Pelvic Pain During Menopause: What is Happening and How to Manage it?

While cruising through life, managing the typical menopausal symptoms and suddenly, out of nowhere, you start experiencing something unexpected- pelvic pain! The region of the body is located between the abdomen and the thighs. At first, it is subtle, mild discomfort that you brush off but as time goes on, it becomes more persistent and intrusive. Sounds familiar? You are feeling like what is this and why? You are not alone. 

Pelvic pain during menopause is a silent struggle for many women, often overlooked in the broader conversation about menopause. It is a frustrating issue that exacerbates during menopause and is one of the most troubling symptoms that adversely impact women’s quality of life. It therefore deserves attention. Let’s unpack what might be happening and more importantly, how you can take steps to feel better.

First Thing First: What’s Causing the Pelvic Pain

When we talk about pelvic pain, we are referring to discomfort or a heavy sensation in the lower abdomen or pelvic area, consisting of the uterus, ovaries, fallopian tubes, vagina, bladder and rectum. It might be as sharp as stabbing or dull and persistent, that too during menopause, in either way, it is frustrating!  The root cause of pelvic pain during menopause is often linked to one major culprit and that is hormonal changes.

Estrogen- the super hormone in women’s lives that kept everything running smoothly for years, is now on a steep decline.

Without enough of it, the tissues and muscles in your pelvic region lose their elasticity and strength. This sets the stage for issues like vaginal dryness, urinary problems, and even conditions like pelvic organ prolapse.

With the wane of estrogen, other culprits like bladder or bowel problems, pelvic floor dysfunction endometriosis, etc. become prevalent.

Let’s Break it Down and Understand the Common Causes Behind Pelvic Pain

1. Pelvic Organ Prolapses: While experiencing menopausal symptoms, have you ever felt a heavy or dragging sensation down there? That could be pelvic organ prolapse. It happens when the muscles and ligaments that hold up your uterus, bladder, or rectum weaken, causing these organs to shift and triggering pain or discomfort. Prolapse is surprisingly common during menopause due to dipping estrogen.
2. Vaginal Atrophy and Dryness: During menopause, declining estrogen levels cause the vaginal tissues to become thinner, less elastic, and more fragile. This thinning of vaginal tissues increases sensitivity and susceptibility to pain in the pelvic areas.
3. Urinary Tract Infections (UTIs): Frequent UTIs and bladder inflammation can all show up during menopause. These conditions are often linked to changes in vaginal pH and tissue health, and they can lead to persistent pelvic pain.
4. Pelvic Floor Dysfunction: The pelvic floor is like the foundation of your house- it keeps everything supported and in place. But during menopause, this network of muscles gets weakened, leading to spasms and prolonged pain in the pelvic area.
5. Endometriosis or Adenomyosis: You might think these conditions disappear in menopause, but they can linger or even flare up if you are on hormone replacement therapy because it involves the growth of uterine tissue where it doesn’t belong, and they are notorious for causing pain.

How Does Pelvic Pain Affect Daily Life?

Here is the hard truth: pelvic pain is not just a physical issue. It seeps into every corner of your life, from how you move to how you feel about yourself. Chronic pain can make you feel anxious, frustrated, or even depressed.

It is exhausting to carry around discomfort day after day and that’s how pelvic pain impacts your daily routine. Maybe you have stopped exercising because it feels uncomfortable, or you avoid long walks because of that heavy sensation. Over time, these limitations can chip away at your confidence and quality of life. 

But you don’t have to despair because relief is possible. You do not have to resign yourself to living with this pain.

What are the Steps to Take to Find Relief?

The first step is to recognize that pelvic pain is valid and worth addressing because sometimes, psychological trauma hovers over too much, and that too when you are experiencing menopausal symptoms. Once you have acknowledged that, now it’s time to explore your options.

1. Reach out to your gynecologist or urogynecologist as he/she is the best ally here. They can help pinpoint the cause of your pain and recommend targeted treatments. Don’t hold back and describe your symptoms in detail.
2. Your healthcare providers may recommend you to be on estrogen vaginal therapy. If dryness and thinning of the tissues are part of your problem, localized estrogen therapy works wonders. Creams, rings, or tablets deliver estrogen directly to the vaginal tissues, improving elasticity and reducing pelvic pain.
3. You may also be recommended for physical therapy to strengthen your pelvic floor. It’s fantastic for menopausal women where a therapist teaches you exercises like Kegels to strengthen weak muscles or relax overly tight ones.
4. After consulting a doctor, they may suggest to you if it is the UTI or bladder problems that are discomforting you. Accordingly, doctors will strategize to prevent and treat the infections. Staying hydrated and practicing good hygiene can help too.
5. Doctors may suggest systemic HRT and that can be a game-changer. For some women, the HRT can alleviate many menopausal symptoms, including pelvic discomfort.
6. Without hushing or jumping into the medications or if you have mild pelvic pain, you can manage it naturally. There are plenty of natural options to explore. Warm baths, yoga, and gentle stretches can help ease muscle tension. You might also consider acupuncture or massage therapy for pain relief. For this option, you must be patient enough to see the positive and sure-shot results.

Managing Pelvic Pain with Lifestyle Changes

Sometimes, simple adjustments to your daily habits can make a significant difference.

1. Dietary Choices: Avoiding processed foods, caffeine, and sugar can help reduce inflammation and discomfort. Incorporate fiber-rich foods, lean proteins, and omega-3 fatty acids to support overall health.
2. Hydration: Staying hydrated can help manage urinary and digestive symptoms.
3. Regular Exercises: Low-impact activities such as yoga, swimming, or walking strengthen the pelvic floor, improve circulation, and reduce stiffness.

Breaking the Silence: It’s Okay to Ask for the Help

Here’s something that needs to be said loud and clear: pelvic pain is nothing to be ashamed of. Yet so many women hesitate to talk about it, worried they will be misunderstood.

If you are experiencing pelvic pain, don’t hesitate to reach out for help. You deserve to live without discomfort, and there is no reason to suffer in silence. So, let’s change that narrative.

Key Takeaways

Pelvic pain during menopause is not a sentence, it is a challenge, yes, but one that can be met with the right support and solutions. By understanding the root causes and exploring treatments, you can find relief and reclaim your comfort.

So, take the first step today. Talk to a specialist, try some new approaches, and remember: you are not alone in this journey. Many women have walked this path before and with the right guidance, you will come out stronger on the other side. 

Citations

• https://pelvicrehabilitation.com/conditions/menopause-pelvic-pain/
• https://www.gennev.com/learn/pelvic-pain-during-menopause#:~:text=What%20causes%20pelvic%20pain%20in,possibly%20even%20worse%20during%20menopause
• https://www.medstarhealth.org/blog/menopause-symptoms-and-pelvic-pain
• https://www.thepelvichub.com/pages/menopause?srsltid=AfmBOor92zf8tq7dbq9S8cqbUczA9kQoUdJpq_tzSPvPxBx7qmiMRzm0
• https://www.jacr.org/article/S1546-1440(23)00418-0/pdf