Peri Menopause and Menopause and your Pelvic Health:
Specialist Physiotherapy in Bath , Corsham and West Kington
Helping active women navigate perimenopause without giving up the exercise they love.
Menopause & Pelvic Health
Peri-menopause and menopause can bring changes that many women simply aren’t prepared for, and hormonal shifts can start earlier then expected, sometimes from the mid 30’s onwards.
You might notice:
You suddenly need the toilet more urgently
You leak when you run, cough or jump
Exercise feels harder on your body than it used to
You feel heaviness or pressure vaginally
Sex feels uncomfortable or painful
You’re waking at night needing the loo
Your core feels weaker
You feel dry, irritated or uncomfortable
You’ve stopped trusting your body during movement
You feel frustrated that nobody talks about this
These symptoms are common, but they are not something you just have to “put up with”.
Specialist pelvic health physiotherapy during menopause can help you better understand what’s happening in your body and support you in returning to movement, exercise and daily life with confidence.
“It’s far more then hot flushes and poor sleep”
Menopause and Exercise:
Menopause is not just a pelvic issue. It is a whole-body transition.
The 40’s and 50’s are an important time for our body - we need to bank bone density, gain fitness, muscle mass, alongside navigating work, home and maintaining relationships. Specialist pelvic health physiotherapy can help you understand what’s happening in your body and support you in feeling stronger, more comfortable and more confident again, and I love nothing better then getting women active during their menopause.
Many women notice that:
running suddenly causes leaking
jumping feels uncomfortable
lifting feels heavier through the pelvis
recovery feels different
their body no longer feels as resilient
This can feel frustrating — especially for women who have always been active.
With the right pelvic floor rehabilitation, breathing strategies, strength work and movement support, many women continue:
Running
strength training
Pilates
CrossFit
hiking
Lead an active life
The good news is that menopause does not mean you need to stop exercising.
Why Symptoms happen?
As oestrogen and progesterone levels begin to fluctuate — sometimes from as early as our mid-30s — many women notice changes in their body that they weren’t expecting.
Hormonal changes can affect the pelvic floor, bladder, vaginal tissues, connective tissue and muscle recovery. Some women notice symptoms such as bladder leaks, urgency, heaviness or changes during exercise.
These changes can feel confusing, particularly if you’ve always felt strong and confident in your body.
Pelvic floor function is influenced by much more than the pelvic floor alone. Breathing, posture, abdominal strength, stress levels, movement patterns and exercise load can all play a role.
This is why treatment is never simply about “doing Kegels”.
How Pelvic Health Physiotherapy Can Help
Pelvic health physiotherapy during perimenopause and menopause focuses on supporting your body through transition.
A thorough assessment helps us understand:
how your body is functioning as a whole
what may be contributing to your symptoms
what your pelvic floor specifically needs
how to help you move and exercise with confidence again
Treatment may include:
Gentle pelvic floor assessment and retraining
Bladder retraining strategies
Deep core strengthening
Postural and breathing work
Movement progression that respects energy levels
Advice around tissue health and load tolerance
Collaboration with your GP or menopause specialist if needed
This isn’t about doing endless pelvic floor exercises. It’s about understanding what your body needs now.
Thank you so much for your help and advice, it was greatly appreciated. I feel reassured by your keen understanding and clear and direct approach. Thank you also for the written comprehensive assessment. It was very good to have that to show Dominick instead of me trying to explain! And it was excellent to be told to make time to relax! I’m doing the exercises regularly and have started taking HRT - hoping that will be beneficial.
Many thanks again.
Take care,
Anni - Pelvic health Menopause appointment
What to expect
Your initial appointment (60 minutes) provides time and space to talk through your symptoms and concerns.
We will assess:
Pelvic floor function
Abdominal and core strength
Movement patterns
Areas of tension or compensation
You will leave with:
Clarity about what’s happening
Practical, achievable strategies
A personalised plan
Reassurance and guidance on how to manage your pelvic floor during menopause
Internal assessment is always optional and performed gently, with your comfort as the priority.
Frequently Asked Questions
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Yes!! Pelvic health physiotherapy can help manage bladder symptoms, prolapse, pelvic pain, vaginal discomfort and return to exercise during peri-menopause and menopause.
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It is common, but it is not something you simply have to accept. Pelvic floor rehabilitation can often significantly improve symptoms
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Absolutely. I love getting womene active in midlife! Many women benefit from tailored rehabilitation and strength work to support their pelvic floor and confidence during exercise.
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Yes — pelvic health physiotherapy can help address pelvic floor tension, tissue sensitivity, breathing patterns and muscle function contributing to discomfort.
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No. An internal examination is never compulsory.
Your appointment is always centred around your symptoms, your goals and what you feel comfortable with.
I'll explain exactly what an internal examination involves, why it may be helpful, and answer any questions you have before asking for your consent.
For many women, an internal assessment provides valuable information about how the pelvic floor muscles are working, helping us tailor your treatment more effectively.
However, if you don't feel ready, there are many ways to assess and begin treating your symptoms without one.
The decision is always yours, and we'll work together to find the approach that feels right for you. If vaginal assessments have been painful in the past - there are lots of ways I can make them comfortable for you.
Why work with me?
✔ Specialist Pelvic Health Physiotherapist
✔ 18+ years' experience
✔ Pilates instructor
✔ Women's strength and rehabilitation specialist
✔ Return-to-running expertise
✔ One-hour appointments
✔ Clinics in Bath, Corsham & West Kington
✔ Friendly, practical, evidence-based care
Start to feel more like yourself again?
Walking without constantly searching for the nearest toilet.
Running without worrying about leaking.
Lifting weights with confidence.
Enjoying intimacy again.
Trusting your body.
That is exactly what specialist pelvic health physiotherapy is designed to help with.
“Dear Claire,
It was such a treat to meet you. You were so lovely and encouraging and I feel really positive that we have a way forwards, which I really appreciate.”