Pelvic health physiotherapist Sarah Plunkett wrote a fantastic blog for us about menopause and what her best tips are for someone going through the change.  



Menopause can be the dread of women with symptoms like hot flushes, osteoporosis, weight gain and mood swings to mention a few. Can women help to reduce their risk of experiencing these symptoms? Can it be a time of positive change?

As women approach menopause and their hormone levels decline it is thought that it is not so much the decline in the hormones that causes the unpleasant symptoms of menopause, but when the different sex hormones decline at different rates.

Essentially hormonal health and balance is reflected by good general health, so a good healthy lifestyle can make a great difference to how you experience menopause.



So what can help to keep our hormones in balance as they decline?

  • Keep your weight healthy. 

Abdominal fat in particular is a culprit for hormone imbalance.

Increased weight will also put downward pressure on your pelvic organs and put strain on your joints.

Being underweight isn’t good either as it increases your chance of osteoporosis.

Include some aerobic exercise in your week *see exercise below.



Include healthy fats in your diet as your body uses them as building blocks to make hormones. Lower GI options will help keep blood sugars under control and therefore weight under control, your gut bacteria healthier and avoid the sugar high low cycle.


  • Keep stress levels under control. Stress increases cortisol and insulin production which further impacts the balance of our sex hormones and will worsen menopausal symptoms. This directly impacts negatively on your abdominal fat, bone density, cardiovascular and mental health.

Stress is a normal part of life and necessary to get us out of tricky situations. But when daily life is causing feelings of stress and anxiety we need to find better ways of coping with our day. Take to time to recognise what factors are adding to your stress, write them down, talk about them.

Mindfulness, relaxation techniques, yoga, pilates, a walk or just a chat with a friend can make all the difference. If you are not getting ontop of your stress talk to your GP who can advise you further.



  • Exercise is an essential part of a healthy lifestyle

Menopause is not the time to just put your feet up and slow down, exercise is a vital part of feeling good during this time. Exercise impacts our hormonal health in so many ways and to get best results, keep it varied and challenge the body in different ways. Always respect and listen to your body. Zero to hero is not good at any age, but around the menopausal age, working your body too hard too quickly can deplete your energy reserves, and it can take longer to recover from and end up having significant negative health effects.


Varying the intensity within one exercise session dramatically increases the health effects. Research shown High intensity Interval training or HIIT has optimum effect on hormonal balance. This could mean including hills in a brisk walk, a spin class, or varying the pace in an aerobic or Pilates session. A game of tennis is a great way of getting varied intensity and weight bearing.


I’m a big fan of walking, and you can add in a few minute jogs within your walk to increase the challange. It’s free, connects us with nature (which has proven health benefits) and allows us to absorb Vitamin D. Varying your route, pace and gradient will help stimulate your bones to maintain and even increase bone density. Walking can be really social too, why not organise a walk with a friend rather than that coffee or cocktail?!

When you’re walking, engage your core and let your arms swing freely.


Keep your core strong! Your core is comprised of your Pelvic floor, your deep Abdominal muscles and your deep back muscles. Your core supports your pelvis and back joints allowing for good posture, and supporting your pelvic organs, and continence and even strength of orgasm. Win Win! Simply working and relaxing the pelvic floor muscles is a good place to start. There’s a great App called Squeezy, developed by Physiotherpists in the NHS which makes working and relaxing the pelvic floor much easier to do well.


  • Don’t ignore the leaks! Although incontinence is common it’s not a necessary sentence. The majority of incontinence can be improved or resolved with proper guidance with a Women’s Health Physiotherapist.


Modified Pilates with an instructor experienced in women’s health is a wonderful way to strengthen your core as well as improve flexibility, posture, and balance. Be careful with Traditional Pilates and exercises that involve lifting both feet off the floor at the same time or sit up like moments which will cause downward pressures on your pelvic organs increasing chances of pelvic organ prolapse.


Once your core is stronger you can include some resistance or strength training. It has a direct impact on your hormone levels which can lead to increased sex drive, bone density and improved mood as well as increasing strength and muscle mass. And when you have more muscle you’ll burn more calories! No need for expensive weights, a length of resistance band or a 1-2 litre bottle will be ample to get you started.


