A big part of my practice focuses on pelvic floor therapy and through that, I address contributing factors such as hormones, gut health, stressors or triggers (post partum, trauma, etc). First let’s start with what Pelvic Floor Therapy is: 

Pelvic floor therapy is a specific form of physical therapy that focuses on the muscles, ligaments, and tissues in the pelvic region. It is commonly used to treat various conditions such as pelvic pain, pregnancy, urinary incontinence, and pelvic organ prolapse. The therapy involves exercises, manual techniques, and other interventions to strengthen and improve the function of the pelvic floor muscles.

Usually Pelvic Floor Therapists, are Physiotherapist, however, as a Naturopathic Doctor and our Primary Care background, Pelvic floor therapy and PAPS, with training, are within our scope. 

How Can BHRT help your pelvic floor? 

First let me explain BHRT 

This is a treatment that involves the use of hormones that are biochemically similar to the hormones naturally produced by the body. They are derived from natural sources such as soy and yams, that gets chemically altered to create a therapeutic substance (ie estradiol) 

. It is used to address hormonal imbalances, particularly in menopause or perimenopause, by supplementing or replacing hormones such as estrogen, progesterone. BHRT is typically prescribed by healthcare professionals and is tailored to an individual's specific hormone need

Estrogen (in the form of estradiol, a stronger and safer form of estrogen) receptors are found in the female lower urinary and genital tract. 

A decrease in estrogen (ie menopause) can impact the pelvic floor through atrophic changes, urinary symptoms (estrogen helps with bladder control and muscles in the pelvic floor) and muscle integrity (ie. prolapse). BHRT has shown beneficial effects for Pelvic Floor patients dealing with vaginal atrophy including burning, dyspareunia and urinary incotninec. On top of your pelvic floor,  BHRT can also help balance hormones for those dealing with concerns with sex drive, skin health, insomnia, irritability, hot flashes, night sweats, fatigue, weight concerns and mood!

Great so does that mean BHRT can help if I have weaker pelvic muscles? 

First of all, having weakness or laxity in the pelvic floor does not mean you are a good candidate for estrogen therapy. It really depends on whats going on and your health history. Though BHRT is not proven to help repair prolapse, it may help reduce the risk of prolapse as estrogen decreases. 

As a Naturopathic Doctor with prescribing rights, I have the knowledge and skills to assess for your need of BHRT and implement it safely and effectively, if indicated. I think there is a misconception that because it is (more) ’natural’,  it is safe. This is not true. Whether natural or not, for any substance (not only those impacting hormones but particularly those impacting hormone’s), health history, interactions, dosage, duration, indication, are very much important. BHRT can cause risk if not implemented by a practitioner who has knowledge in it. Naturopathic Doctors take a hefty prescribing exam and additional hormone therapy training to have knowledge in physiology and pharmacology.

We also look at other aspects contributing to your health concerns and address those too. One example for pelvic floor specifically is, if there are gut concerns ie bloating or constaption, it can cause straining and irritation in the pelvic floor.  Naturopathic Doctor, I can effectively address the root cause of your gut health to correct pelvic floor concerns, or vice versa. I have another post on pelvic floor and gut health so I wont go into too much detail (you can read that here)

Another thing I should mention, when I work with patients, the most common question I get with pelvic floor is - "am I to weak or should I just do kegels?”

I cannot stress this enough. Without a proper assessment, it is hard to tell if your pelvic floor is causing symptoms due to too much tension or weakness. This greatly impacts my role as a PFT and your exercise (ie kegels vs stretches or relaxation exercises). A good anaology for pelvic floor symptoms suh as urinary incontience, is to think of a bicep curl. When you perform a bicep curl from a certain angle (ie 180 or 90 degrees), you initiate certain muscles for that contraction. Now imagine you have a restriction, that only allows you to perform a bicep curl from here (10 degrees), well you wont get the same range,  Or if you are restricted with tension here ( 120 degrees ), perfomring a bicep curl will be alot harder. The same with your pelvic floor. If you are consistenly contracted or there is too much tensions in the pelvic floor, we have to relax the muscles in order to gain proper contraction and strength. Continuing to strengthen (ie kegels), can actually cause more harm than good. So please dont do kegels, without consulting first.

While both pelvic floor therapy and BHRT can contribute to overall well-being, and pelvic floor, it's important to consult with healthcare professionals to determine which treatment, if any, is appropriate for your specific needs.