Pelvic floor and menstruation

Did you know hormonal changes during the menstrual cycle can affect your pelvic floor muscles? 

Your menstrual bleed or period occurs as a result of a drop in hormones estrogen and progesterone at the end of the menstrual cycle. 

These hormones have a large effect on your reproductive system during your cycle: 

  • Estrogen develops and releases the eggs from your ovaries, in a process known as ovulation.
  • Estrogen thickens the uterus (womb) lining.
  • Progesterone prepares the womb for an embryo.
  • If a pregnancy does not occur, the egg is reabsorbed, the hormone levels fall, and the uterus lining sheds and leaves the body - known as the ‘period’. 

Estrogen also increases the integrity of soft tissues (like muscles and fascia), so your pelvic floor may feel strongest in the first phase of your cycle, when estrogen levels are high. During menstruation, when estrogen is lowest, you may notice your pelvic floor muscles (and all muscles in general) are more fatigued or weaker - this is normal!

Can you do Kegels while on your period?

Pelvic floor muscle exercises can still be done while on your period, including the use of Pelvic floor trainers! While some with severe cramping or pelvic pain may not feel comfortable with internal trainers during this time, others may find there is some slight relief from gentle pelvic floor contractions. 

For those who do continue to use their Perifit throughout their period - it's worth noting that throughout your cycle, your scores may vary. It's nothing to worry about, though, as this is just a natural fluctuation in your strength as part of your monthly cycle.

Can you do pelvic floor exercises with period pain?

While some discomfort during the period may be considered ‘normal’, severe period pain can sometimes be caused by an underlying gynaecological condition such as fibroids or endometriosis. If period pain is severe, not responding to pain relief, or associated with other symptoms such as painful sex then it is best to seek medical advice from your general practitioner or gynecologist, who can investigate further. 

Period pain or cramping can be worsened by “overactive” or tight pelvic floor muscles associated with these conditions. For those with endometriosis or ‘dysmenorrhoea’ (painful periods), paying special attention to the relaxation phase of your Kegel training can be a great way to help reduce pain and tension during your period. 

As well as pelvic floor training that focuses on relaxation, continuing with general exercise has been found as an effective way to reduce the symptoms of painful periods. Switching to lower intensity or gentle exercise; like yoga, walking or swimming may be preferred during this time. 

While everyone experiences their period differently and should choose what feels right for them during this time, it is ultimately safe to continue pelvic floor training and exercise in general throughout the entire menstrual cycle. 

Article written by
Laura Justin
Qualified and Registered Australian Physiotherapist
Women's and Children's Health
@thefamilyphysio 

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