When most women think about aging, they think about things like gray hair, reading glasses, or achy joints. What many don’t realize is that the pelvic floor — the group of muscles, ligaments, and connective tissues that support the bladder, uterus, rectum, and other pelvic organs — naturally changes over time too. The good news? Understanding these changes and knowing when to seek guidance can help you stay active, comfortable, and confident at every stage of life.

 

Changes you may notice after 40

Pelvic floor changes are incredibly common as women age, and most are manageable with the right care. Here are some things you may experience and should bring up with your healthcare provider:

-Occasional urinary leakage – a small leak when you cough, sneeze, laugh, or exercise is one of the most common signs of pelvic floor change

-Increased urgency – feeling like you need to get to the bathroom more quickly than you used to

-More frequent bathroom trips – needing to go more often during the day or waking up at night to urinate

-A sense of heaviness – a feeling of fullness or pressure in the pelvic area, especially after long periods of standing

-Discomfort during intimacy – changes in comfort during sexual activity that feel new or different

-Changes in bowel habits – occasional difficulty with constipation or feeling like you’re not fully emptying

These experiences are more common than you might think, and in most cases, they are very treatable. Bringing them up with your doctor is a great first step toward feeling better.

 

Why does this happen?

Your body goes through a lot of natural changes over decades, and your pelvic floor is no exception. Some of the most common contributing factors include:

-Hormonal shifts – as estrogen levels gradually change during perimenopause and menopause, the muscles and tissues in the pelvic region may lose some of their tone and elasticity

-Cumulative life events – pregnancies, deliveries, and years of daily physical activity all add up over time

-Everyday habits – things like chronic straining, prolonged sitting, heavy lifting, or even high-impact workouts can gradually affect pelvic floor function

-General aging – just like the rest of your body, pelvic floor muscles naturally change with age, and that’s perfectly normal

The important thing to remember is that these are common, well-understood changes — not something to fear.

 

 

Why awareness matters

According to the National Institutes of Health, nearly one in four women in the United States experiences some form of pelvic floor change. Despite how common it is, many women don’t talk about it — sometimes because they assume it’s just a normal part of aging that they must accept. The truth is you don’t have to simply live with discomfort. When addressed early, most pelvic floor concerns respond very well to conservative, non-invasive treatment.

 

Simple steps to support your pelvic floor health

Taking care of your pelvic floor doesn’t have to be complicated. Here are some approachable ways to stay ahead of changes:

-Pelvic floor physical therapy – a specially trained therapist can create a personalized plan to strengthen and support your pelvic floor in a gentle, effective way

-Stay active – regular, moderate exercise like walking, swimming, or yoga helps maintain overall muscle tone, including the pelvic floor

-Mind your habits – staying hydrated, eating fiber-rich foods, and avoiding chronic straining all support healthy pelvic function

-Know your body – being aware of what feels normal for you makes it easier to notice when something shifts

 

“My favorite part of working with the perimenopause/menopause population is empowering woman on their pelvic floor health and educating that issues such as pain with sex or leaking urine are not normal parts of aging that they just need to deal with. But there are treatments, exercises and easy behavioral changes that can greatly improve their quality of life.” – Annie Neisen DPT, PT, WCS.

 

Interested in learning more? Schedule a pelvic floor therapy consultation today: https://www.matherhospital.org/

 

Resources:

https://www.nichd.nih.gov/health/topics/pelvicfloor

https://www.acog.org/womens-health/faqs/pelvic-support-problems

https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems-women