Menopause info part 5:

A 10-part series exploring the causes, symptoms, and treatments for Menopause.  Keep an eye out for the next information post…

Exploring Symptoms: The ‘lady bits’, bladder and bowel!

Vulvovaginal atrophy (wasting/degeneration) /Urogenital atrophy:

Quite a common issue for tissue quality to change/reduce.

Women are sexually active for much longer than they were in the past so can be more noticeable.

Pain on penetration can sometimes be an issue, this can be improved with surgery (Fenton’s procedure)

Vaginal discharge – the natural ecosystem can be disturbed and lead to issues such as bacterial vaginosis.

Vaginal (anterior or posterior) Prolapse is/should not be painful.

Speak to your GP to exclude other pathologies.



Bladder function can be affected as it is formed from same embryological cells as vagina, so it is just as oestrogen dependent.

How does the bladder normally work?

Between muscle fibres are small spring like stretch receptors

On stretching, messages are sent to the brain from the bladder giving you an awareness of fluid, often when around 100-150mls urine (normal thoughts: ‘I’m going out, so I’ll go for a wee’)

Bladder fills at rate dependent on what we drink.

Increased filling = increased messages when you reach 300mls urine in the bladder

450mls in bladder = intense message to need to urinate



When we urinate: Voluntary message from brain to bladder muscles to contract and push fluid out, we relax muscles and let urine out and empty the bladder completely.

If frequent running to toilet occurs, the messages sending process can develop into ‘bad’ habits that result in urge incontinence where believe we have to urinate every time we receive a message telling us there is urine in the bladder (even if it is only a really small volume).  It is the message system at fault, rather than leaking valve around urethra.

Bladder irritability – a common issue

Treatment = oestrogen will remedy it (topical cream via GP)

Stress Incontinence can develop with reduced pelvic floor strength and result in leakage when there is an increase in pressure around the trunk – when we cough, sneeze, or laugh.

Bladder and pelvic floor retraining can be relearned with guidance during a women’s health physiotherapy appointment.


Bowel changes:

Irritable bowel or other associated changes in your normal bowel function (constipation) might be noted.  Dietary/nutrition advice can help with the addition of supplements to support the gut and function.  In addition, a holistic approach is often helpful to address any triggers outside of ‘just diet’ such as stress.

  • Female sex hormones influence gut microbiome.
  • Increased gut permeability and inflammation can occur.
  • Probiotics in diet can reduce bone loss and help reabsorption.
  • Hormone replacement (HRT) can improve bowel transit time and ease of passage.


For Nutrition assessment and further information on improving nutrition elements such as blood sugar levels, magnesium, fibre, vitamin B12 and iron deficiency, Book an appointment with Robyn Cardy BSc Hons, our Chartered Nutritionist for more information on this area.

For further advice, exercise, nutrition, or physiotherapy treatment please book an appointment with Anna Clayton (Physiotherapy), Robyn Cardy (Nutrition) and Ben Durham (Personal training/Exercise plan)

01284 748200 or email



Maynewater Lane, Bury St Edmunds, Suffolk, IP33 2AB | 01284 748200 |

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