Midlife / Menopause

  • Vaginal discomfort including itching, burning and pain
  • Sexual health, dyspareunia (painful intercourse) and altered intimacy
  • Bone health
  • Menopause weight gain
  • Fitness goals and modifications for midlife
  • Genitourinary syndrome of menopause
  • Vulvovaginal atrophy, atrophic vaginitis
  • Bladder control issues, urinary urgency, frequency, incontinence, nocturia
  • Pelvic Organ Prolapse (POP)
  • Fecal incontinence and smearing, flatulence incontinence
  • Post-hysterectomy care and concerns

Pelvic Health, bladder control, pelvic organ prolapse, painful intercourse (dyspareunia), pelvic floor dysfunction, vulvodynia, lichens sclerosis and other pelvic concerns: We are here to help you through all phases of your life, including midlife and menopause. Perimenopause and the menopausal years bring transitions to a woman’s body, including her pelvic health, bone health and weight. Leading up to menopause and during menopause your hormonal changes will cause you to experience more vaginal dryness and thinning of some tissues. We have helped many women in midlife and menopause who are experiencing painful intercourse, vulvar itching, vaginal discomfort, pelvic organ prolapse and pelvic floor dysfunction. Often there is a combination of pelvic floor dysfunction, myofascial restrictions, strength and flexibility changes and behavioral habits that are exacerbating the health of your vulva, vestibule, vagina, pelvic floor and bladder control. We will work with you, gently, to optimize these areas and to address all other musculoskeletal contributions and reduce your symptoms. Your physician providers are important to your care, as well, and we are happy to partner with them to optimize your outcomes.

Genitourinary Syndrome of Menopause (GSM), vulvovaginal atrophy, Atrophic Vaginitis: Genitourinary syndrome of menopause (GSM) is a newer diagnostic term that has been adopted to reflect that a woman in menopause may experience changes in her genital region, urinary system and sexual comfort. GSM is meant to replace the older, more commonly used terms, vulvovaginal atrophy and atrophic vaginitis, now known to be limited terminology that does not reflect the full spectrum of issues that a woman can experience during menopause. These GSM symptoms can include urinary urgency, painful urination (dysuria), recurrent urinary tract infections, vulvovaginal dryness, burning and irritation and sexual pain/discomfort, reduced function and lack of lubrication. At Purple Mountain Physical therapy, we provide you meaningful, comprehensive treatment to address the underlying myofascial issues, such as pelvic floor dysfunction, connective tissue restrictions, trigger points, joint stiffness and weakness, that may contribute to you experiencing these constellations of symptoms. We have treated many menopausal women with these symptoms and have helped them recover and feel more like themselves. We will help you rehabilitate your pelvic region so that you, too, can feel better in all of these commonly effected areas.

Bone health, osteopenia, osteoporosis: With regard to bone health, at Purple Mountain Physical Therapy we believe in being proactive to maintain your bone health. Bone health is a lifelong pursuit and as a woman enters her perimenopause and menopausal years she should be thinking about bone health to avoid osteopenia and osteoporosis. This is much more complex than taking a calcium supplement! Lifestyle choices to optimize bone health in a safe and effective strategy can be implemented. Do you have osteopenia? If so, what are you doing about it beyond perhaps taking a medication and getting a bone density scan? Do you know if your lifestyle routine is optimal to support your bones?

Your bone is dynamic and undergoes continuous self-regeneration, called remodeling. Remodeling removes our old bone (through resorption) and replaces it with fresh, new bone. Low levels of estrogen in menopause substantially increases bone resorption over formation of new bone, leading to accelerated bone loss. In addition to estrogen related bone loss, there are also age-related bone loss mechanisms whereby both men and women transition away from building new bone and towards more net bone loss. However, lifestyle choices and habits also influence bone health and we can help guide your choices.

Osteoporotic fractures can occur as a result of bone density deficiency, balance problems and strength deficits. Physical Therapy to improve your balance, posture, strength and fitness levels can help your bone health. Sedentary lifestyles, poor nutritional status, smoking, aging and low estrogen levels all contribute to deterioration of bone health.

Proactive lifestyle choices can help you optimize your bone health. At Purple Mountain Physical Therapy we can provide you with a consultation regarding lifestyle choices and fitness measures that would be recommended to optimize your bone health and to combat the deterioration in posture and stature that occurs with advanced osteoporosis. We’ve worked with many women who have osteopenia and osteoporosis to advise them on safe exercise choices and lifestyle modifications. In fact, we’ve often had our patients who have osteopenia report to us that they perform some exercises at their gym that we think could be placing them at risk for bone fracture. We can help guide you to make safer choices. These same women are often not completing very important exercises that are known to support posture, bone health and to combat the musculoskeletal changes that occur with bone loss. If you wonder what you should be doing, what would be safe and what is most effective, we offer you expert advice on how to protect your bones going forward.

Midlife and Menopause fitness and weight control: We cannot tell you how often we have heard from women in the perimenopause and menopausal years “I didn’t change a thing and now I’ve gained five pounds!”. Perhaps, that’s the problem, you didn’t change a thing, but your body was undergoing a complete transformation of hormonal shifts towards menopause. As your body transitions into perimenopause and through menopause you may find it easier to gain weight. Your fitness routines that worked splendidly for you throughout your 30s may no longer give you the benefits you need. Or, perhaps, you are developing tendinitis and joint problems so you can’t do that fitness routine anymore. Or, you find your energy levels aren’t what they once were and your propensity to work out like an Olympian has diminished. Whatever you notice is going on with your body and your fitness routine during perimenopause and menopause, we are here to support you! We understand the frustration and stress of your body changing and not feeling like you look or feel your best. We offer you a consultation to review your fitness and weight goals and to advise you on how to best proceed. Your body is changing and your fitness routine, lifestyle choices, nutritional status should also change to meet your body’s new needs. We are doctors of physical therapy with advanced training in treating women in their perimenopausal and menopausal years. We can help you devise a healthy fitness program and lifestyle modifications going forward that you can implement on your own.