Your Pelvic Floor in Perimenopause: What Changed and What to Do About It with Christina Walsh

If you’re a woman in perimenopause or menopause, you may have noticed changes in your pelvic floor health—maybe a little leak when you sneeze, or a new sense of urgency. You’re not alone, and you don’t have to just “live with it.” I recently sat down with Christina Walsh, PT and co-founder of Tighten Your Tinkler, to talk about what’s really happening, why it matters, and what you can do.

Why Does the Pelvic Floor Change as We Age?

As Christina explains, the pelvic floor is made of soft tissue—no bones holding everything in from below. During perimenopause and menopause, estrogen and collagen levels drop, leading to weaker, thinner tissues. This can result in symptoms like leaking, urgency, and even prolapse (when organs shift downward).

1 in 3 women will develop clinically significant prolapse in their lifetime.
1 in 2 women who have given birth will experience it, regardless of delivery method.

Common Pelvic Floor Issues

There are two main categories:

Pelvic Floor Dysfunction: Milder symptoms like occasional leaks, urgency, or backache.
Prolapse: More severe, with organs shifting and a feeling of heaviness or pressure.

Symptoms can be life-altering, affecting everything from travel plans to intimacy. And while it’s common, it’s not “normal”—and it’s not all in your head.

Why Your Doctor Might Not Mention It

Many women assume their OB/GYN will check for these issues, but most are not specifically trained in diagnosing prolapse. Dismissal or minimization is unfortunately common. If you feel something is wrong, trust your body and seek help—don’t wait until surgery is your only option.

What Can You Do? Practical Tips

Christina’s advice is refreshingly practical:

Hydrate: Drink enough water (add electrolytes if needed).
Fiber: Get enough to avoid straining during bowel movements.
Toileting posture: Use a squatty potty or similar stool for better alignment.
Avoid Kegels: Instead, focus on functional strength and relaxation (try the 90/90 decompression position).
Wear loose clothing: Avoid compressive garments and high heels.
Choose low-impact exercise: Walking is best if you’re experiencing symptoms—avoid adding load (like weighted vests) until your foundation is strong.
Try a vibration plate: For bone density and muscle activation, this can be a great low-impact option.

The Signature Program & More Resources

Tighten Your Tinkler’s Signature Program offers a holistic, non-invasive approach to restoring pelvic floor function. Christina recommends starting with their free online quiz to see if you’re a good fit. The program includes relief techniques, functional movement, and access to a supportive community.

If you’re interested, use code GracedHealth for $50 off (details in the show notes).

Final Thoughts

Honor your body by listening to its signals. Small steps—hydration, posture, gentle movement—can make a big difference. And remember, you’re not alone. Reach out for support, take the quiz, and know that healing is possible.

You deserve to feel strong, confident, and supported at every stage of life.

Links

Episodes Featuring Christina and Jenn of Tighten Your Tinkler:

These two common exercise moves aren’t helping your pee issues. Here’s why. Season 15 Episode 9

The surprising reason for your back and hip pain (not visible on x-ray) Season 13 Episode 13

Episodes Mentioned

Should I wear a weighted vest

Fiber and menopause

Resources

Take the 5-minute quiz

https://www.tightenyourtinkler.com/backandhiprelief

Use code GRACEDHEALTH for $50 off the Tighten Your Tinkler Signature Program