  • Make sure to stretch! Stretching is best done when your muscles are warm after you exercise. Stretching will help prevent and treat stiffness as well as giving you a feel good endorphin boost!



  • Support your body well. Wearing good footwear, and addressing underlying issues such ‘fallen arches’ or aches and pains with a Chartered Physiotherapist will mean you can enjoy exercising comfortably.

If you are aware of Pelvic Floor weakness, wearing  EVB Sport Shorts for exercise has been shown to improve the function of the Pelvic Floor, improve posture and reduce leaking. Think of them as a sports bra for your pelvis!




  • Sex is good for your health. Its a natural stress buster, immune booster and helps emotional bonding in a relationship. But sex life can be effected for some women during and after menopause. Decreased Eostrogen levels, vaginal dryness together with disturbed sleep and mood changes can mean deceased sexual desire and enjoyment. Can anything be done? The good news is strength training causes your body to produce Testosterone production which can boost sex drive. So there is another benefit to exercising!


Using water based lubricants can counteract vaginal dryness and make penetration more comfortable. Also low dose oestrogen via the vagina in the form of creams, ring or tablets are available on prescription which boost collagen production and the bodies own lubrication without the side effects of systemic transdermal or oral HRT.


Be honest and open with your partner and talk through problems your experiencing.



  • Keep your gut healthy. There is a strong link between gut health and hormonal balance. Not only will your bowels be more regular (and this directly impacts hormone balance as excess hormones are excreted in bowel movements.) The gut is responsible for producing most of our serotonin (low serotonin can cause depression, sleep and memory problems and decrease sex drive and digestion). Eating natural, unprocessed foods, including fresh fruit and vegetables. A new study has shown that vegetables are 4 times healthier than fruit, so don’t over do the fruit as it contains alot of sugar. Most recent research supports the Austrailian guidelines of 5 veg plus 2 fruit as a better guide than our ‘5 a day’ in Ireland. Probiotics have been shown help to address a poor gut bacteria balance, and are found in fermented food such as  Kefir or Bio Yoghurt or available in powder or capsule form.


Keep sugar as an occasional treat as sugar will spike insulin and cortisol levels which directly impact our sex hormone balance and increase risk of Diabetes and cardiovascular problems.

A high sugar diet will also knock your gut bacteria balance off which will affect your general and mental health. Processed foods tend to contain much higher levels of sugar, so be label-smart. Women should limit their sugar intake to 25g, which is approximately 6 teaspoons.


Get your Magnesium

Magnesium has many benefits for the body and mind such as improved sleep, reduced anxiety and decreased muscle tension, and cardiovascular benefits, also helping insulin resistance and bone density.

Many women report that Magnesium supplements can helps reduce the amount of ‘hot flushes’ women experience in Menopause and research is currently being carried out on this.

Magnesium levels can be low in processed foods so opt for fresh leafy greens and pulses, nuts and seeds. Foods such as bread and many medications can reduce absorption of Magnesium, so many people will benefit from supplementation orally or topically with a spray or gel.


Get your Vitamin D

In Ireland most of us don’t get enough sunshine on our skin to give us enough vitamin D. We need Vitamin D for healthy bones, immunity, reducing risk of cancer and MS. Supplementing with Vitamin D in Ireland is essential.



Practise good sleep hygiene! This has nothing to do with cleanliness! Its all about lifestlyle factors that promote a normal sleep pattern. Here’s a few tips…

  • Getting out in the day light every day. And keep lighting low and relaxed in the evening.
  • Exercise during the day can help you get a good nights sleep. But for exercising in the late evening, keep it low intensity such as gentle yoga, pilates or stretching.
  • Include some relaxed breathing exercises as part of your bedtime routine.
  • For more sleep hygiene tips see


Summing up simply…To have a healthier and happier Menopause, aim to have a good healthy lifestyle. Stay active, make changes needed to exercise level gradually, eat well and keep social!

Enjoy your health and enjoy your body!


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