Perimenopause and Pelvic Pain

I haven’t posted in a while. My pain didn’t go away… it’s been pretty consistently managed, but the past few years have been a little different thanks to “the change” i.e. perimenopause. So I thought it was time to write about that. I was warned by my pelvic floor physical therapist that my pain might “get worse with menopause” but I was thinking age 50… because that’s when I estimated I’d hit menopause. Problem was — nobody ever tells you about perimenopause. And pelvic pain is definitely wrapped up in our hormones. And perimenopause is all about hormone fluxuations. So yeah, it’s a thing and it’s a big thing.

I can’t say how it’ll be for anybody else because everybody’s pelvic pain is different and everybody’s experience with perimenopause is different. There are a massive amount of varying symptoms that can happen for both. And it takes time and expert assistance to sort through them and figure out what’s causing what and how to manage it best. Mine started around age 44.

At first, I was hit hard by some serious fatigue and longer periods. Took a while to realize I had deficiencies of iron, B12 and D due to the additional loss of blood. Then we had to look at the thyroid and maybe issues there. Hormone testing of estrogen and progesterone. Eventually I ended up using some natural hormone supplement creams that are gentle and help ease the situation. But that’s just me.

Pelvic Pain and Rehab Center has several blog posts about menopause, perimenopause and pelvic pain. They’re the experts, not me, so I defer to them on the subject, but just know that you’re not alone if you’re in that zone between age 40 and 55 and strange things are starting to happen — different pain than you had before.

The other thing that happened to me was prolapse — there are various types that you can look up online, but that was expected due to what happened with my delivery and neuralgia. Unfortunately it was triggered by a rough pelvic exam that dislodged my bladder from its position. Not a fun experience. Prolapse can be painful and uncomfortable in its own way.

Recently I had a new thing happened that we’re still trying to figure out. I think it’s related to the prolapse and the nerves being overly sensitive. Neuralgia can get worse with hormone changes on its own — nerves and tissue not having the hormone support that naturally calms / reduces pain — so that can be a new problem, in new locations. And there can be referred pain as well. I’ve had pain in new locations and that’s what tipped me off that it was something to work through. It can be tricky when other pain is happening, to separate one thing from another. So as usual, more problem solving.

I’m still hoping to take a more aggressive approach to treating my pelvic pain and in an ideal world would do that before my periods finally end since they tend to calm my pain when the tissue is naturally softened, but there’s a lot of risk involved in potential surgeries and treatments — I’ve heard the horror stories on the email lists and in the Facebook groups. There’s a lot that can go wrong. But definitely hormones are involved. Keep that on your radar, at whatever stage you’re in if you’re someone with pelvic pain.


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