The physical changes that come with menopause can lead to some pelvic floor disorders and symptoms. For example, you may experience pelvic pain, urinary incontinence, or pain during sexual intercourse.

Your pelvic floor contains multiple muscles that influence several processes in your body. Changing hormone levels associated with menopause and the general aging process can affect your pelvic floor.

When these muscles don’t work properly, they can affect the structures and functions of your pelvic organs and may lead to a variety of symptoms.

If you’re experiencing symptoms that could be related to your pelvic floor, talk with your doctor about steps you can take to find the underlying cause and manage your symptoms.

Pain associated with pelvic floor conditions can occur in several places. Decreasing estrogen levels can negatively affect the function and structure of your pelvic organs, including your bladder, urethra, and genitals.

Symptoms can include:

  • vaginal pain or a burning sensation
  • pain while urinating
  • pain during sexual intercourse

If you’re experiencing severe or persistent pelvic pain, consult a doctor.

In addition to pain while urinating, you might notice other symptoms related to the urinary system during menopause. These include:

  • urinary incontinence
  • frequent urges to urinate
  • urinary tract infections (UTIs)

According to a 2019 research review, menopause-related changes in estrogen levels can lead to a decrease in the amount of urine your bladder can store. As a result, you may need to urinate more often.

Urinary incontinence (unintentional urination) can also occur as your bladder and urethra become less structurally stable.

Lastly, estrogen helps maintain the health of your urinary tract. When your estrogen levels drop, your vaginal and urinary tract tissues can become thinner and more susceptible to bacterial infections. Your UTI risk may also increase as the bladder muscles weaken, leading to incomplete bladder emptying during urination.

»More on this:Menopause and UTIs

A 2024 study involving 197 menopausal women suggests that symptoms related to pelvic floor conditions may influence sexual dysfunction.

The term “sexual dysfunction” can refer to a variety of symptoms, including:

The study notes that symptoms such as urinary incontinence and pelvic pain may influence sexual function the most.

Additionally, a 2021 study suggests that perimenopausal women experiencing pelvic floor dysfunction — particularly those with obesity and those who are not using hormone therapy — may have reduced sexual function.

Weakening of the pelvic floor muscles and tissues can mean that your vagina and uterus don’t have as much support as usual. A lack of support can cause the pelvic organs to fall from their typical positions into your vagina.

This is called pelvic organ prolapse. It can cause symptoms such as:

  • a feeling of vaginal bulging
  • vaginal pressure or heaviness
  • difficulty urinating or emptying your bowels

Pelvic organ prolapse may be more severe and more likely to cause symptoms if it occurs during menopause than if it occurs in other stages of life.

Your doctor may be able to diagnose pelvic floor disorders in a few ways. In some cases, an evaluation of your symptoms and medical history may be enough, but in other situations, additional tests may be necessary.

For example, your doctor may take samples of your urine or vaginal discharge to rule out infections. Some instruments and imaging tests can also help your doctor evaluate the function and structure of your pelvic floor muscles.

Tip

Keeping a detailed record of your symptoms can help your doctor determine the best ways to diagnose and manage pelvic floor disorders.

Learn more about how to track menopause symptoms.

The right treatment plan can depend on what’s causing your symptoms.

For example, if you have a UTI, you’ll likely need antibiotics. If you notice pain during sexual intercourse, you may benefit from vaginal moisturizers or lubricants.

Local estrogen treatment may relieve symptoms such as vaginal burning and urinary incontinence in some people, but more research is necessary.

Some people may also benefit from working with a professional who specializes in pelvic floor therapy to improve muscle and nerve function. This type of therapy can involve:

  • stretches or exercises
  • biofeedback therapy
  • electrical stimulation

In some cases, more intensive treatments may be necessary. Your doctor will tailor your treatment plan to your specific situation.

Tip

You may be able to strengthen your pelvic floor muscles at home. Ask your doctor about incorporating core exercises and pelvic floor exercises, such as Kegel exercises, into your routine.

Check out these pelvic floor exercises.

Menopause can cause pelvic floor disorders that may lead to a variety of symptoms. Some people may notice pelvic pain, increased urinary frequency or incontinence, or sexual symptoms such as pain during intercourse.

Talk with your doctor about any symptoms you’re experiencing. They can help you find the cause and the right treatment plan.