Navigating Menopause


The menopause transition is the time period that connects a woman’s reproductive or childbearing years with menopause. Menopause can be an emotion invoking time in a woman’s life, whether there is fear, relief, uncertainty, or any variety of emotions. The road to menopause is the decade-long time frame in which the average woman’s ovaries will gradually become less and less efficient until they eventually stop responding to the hormones that are produced to invoke ovulation. A woman is said to be in menopause if she has had no menstrual periods for one year. There is often a correlation between the age a woman begins menopause and when her mother began menopause, with the average age being 51.


Understanding the stages:

  • Premenopause: The years leading up to menopause when the cycles start to change. This term can also refer to anytime before a woman goes through menopause.

  • Perimenopause: The years immediately prior to menopause all the way through the first year following menopause.

  • Menopause: The permanent cessation of menstruation.


Menopause is a uniquely individual experience. Some women go right through it without noticing nearly any changes at all while others may have a harder time, often choosing medical assistance to cope with the challenges it presents.


Some classic signs that menopause may be near:

  • Menstrual cycle irregularities

  • Hot flashes (sudden sense of heat or flushing of face and chest with sweating and sometimes chills)

  • Vaginal dryness

  • Problems with sleep

  • Altered pain threshold

  • Weight gain, especially in the belly


Symptoms can be mild to unbearable and can disrupt daily activities. Many of the symptoms that a woman feels are due to changing hormonal levels. Hormones work together to maintain homeostasis or balance. Many women will seek out some type of hormonal therapy to help treat their symptoms, but hormone therapy cannot treat all symptoms including depression, wrinkled skin, and weight gain as your metabolism slows down.


What are some things that you can do to help with how you approach this new phase of life?

  • Regular exercise! Help your body out by providing it with regular strengthening and cardio exercises. As estrogen levels decrease, bone density also decreases. Osteoporosis is commonly known to affect post-menopausal women. Regular exercise will help to maintain a healthy weight, maintain urinary continence, reduce the rate of bone loss, improve strength and balance and decrease risk of falls or injury. In addition, as estrogen levels decrease, endorphins also decrease, lessening your body's natural pain protection. Integrative Dry Needling helps the body maintain homeostasis and stimulates the release of beta-endorphins, acting as natural morphine to increase your pain threshold. Click here to read our dry needling blog.

  • Stay sexually active! Let’s be clear: menopause does not signal the end of a woman’s sex life! While it can cause vaginal dryness and atrophy (muscle wasting), it can be liberating to no longer have fear of menstruation or pregnancy. Staying sexually active will also help maintain pelvic floor strength and necessary lubrication for pleasurable sex, though additional time or use of water based lubricants may be necessary to increase pleasure and tissue pliability. Menopause can be the time women first notice pelvic floor dysfunction with the perfect storm of declining libido (sex drive) and atrophy, both caused by declining hormones. With estrogen loss, abdominal bloating can increase as the balance of the microbiome is affected (bad gut bacteria outweigh the good bacteria). If sexual activity is not possible, regular Kegel exercises can help with atrophy. Click here to read our sex and intimacy blog.

  • Know your limitations and seek help when they are reached! Maintaining core and gluteal strength along with hip range of motion is important. If you have myofascial pelvic pain, pain with intercourse, limitations in mobility, bladder leakage or additional concerns, seek the help of a pelvic health physical therapist. We can also recommend other professionals who can provide dietary and hormonal support.


The ease at which you glide through menopause can be determined at large by the expectations that you set for yourself and the steps you take to help prepare yourself and your body for the changes to come. You deserve to navigate this stage of life with support. Receiving treatment by one of our specialists at Healthy Core Wellness & Rehab can help minimize the symptoms of menopause so you are able to achieve your goals and keep active. Call (330)528-0034 to talk to one of our physical therapists about your concerns or to schedule an evaluation.


written by Joanna Pavlak, DPT - July 2022






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