Urinary & Bowel Incontinence in Menopause

Talking with clients about sensitive subjects to remove barriers to movement in menopause

Urinary & Bowel Incontinence in Menopause

Movement is so important for women going into menopause

Talking with clients about sensitive subjects such as common pelvic floor problems including urinary and bowel incontinence can help to remove these barriers that often prevent them wanting to exercise in menopause.

In a nutshell, women lose lean muscle mass and bone minerals with ageing. This loss accelerates during the perimenopause and continues, albeit at a lower rate, post-menopause.

In terms of our cardiovascular capacity, our VO2 max - our lung capacity – reduces more than our endurance capacity.

Keeping those 3 key changes in mind, loss of lean muscle mass, loss of bone density and a reduction in max lung capacity, helps to shift our exercise towards resistance exercise, impact, and high intensity training.

However, we know that the all-too-common pelvic floor dysfunction, like urinary and bowel leakage or urgency, is a huge barrier to exercise. So how can you best screen for this in a fitness training, yoga or Pilates setting?

Women often feel so relieved when they get an opportunity to talk about their pelvic health. A questionnaire can be particularly helpful if you work with women in a setting where those questions are harder to ask. If you feel you can ask your clients the questions suggested below, that is great, please do!

We’d love to hear your feedback, or what you would add to our suggested questionnaire.

The Menopause Movement Model Questionnaire

Pelvic floor dysfunction is a common and often huge barrier to exercise. Depending on the answer to the questions below, we probably may to modify your exercise and we’d recommend you see a pelvic health(women's health) physio (WHP).

The WHP will carry out an internal assessment and using their recommendations, we’d aim to work together, so you can continue to exercise safely and manage your symptoms. Women’s health pelvic physio is effective, please don’t stop exercising, most bladder and bowel issues can be helped!

o  Do you ever leak urine or faeces during exercise or any other time?

o  During exercise, particularly in a quiet class, do you ever have difficulties controlling wind?

o  Do you ever feel the need to go to the toilet quickly or do you not make it to the toilet on time?

o  Do you ever feel a heaviness or dragging feeling in your vagina, or have you seen a bulge?

o  Do you have pain in your genital region (vulvae or vagina) during sex, inserting a tampon, cycling, or any other time?

o  Do you have any constipation?

o  Do you have a persistent cough, wheeze or sneeze?

o  Have you had any pelvic surgery or injury? 

o  Are you breastfeeding?

o   Have you gone through, or are you going through menopause?

o   How would you describe your periods?

o  Is your BMI (mass body index) over 25? (Whilst BMI partly lacks validity, there is a correlation between pelvic floor dysfunction and BMI )


Find a WHP who can help!

·The Menopause Movement Directory

·The POGP/Squeezy App Directory


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