This weekend (10th October 2026), I had the opportunity to lead a pelvic floor talk and workshop at the Nuffield Health Gym in Taunton, Somerset. I left that space with not only my heart full, but with many thoughts in my mind that I would like to talk to you about.
We had a great crowd, there were so many women wanting to learn about pelvic floor united by one question: what on earth is this that Maria is talking about? I saw so many faces looking at me without blinking, sometimes smiling, yet I could see a movie passing by her minds with so many things I was talking about that they could finally put a name to it, relate to it or feel that they are seen, heard and that society is not just dictating a “hormonal issue“.
The history behind it
I am a big fan of anthropology, and anthropology studies why we behave the way we behave as a society inserted in a culture (in very simple terms). I think we need to go back to 1760. This is when the Industrial Revolution started, here is England. Until then, women were stay at home mums/wives and they would care for their house and children while the husband would go out to work. They had a community of other women and mums around them, they had the village and I am not talking solely about postpartum, I am talking about every change a woman needs to go through their life. With the Industrial Revolution, a lot of good things came with it: we are able to go out of the house to work, we receive our own money, we can vote, we can purchase our own things and, later on, with the introduction of contraception to the working women could be free to enjoy their sexual life without feeling worried about getting pregnant. But with all of this came a little problem: who will now take care of the house and the children if both husband and wife are working? The village is working too.
One thing the women all mentioned during the talk is the mental and physical burden they have to keep going through and despite now they have a better sense of self and are able to choose what they want, they also need to perform housework duties when they return home. With this comes holding the urine for longer so they can finish one more task, they need to cook and sort out the laundry and the gym workout is left behind. There is also a thought of I have achieved the peak of my career but since I am now “menopausal“ I still have to perform the same as before because I have deadlines which I find harder due to all the changes my body and brain are going through the menopause transition while my workplace does not offer much flexibility. There was a common consensus: as if my worth has finished from the moment I am not able to have more children.
What can change now?
Let’s dive now into the more clinical terms.
As estrogen levels naturally decline during this transition, the tissues of the pelvic floor, vagina, and urinary tract are directly impacted. This is clinically referred to as Genitourinary Syndrome of Menopause (GSM), a chronic and progressive condition that encompasses a cluster of symptoms such as vaginal dryness, urinary urgency, incontinence, and dyspareunia (pain during intercourse) (Bortolin et al., 2024). Unfortunately, there is a pervasive social norm that leaking, heaviness, or pelvic pain is simply an inevitable, untreatable part of aging. This is not true.
When going through the menopause transition, our bodies naturally have a decrease in elastin and collagen. These molecules are very important to maintain the tissues moving fluidly. You will notice that you will have more rigity in movement around your shoulders and hips (sometimes a frozen shoulder may appear) and also your pelvic floor. The dryness can then affect your exercises as it can give you a feeling of chafing when you exercise, walk or even when being intimate.
Proactive pelvic floor physical therapy is a highly effective, conservative approach to managing and reversing these symptoms without relying solely on medications or invasive procedures. Recent academic research heavily supports this. A comprehensive 2025 systematic review and meta-analysis evaluated the effects of pelvic floor muscle training (PFMT) on postmenopausal women, revealing significant improvements in overall sexual function (Sánchez-García et al., 2025). The study demonstrated that targeted PFMT positively affected arousal, orgasm, and sexual satisfaction, proving that guided muscle rehabilitation is a powerful, evidence-based tool for restoring intimate vitality and physical comfort.
Beyond intimacy and comfort, the hormonal shifts of menopause can fundamentally weaken the structural support of the pelvic organs, making women increasingly susceptible to pelvic organ prolapse and urinary incontinence. Rather than viewing these functional changes as an inevitable decline, proactive pelvic floor physical therapy serves as a critical first line of defense. A 2024 Cochrane review update on interventions for urinary incontinence in women reaffirmed that structured, supervised pelvic floor muscle training remains one of the most clinically effective and accessible conservative treatments available, significantly reducing symptom severity and improving daily quality of life (Dumoulin et al., 2024).
At Flor, we specialise in this targeted, evidence-based rehabilitation, ensuring that your pelvic floor is equipped to support you through this transition. Book your appointment today
References
Bortolin, M., et al. (2024). Genitourinary syndrome of menopause (GSM): recommendations. Sexual Medicine Reviews, 14(1).
Dumoulin, C., et al. (2024). Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women. The Cochrane Database of Systematic Reviews, 12(12), CD009508.
Sánchez-García, A., et al. (2025). Effects of pelvic floor muscle training on sexual function of postmenopausal women. A systematic review and meta-analysis. Sexual Medicine, 13(4).