• The bladder can become less elastic and therefore has more difficulty stretching.
• As the bladder fills with urine, this loss of stretch may irritate the bladder muscle and it can be difficult to hold as much urine as before.
• Combined with low tone pelvic floor muscles, this makes it much more difficult to hold on or to put off going to the toilet.
• Vaginal oestrogen can be prescribed to help with these symptoms in conjunction with a pelvic floor exercise programme.

Many women find they begin to gain weight with the onset of the menopause.

Unfortunately, excess weight adds to the load onto the pelvic floor muscles, further exacerbating these problems. The specialists at Menopause Care can offer nutritional advice to help you maintain a healthy weight during menopause.

Thinning and inflammation of the vaginal walls due to the change of hormones can cause vaginal burning, itching, irritation, dryness and discomfort and/or painful intercourse. The urethra can also change and you might have an increased risk of urinary tract infections.

Diabetes has specifically been identified as putting women at higher risk as nerve damage (neuropathy) is a common complication of diabetes. Nerves to the bladder and bowel can be damaged, causing loss of sensation, poor emptying and constipation.

The uterus, together with our facia, also helps support the other pelvic organs. We recommend following a pelvic floor health programme before

surgery and doing rehab post-surgery to gain full functional strength.

There are many reasons for the weakening of the anal sphincter. One being when giving birth, the anal sphincter can be damaged. This may not become a problem until later in life.