Perinatal, Perimenopausal Self- Care, and Pelvic Health

Similar changes can happen in the pelvic floor muscles in the perinatal time frame as well as the perimenopause time.
Hormone changes can have a profound effect on the pelvic floor muscles and women need to know how to navigate these life stages.

Pregnancy and birth can alter the function of the pelvic floor muscles (PFM), while the demands for lifting, carrying and and other aspects of infant and toddler care create increase challenges.

Pain with se*ual activity (dyspareunia) is common, but shocking to those who are not prepared for this.(It is temporary for most).

PFM work with postural muscles for “trunk control” and these muscle groups are weaker in most postpartum women at 8 months.

Women need a program, and plan instead of being expected to “bounce back”.

The direct impacts of pregnancy and birth on muscle integrity, abdominal and pelvic organ positioning, and bladder and bowel functioning can create symptoms that impact quality of life. (I know-I had challenges, totally unexpected!)


Perimenopausal changes from declining estrogen, progesterone and testosterone can alter PFM function as well.

Specific changes can entail reduced PFM strength and elasticity, less lubrication, tendency to dryness and increased urinary tract infections (UTI), and dyspareunia.

In association with PFM weakness, pelvic organ prolapse (POP) can occur, or worsen, requiring medical screening and treatment.

Modern media portrays the negative side of this life phase, perimenopause and menopause, however it can be a vibrant and fruitful phase of life well.

Women need to have self care and lifestyle habits for health, if not already in place, to help pelvic health, and overall health.

Adding a few new positive health practices per month can create renewed energy, focus, quality sleep and sustainable fitness, and help with the aforementioned pelvic health challenges as well.

Perinatal and Perimenopausal pelvic floor muscle problems are easy to fix with kegel exercises.
Answer: False!


Research studies find that women often have an incorrect effort and may breath hold, bear down, and contract global muscles (ie gluteals, adductors, abdominals) vs. the PFM.

Verbal instructions such as “do kegels” do not work for accurate PFM contractions for many women.

We should not be “clenching” the PFM  all the time  (more on that in another post).

There are many methods to train the PFM that can help them work with other core muscles during activities.

If possible, have a session with a Pelvic Health Physical Therapist and learn the multitude of ways to optimally relax, contract, and co-contract with other muscles when needed.

Targeted strategies for bladder health, dyspareunia, POP care and  fitness training can help meet your lifestyle goals and optimize your function.

Check in for the bladder care, bowel care and and yoga/fitness offerings on this site, your

Schedule with me in San Diego, in person or via Telehealth as needed,

858 598 4915

Mason Home Fitness, Central Station Well

4241 Jutland Dr Suite 103

San Diego CA 92117



ps The Pelvic Rehabilitation Guide Across the Lifespan

is now available on Amazon; This textbook has health pearls for the

general public seeking pelvic health information and treatment strategies, as well

as content for health -care professionals. Need to know information. Health care aware, health literacy.