Menopause Vaginal Changes & Pelvic Health in Norwich
Falling oestrogen levels during perimenopause and after menopause can affect the vulva, vagina, bladder, urethra, and pelvic floor. These changes are often described as genitourinary symptoms of menopause or genitourinary syndrome of menopause (GSM).
Symptoms are common, but that does not mean you should simply tolerate them. Medical treatment and pelvic health physiotherapy can work together to improve comfort, bladder control, sexual function, and confidence with activity.
Which Cliniko appointment should I book?
If this is your first appointment for this concern, choose Initial Pelvic Health – 60 mins (for women and men) or Initial Pelvic Health – 45 min Express Check (for women and men). If Ellie has already assessed you for this concern, choose Follow-up Pelvic Health – 45 mins or Follow-up Pelvic Health – 60 mins.
Common symptoms
- Vaginal or vulval dryness, burning, itching, or irritation.
- Discomfort with touch, penetration, or medical examinations.
- Reduced tissue elasticity or a feeling of tightness.
- Urinary urgency, frequency, discomfort when passing urine, or recurrent urinary infections.
- Bladder leakage or changes in pelvic floor control.
- Pelvic floor tension that develops in response to dryness or pain.
- Reduced confidence with intimacy or exercise.
Symptoms can first appear during perimenopause or years after periods stop, and may gradually become more noticeable without appropriate treatment.
Medical treatment matters
A GP or menopause clinician can assess whether local vaginal oestrogen, non-hormonal moisturisers, lubricants, or another treatment is appropriate. NICE recommends offering vaginal oestrogen for genitourinary symptoms associated with menopause, with individual discussion and review.
Physiotherapy does not replace medical treatment for low-oestrogen tissue change. It addresses the pelvic floor, bladder, movement, and pain-related factors that may continue alongside it.
How pelvic health physiotherapy may help
- Assessing whether the pelvic floor is weak, overactive, poorly coordinated, or painful.
- Relaxation and breathing strategies for pain or protective tightening.
- An individual strengthening programme when weakness or leakage is present.
- Bladder retraining for urgency and frequency where appropriate.
- Advice on pressure management, exercise, and return to impact activity.
- Gentle, consent-led external or internal soft-tissue release, myofascial or trigger-point techniques, and graded exposure when comfortable; hip or pelvic mobilisation, acupuncture, or dry needling may be considered where appropriate.
- Guidance for returning to intimacy without pushing through pain.
- Liaison with your GP or specialist when symptoms need medical review.
Symptoms that need medical assessment
Bleeding after menopause, unexplained vulval skin changes, sores, unusual discharge, persistent pain, or suspected urinary infection should be assessed medically. Seek urgent help for fever, flank pain, vomiting, or feeling acutely unwell with urinary symptoms.
FAQ
Is vaginal dryness just a normal part of ageing? It is common around menopause, but effective treatments are available. Persistent discomfort deserves assessment.
Can pelvic floor exercises help? They may help when weakness contributes to leakage or reduced support. If the muscles are tight or painful, relaxation and coordination may be more appropriate first.
Can physiotherapy help with painful sex during menopause? Yes, when pelvic floor tension, sensitivity, movement, or fear of pain contributes. Hormonal tissue changes should also be assessed and treated medically where appropriate.
Do I need an internal examination? No. It is optional, explained in advance, and only performed with your consent.
Further information
For joined-up support with pelvic floor and menopause-related symptoms, view appointments and book.