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Menopause, Menopause Awareness Month, October, Hormones, Pelvic Floor Health, Women's Pelvic Health, Women's Health, Physical Therapist Near Me, Physical Therapy, I'move, Imove, Michigan

October is Menopause Awareness Month

By Dr. Brooke Meinema PT, DPT, FAFS

Each women’s journey is unique, but at some point during their lives, nearly all women will experience menopause. With October being Menopause Awareness Month, there’s no better time to discuss what this actually means. What can we expect during menopause, why does this happen, and what can we do about it?

Menopause is the point in time when a woman has not had a period for 12 months. This usually occurs between the ages of 45 and 55 with an average age being 51. The time frame leading up to menopause is considered the perimenopausal phase. This time frame typically lasts around 4 years commonly beginning when a woman is in their mid-40s, but sometimes this can begin as early as their mid-30s. During this phase, hormone levels change and fluctuate leading to different symptoms. The chart below depicts a brief description of each hormone, how menopause affects this, and what symptoms you can expect due to the hormone change (this chart can be found on The North American Menopause Society’s website)*.

The rise and fall of women’s sex hormones
Estrogen Progesterone Testosterone

What does this hormone do?
  • Stimulates growth of breast tissue
  • Maintains vaginal blood flow and lubrication
  • Causes lining of the uterus to thicken during the menstrual cycle
  • Keeps vaginal lining elastic
  • Many other functions, including preserving bone
Prepares lining of the uterus for a fertilized egg and helps maintain early pregnancy Although known as the “male” hormone, testosterone is also important to women’s sexual health:

  • Plays a key role in women’s estrogen production
  • Contributes to libido
  • May help maintain bone and muscle mass

How do menopause
and age affect this hormone?
During perimenopause, levels fluctuate and become unpredictable. Eventually, production falls to a very low level. Production stops during menstrual cycles when there is no ovulation and after final menstrual period
  • Levels peak in a woman’s 20s and decline slowly thereafter. By menopause, level is at half of its peak.
  • Ovaries continue to make testosterone even after estrogen production stops
  • Testosterone production from adrenal glands also declines with aging
    but continues after menopause

What symptoms may result
at midlife?
  • High levels can result in bloating, breast tenderness, heavy bleeding
  • Low levels can result in hot flashes, night sweats, palpitations, headaches, insomnia, fatigue, bone loss, vaginal dryness
Lack of progesterone can cause periods to become irregular, heavier, and longer during perimenopause Effects of testosterone decline are uncertain

Adapted, with permission, from Shifren JL, Hanfling S. Sexuality in Midlife and Beyond: Special Health Report. Harvard Health Publications, Boston, MA. Copyright © 2010 Harvard University.


What many women hear about menopause, and the reason it often gets grumbled about, are some of the symptoms associated with it: hot flashes, mood swings, trouble sleeping, ugh! While these are the common symptoms we tend to hear about, there are other symptoms that are also very common that we need to talk about and address: decreased sex drive, vaginal dryness, discomfort during sex, urine leakage. While these symptoms are commonly experienced, they do not need to be considered normal. The good news is, most of the symptoms of menopause can be treated! If you are experiencing these symptoms, bring them up to your medical provider.

How can these symptoms be addressed with women’s health physical therapy and what should you expect when working with your therapist? First step: education on what your body is experiencing, what can be expected, and what should or should not be considered normal is where we should start. Next, helping you to understand how your bladder, bowel, and sexual system should be functioning and ways to address dysfunction. Also, discussing diet and exercise, as this can greatly impact your bowel and bladder health and function. And finally, addressing your muscular system to help you continue exercise or keep up with the activities you enjoy throughout the whole perimenopausal through postmenopausal stages of life. Just know this: it’s never too early or too late to start taking care of your body.

For a free 10-minute consultation, visit us at and fill out the form to contact a Women’s Health Physical Therapist and schedule your consultation.

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