Menopause – the stage of crossing the threshold into “wise womanhood” and BECOMING 

Angie Stenback, Co-Founder and Executive Director of The WOMB, sat down with Gerda Hayden, Pelvic Health Physiotherapist and Menopause specialist, to talk about what the heck is going on in the peri-menopausal period


There’s a lot of cloudiness around the use of the words menopause and peri-menopause. Could you clarify?

Peri-menopause is the 2-10 years before menopause in which symptoms such as hot flashes, weight changes, mood swings, brain fog, vaginal concerns (dryness, painful sex) can be apparent and/or bothersome.

Menopause is a point in time – the “one year since your last period’ anniversary. After that a woman is considered “post-menopausal”.


What is the connection between the pelvic floor and menopause?

Hormonal changes can really show up in the pelvic tissues and may be the only signs and symptoms that women experience. But because it’s ‘normal’ (NOT!!) to leak as we get older, these matters are often not addressed or talked about.


Tell me more about these hormone changes.

Estrogen is a ‘fertilizer’ hormone. It makes things grow and keeps things moist and pliable and squishy. Its decrease can mean tissues are less elastic, thinner, more prone to injury and irritation. This can be evidenced by bladder urgency and frequency, frequent UTI’s, prolapse, vaginal dryness, vaginal dryness.

Simply put, progesterone is the main hormone responsible for regulating your cycle. When levels decline, the hormone which typically is the “lawn mower” of the uterine lining doesn’t tell the uterus to shed, so there is an increase in the thickness of the uterine lining. When it finally does shed, that’s often when you will get the “crime scene worthy” periods.


How do these factors influence sexual function and libido?

Pain, overwhelm, changes in mood and a sense of self can all really impede libido and pleasure. But understanding the root causes and some great topical options can improve things A LOT.


Are certain people more at risk of having increased symptoms? 

A high stress lifestyle, diet higher in processed foods and alcohol, inadequate intake of fruit and veggies. Essentially any behaviour that promotes an increase in systemic inflammation can increase the symptoms a woman experiences.


What can women going through peri-menopause do to prevent these issues?

They can start with paying attention to an anti-inflammatory diet, good sleep, gentle exercise, nourshing self-care practices,  get properly assessed by a pelvic health professional, and see a naturopathic doctor!


What do YOU do as a Pelvic Health Physiotherapist to help during this period?

I talk about things – ALL things – and ask questions. We aim to optimize lifestyle behaviours such as sleep and exercise while also addressing any pelvic floor concerns relating to muscular tension, inco-ordination and connective tissue concerns


When is it too late to seek help? 



Are there other practices, or practitioners that you work alongside to support women to the fullest during this period?

Yes! Naturopathic doctors, osteopaths, chiropractors, registered massage therapists and counsellors… we all have a role to play in a woman’s WHOLE health.


How can women in the peri-menopausal period find the positive in this?

It’s a season of reflection of lifestyle up until this point and an opportunity to decide how we amazing we want to feel and spend the next half of our lives!!


Menopause is a stage of coming into considerable power and status. It is Crossing the threshold into “wise womanhood” and BECOMING – a leader of communities, of families and wisdom.

Begin Your Journey Today