Perimenopause marks the transition toward menopause, a phase that can last several years and bring shifts that affect much more than mood or menstrual cycles. One area often overlooked is pelvic support.

As estrogen levels fluctuate, the pelvic floor and surrounding tissues change. Many women begin to notice new symptoms: heaviness, leaking, discomfort during intimacy, or a feeling that their core is “less stable.”
Understanding these changes is the first step to adapting with confidence.ence in your body.
If you need more information, don’t hesitate to contact us.

Why Pelvic Support Changes During Perimenopause

1. Hormonal Fluctuations

Estrogen plays a key role in maintaining tissue elasticity and hydration. When levels drop:

Pelvic tissues become thinner and less supple
Connective tissues may lose strength
Muscles can fatigue more easily

This creates a perfect storm for feelings of weakness or instability.

2. Changes in Muscle Coordination

Perimenopause is often accompanied by:

Increased tension in some muscles (especially the pelvic floor)
Reduced activation in others (deep abdominals, glutes)

This imbalance can contribute to:

Pelvic heaviness
Urinary leaking during exercise
Lower back or hip discomfort

3. Impact of Life Load

Perimenopause often coincides with high-stress life phases: caring for children, ageing parents, career transitions. Chronic stress increases sympathetic activity and can lead to:

Overactive pelvic floor muscles
Shallow breathing
Core rigidity rather than true stability

Common Pelvic Symptoms in Perimenopause

Pelvic heaviness or pressure
Urinary urgency or leaking (especially with coughing or jumping)
Vaginal dryness or discomfort during intimacy
Constipation or changes in bowel habits
Lower-back or pelvic girdle pain

👉 Many women think these symptoms are “just ageing,” but they are treatable.

How Physiotherapy Can Support You

1. Pelvic Floor Assessment & Rebalancing

A physiotherapist evaluates whether the pelvic floor is:

Overactive and tense
Underactive and weak
Poorly coordinated

Treatment may include relaxation, strengthening, or a combination of both.

2. Hormone-Sensitive Exercise Strategies

Not all exercises feel the same during perimenopause. Physio can guide:

Low-impact strength training to improve tissue support
Core and glute activation for better stability
Mobility and stretching to reduce tension

Regular movement also supports metabolic health, sleep, and mood regulation.

3. Breathing Techniques for Core & Pelvic Support

Diaphragmatic breathing helps:

Reduce pelvic floor overactivity
Improve abdominal-pelvic coordination
Lower nervous system stress

It’s one of the simplest yet most transformative tools.

4. Education on Pressure Management

Learning how to manage pressure during daily activities like lifting, coughing, or exercising can prevent or reduce symptoms of prolapse and leaking.

5. Sexual Health & Comfort Support

Guidance on:

Lubrication and moisturising options
Relaxation strategies
Comfortable positioning
can make a significant difference in intimacy during perimenopause.

Beyond Physiotherapy

A holistic approach often brings the best results:

Medical care: hormonal options, vaginal estrogen, or other treatments
Nutrition: supporting metabolic changes and reducing inflammation
Psychological support: addressing stress, mood fluctuations, identity shifts

Perimenopause affects both body and mind and you don’t have to navigate it alone.

Taking Control of Pelvic Health in Perimenopause

Pelvic support naturally shifts during perimenopause, but these changes are not inevitable or irreversible. With the right guidance, women can feel stronger, more comfortable, and more connected to their bodies.

✨ Experiencing pelvic heaviness, leaking, or discomfort during perimenopause? Book a consultation at Renard Clinic with our women’s health physiotherapists for personalised, evidence-based support