“HOW THE HELL DID I end up HERE?”
A story of hope navigating menopause
I could hear the frustration and slight astonishment in ‘J’s’ voice when our conversation started.
“How did I not know this about my own body!? I’m 54 years old!”
I reassured her that she wasn’t alone and to share where she thinks things began to change.
This is ‘J’s’ story (for the purposes of privacy this client is being named ‘J’) …
“I never heard about the ‘pelvic floor’ until a week ago” she said.
Things ‘started’ at age 49. Her period had stopped for a year and menopausal symptoms began that she had no idea she would experience.
She took me back 20 some years ago to 3 cesarean births and an ectopic pregnancy between her first and second children.
“Back then you didn’t talk about those things, you just carried on like nothing happened. I was fortunate that my right tube could be repaired and that we could have our third child down the road” she continued to explain.
“But here I am now, 5 years later, menopausal, living with symptoms and trying to accept them. It is leaving me feeling embarrassed and lost” she continued.
J went to see her OB/GYN thinking that she would receive more answers. She was met with a prescription to treat her vaginal dryness and a recommendation to Google pelvic floor exercises for prolapse and to just do what she could find.
J sat there wondering, what was a prolapse? How serious was this and what on earth was Google going to successfully tell her?
“Why didn’t she give me more Lindsay!? This was close to 4 years ago and now my symptoms are worse.”
For those years J avoided things that brought joy. Her quality of life was suffering and her ability to find answers was limited.
“I’m at a point now where intercourse has become painful. I want to avoid it in anticipation of pain. I try to pay attention but I really don’t know what to pay attention to!?”
J mentioned she finally found some relief when she recently came across a workshop dedicated to pelvic floor health.
She signed up not knowing if this was something she needed. Day 1 of week 1 passed and she was a little overwhelmed and a bit frustrated.
“I can’t seem to do the exercises the way she’s instructing. I don’t know how to connect to my body that way.”
She finally said out loud…
“Lindsay, how the hell did I end up here!?”
I think she wanted to scream it to be honest.
She shared words like frustrated, hopeless, pain, embarrassed, limited. It broke my heart that 5 years of her life had passed and she didn’t know where to go.
We talked…
We talked about how education was key and that her finding the workshop would bring her support and knowledge.
I asked her, “after that first pelvic floor session did you go straight home and sit down with your daughters to share all that you had learned about your pelvic floor and what they should be aware even in their 20s?”
“I DID! I walked into the house, immediately called my daughters over and sat them down to chat about what I wish I knew then but am learning now” she stated.
Here’s the thing that I am learning with women as they begin experiencing menopause, they start paying attention to an area of their body that, for so many years, was ignored, disregarded, shamed, put aside, you name it, it was (and still is) taboo to discuss.
In the Journal of Affective Disorders, an article titled “The risk of depression in the menopausal stages: A systematic review and meta-analysis” states that for many women, menopause transition can be a period of emotional and physical changes, with different menopausal stages associated with varied risk for depressive symptoms and diagnosis. Therefore, with this risk of depression in peri-menopause, there is a need for [more appropriate] screening and support in this potentially vulnerable group.
Now I am not here to diagnosis depression, what I am taking aim at is our need to direct women, ALL women, at all stages of life to the appropriate resources.
“Lindsay, where do I go from here?” J asked.
I broke down all the right things that J had done to this point:
She sought out support from her OB/GYN, although it was met with an unfortunate recommendation she was seeking help where she thought she would find it.
She tried to recognize symptoms and embrace them for what they were.
She spoke openly to her husband about the changes she was experiencing and she was met with understanding and support.
She signed up for a workshop she knew little about but now feels it will bring her knowledge.
She recognizes her good days and bad days.
We talked for over an hour in her phone consultation. I couldn’t leave her with more questions and she needed a plan moving forward.
She was thankful that I could explain things to her like how her cesarean births could have affected her body throughout the years as she was never directed to do any post-op care and recovery. I explained that although the workshop may seem a little overwhelming at the moment she is learning crucial information that she will be thankful for. I told her to ask the instructor for modifications when she was feeling overwhelmed or lost. J lives across the country from me so I did my best to help her look within her community.
And we created a game plan…
She is seeking out a pelvic floor physiotherapist and making an appointment first and foremost. J was not aware of this professional treatment option. No fault to her, unfortunately pelvic floor physiotherapy isn’t referenced in many appointments with doctors or OB/GYNs.
She is going to complete her workshop, ask questions, gain knowledge, and ask for modifications where needed.
I sent her a few exercises to help her begin foundational practices like breathing, relaxing the pelvic floor, and gently mobilizing her body.
In a months time, when she has completed her workshop and hopefully had an assessment from a pelvic floor physiotherapist, we will begin our ZOOM sessions together.
“Lindsay I feel hope!
You have given me hope when I didn’t think it was possible”
she said.
Those words took my breath away at first. A woman’s life had been so altered up to this point and now she had a clear plan to start feeling like herself again.
Stories like this are far too common! Did you know that it takes women upwards of 6 years of living with some form of pelvic floor dysfunction to finally seek help?
6 years of decreased quality of life.
6 years of avoiding experiences that bring them joy.
6 years of making modifications to routine based on bathroom stops, wearing pads for incontinence, or avoiding gatherings altogether.
6 years of possible altered relationship intimacy.
What’s more, is that in a systematic review titled “Do women have adequate knowledge about pelvic floor dysfunctions?” they found that most women have a gap in the knowledge of pelvic floor muscle dysfunctions, do not understand their treatment options, and are not able to identify risk factors for these disorders.
So I say again, you are not alone.
If this is a story that resonates with you, there is help and there is support, and I would love to help you navigate this. I will do my best to support your journey in any way that I can.
You deserve to live a life without limitations.
1) Badawy, Y., Spector, A., Li, Z., Desai, R. “The risk of depression in the menopausal stages: A systematic review and meta-analysis”. Journal of Affective Disorders. (2024). [PubMed].
2) Fante, JF., Silva, TD., Mateus-Vasconcelos, ECL., Ferreira, CHJ., Brito, LGO. “Do women have adequate knowledge about pelvic floor dysfunctions? A systematic review”. RBGO Gynecology & Obstetrics. (2019).[PubMed].
