring between ages 45 and 55. However, many changes begin much earlier during perimenopause—a transitional phase that can start as early as the late 30s to early 40s and last several years.
During this time, fluctuating levels of estrogen and progesterone can affect a wide range of systems in the body, including:
- Sleep and mood regulation
- Bone density and joint health
- Vaginal and bladder tissue integrity
- Cognitive function and memory
- Metabolism and body composition
Symptoms vary significantly from person to person. Common experiences include irregular periods, hot flashes, night sweats, sleep disturbances, pelvic discomfort, anxiety, and changes in sexual health. Postmenopause—after the one-year mark—may still involve ongoing changes in these areas.
Gaps in Traditional Menopause Care
Many women find that the traditional healthcare system doesn’t fully address the complexity of this life stage. Primary care visits are often brief, and care tends to focus on prescribing medications for isolated symptoms. While hormone replacement therapy (HRT), selective serotonin reuptake inhibitors (SSRIs), and sleep medications can be appropriate and highly effective for some, these interventions may not address musculoskeletal, pelvic floor, or lifestyle-related contributors to symptoms.
Often women feel dismissed and their symptoms labeled as “normal aging”. A holistic, more integrative approach to care can be helpful in addition to traditional treatments.
Integrating Care, Managing Side Effects
Many women benefit from medical treatments during menopause, including hormone therapy, antidepressants, and other medications. These can be powerful tools for managing hot flashes, sleep disturbances, and mood changes. However, they may also bring side effects that affect everyday function.
We often support women who are already receiving medical treatment by addressing common secondary concerns like:
- Joint stiffness and muscular pain (a common side effect of HRT or hormone fluctuations)
- Pelvic floor symptoms that persist despite estrogen therapy
- Fatigue, brain fog, or tension related to medication side effects
- Decreased libido or discomfort with intimacy
By complementing your medical care with targeted therapy and education, we help you manage the physical changes of menopause in a safe, evidence-informed, and supportive environment.
How We Support Women in Menopause
Pelvic Floor Physical Therapy
Hormonal changes during perimenopause and menopause can weaken pelvic tissues, reduce lubrication, and alter bladder and bowel function. These changes can contribute to:
- Genitourinary Syndrome of Menopause that causes bladder changes, UTIs, and leakage.
- Pelvic organ prolapse
- Constipation
- Pain with intercourse
Pelvic floor therapy includes a thorough assessment and a combination of manual therapy, bladder and bowel re-training, and education to help improve function and reduce discomfort.
Massage Therapy
Therapeutic massage can help address muscle tightness, joint stiffness, and tension headaches—common concerns in menopause, especially as estrogen levels drop and inflammation increases. Regular massage can also support nervous system down-regulation, which may improve sleep and reduce overall stress load.
Trigger Point Dry Needling
Dry needling is used to release trigger points (tight bands within a muscle) and decrease neuromuscular pain. It may be especially helpful for:
- Persistent neck or back tension
- Tension headaches
- Hip or pelvic girdle pain
By reducing muscular tension and improving local blood flow, dry needling may enhance mobility and ease discomfort associated with hormonal shifts.
Movement and Nervous System Education
In our therapy sessions, we often discuss how gentle, regular movement—such as walking, stretching, or resistance training—can support energy levels, bone density, and joint health. We also provide guidance on breathing techniques, pacing, and sleep hygiene to help regulate the nervous system and reduce fatigue or overwhelm.
Frequently Asked Questions
When should I start thinking about menopause care?
Many women benefit from support during perimenopause, which can begin in the late 30s or early 40s. You don’t need to wait until your periods stop to seek help.
What are some lesser-known symptoms of menopause?
In addition to hot flashes and sleep changes, women may experience joint pain, bladder leaks, vaginal dryness, brain fog, heart palpitations, or increased anxiety.
Can pelvic floor therapy help with sexual discomfort or changes in libido?
Yes. Changes in tissue elasticity, blood flow, and muscle coordination can affect sexual function. Therapy can help improve comfort and support better outcomes during intimacy.
Can exercise really make a difference during menopause?
Absolutely. Movement helps regulate hormones, improve mood, support bone density, and reduce pain. Even small, consistent changes can have significant benefits.
What if I’ve already gone through menopause—is it too late?
No. Many postmenopausal women experience ongoing pelvic, bladder, or musculoskeletal symptoms. It’s never too late to benefit from supportive, individualized care.
Supporting Midlife Wellness with Informed, Individualized Care
Menopause is a significant life stage that affects every system of the body. With the right support, it can be a time of strength, clarity, and renewed connection to your health. Whether you’re just beginning to notice changes or have been postmenopausal for years, our team is here to provide thoughtful, personalized care grounded in both clinical expertise and respect for your lived experience.
We offer
- Free Pelvic Floor Screens
- 1:1 visits
- Therapeutic Massage
- Trigger Point Dry Needling