Gynecological physiotherapy for menopause in Valencia
Menopause doesn’t have to mean resigning yourself to leakage, dryness or a feeling of heaviness. Together we look at what is happening and what you can do to feel well.
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Gynecological physiotherapy for menopause
If you’ve been told that leakage or intimate discomfort is normal at your age, here we won’t take that for granted. It’s common, yes, but it can be treated. We listen to you, explain what is happening in your body and look together for what suits you.
With the end of the fertile years, menopause opens a new chapter, which is different and unique for each of us. The permanent end of menstruation has physiological consequences. Falling estrogen reduces muscle tone, especially in the abdominal and pelvic area, and makes problems such as stiffness, joint and muscle pain, loss of muscle mass, urinary or fecal incontinence, vaginal dryness or prolapse more likely at this stage.
Physiotherapy for women in menopause focuses on keeping pelvic health in good shape during these changes. If you have any of these problems, we offer the following gynecological physiotherapy services to improve your quality of life:
- Urinary incontinence
- Fecal incontinence
- Prolapse treatment
- Therapeutic manual therapy
- Treatment after gynecological and breast surgery
What changes in your pelvic floor
Every woman has different hormone levels, so the risk of a urogynecological dysfunction isn’t the same for everyone. In clinic, the most common ones in menopause are:
- Leaking urine when you cough, sneeze, laugh, jump or lift, due to weakness of the urethral sphincters and the muscles around the vagina.
- A feeling of a bulge or heaviness in the vagina, especially when getting up or lifting, when the bladder or uterus descends.
- Constipation, because with less abdominal and pelvic tone bowel transit becomes slower.
- Lower back and pelvic pain, contributed to by loss of bone mass and weakening of the deep abdominal and pelvic floor muscles.
Many of the patients who come to us with urine leakage at this stage had vaginal births with a tear or episiotomy and didn’t work on their pelvic floor afterwards. It’s never too late to start.
“Menopause opens a new chapter, which is different and unique for each of us”
How we work in menopause
Intravaginal electrical stimulation, biofeedback with vaginal probes, pelvic floor exercises and abdominal exercises that don’t load the perineum. Sessions are one-to-one, adapted to your needs, and at each appointment we check how your muscles are responding.
Pelvic floor biofeedback, anal or vaginal electrical stimulation and exercises to strengthen the pelvic muscles, with special attention to the levator ani muscle. We combine this with core work, positions for opening your bowels, manual techniques for constipation and dietary guidelines.
Postural re-education, pelvic floor exercises with biofeedback, vaginal electrical stimulation and hypopressive abdominal training. You learn positions that reduce the load on the pelvic floor at moments of greatest effort, such as opening your bowels or lifting. We also prepare you for and support you through surgery for third- and fourth-degree prolapse.
Therapeutic and whole-body treatments, as a complement to the other therapies.
Physiotherapy after a hysterectomy, mastectomy or other genital surgery, with work on painful or sunken scars and specific training when discomfort continues after mesh prolapse surgery. During cancer treatment we help you with vaginal dryness and quality of life, always in coordination with your medical team.
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Exercise in menopause, supervised at first
During menopause it’s a good idea to exercise the pelvic floor, the deep abdominal muscles and all the tissues that maintain lumbopelvic stability. We recommend doing the first sessions with a professional, who will teach you to locate and contract the muscles correctly, and then continuing at home with your exercise plan.
The plan we usually prescribe focuses on the pelvic floor, the transverse abdominis and the deep back muscles, and combines several types of work:
- Pelvic floor awareness with rib-cage breathing, with slow contractions and even longer relaxations.
- Shoulder bridge with a fitball, rolling up and down one vertebra at a time.
- Hypopressive exercise lying down, with breath-hold and rib expansion.
- Standing balance with the ball, keeping your spine lengthened.
- Core work on all fours, extending opposite arm and leg.
Ideally, do it at least twice a week. If you’d rather have company, small-group Pilates classes with a physiotherapist specializing in gynecology are another good option.
Your gynecologist, always part of the team
Physiotherapy supports, but doesn’t replace, gynecology appointments. Your gynecologist checks the condition of your pelvic organs and decides whether you need hormone treatment. Many patients come to a urogynecological physiotherapist referred from there. If you have any vaginal bleeding after a year without periods, even if it’s light or just once, see your doctor before anything else.
What do we work on in physiotherapy for menopause?
Gynecological physiotherapy in menopause focuses on the pelvic floor and the muscles around it. The goal is for you to move more confidently, have more control over your bladder and bowel, and for intimate discomfort to weigh less on your daily life.
Everything starts with a physiotherapy assessment in which we examine the pelvic floor, abdominal muscles and lower back. From what we find, we design an individual plan that combines clinic sessions and exercises for home.
We work within what your gynecologist or doctor advises. Physiotherapy doesn’t replace medical treatment for menopause or gynecological check-ups; it adds to them to improve your quality of life.
We work on pelvic floor tone and control when there is leakage of urine, wind or stools.
Therapeutic exercise and manual therapy for lower back and pelvic pain.
Postural and hypopressive abdominal work if you feel heaviness in the vagina.
Care for scars and intimate discomfort after surgery or during cancer treatment.
Your journey at the clinic starts like this
STEP 1.
Initial assessment
All patients start with an initial one-to-one session.
- We analyze your case in depth.
- We carry out the necessary examination.
- We explain what is happening and why.
- We design a personalized treatment plan.
- All with no further commitment.
STEP 2.
STEP 3.
Follow-up and progress
Your process doesn’t end after one session. It evolves with you.
- We regularly reassess your progress.
- We adjust the plan when necessary.
- You can combine one-to-one and group sessions depending on your progress.
Frequently asked questions
If you’re asking yourself these questions, you’re not the only one. Here we answer them clearly.
It’s common, but you don’t have to resign yourself to it. Falling estrogen reduces muscle tone, especially in the abdominal and pelvic area, which is why leakage can occur when you cough, sneeze, laugh, jump or lift. It can be treated with physiotherapy.
No. Whether you need hormone treatment is decided by your gynecologist. Physiotherapy works on the pelvic floor muscles, abdomen and posture, and can be done alongside any medical treatment.
All our pelvic floor services start with a physiotherapy assessment session. We examine the pelvic floor and abdominal muscles and the lower back, talk about your symptoms and history, and from there decide on your individual treatment.
Yes, and it’s part of the treatment. We recommend that the first sessions are supervised so you learn to contract the muscles correctly, and then you continue at home with your plan at least twice a week.
No, it’s never too late to start. Many of the patients who come to us with urine leakage at this stage had vaginal births with a tear or episiotomy and didn’t work on their pelvic floor afterwards.
It depends on each patient: your starting point, whether there is a deeper injury or condition, and how committed you are to the exercises at home. After the first session we decide on the right treatment. If you need individual follow-up, most people notice an improvement with a first pack of 5 sessions. From there, if you follow the guidelines at home, you may only need to come back for occasional check-ups. If there is a deeper injury, you may need to go beyond that first pack.