Navigating perimenopause

Dr. Kari Craig-Physical Therapist and Founder, Kare Pelvic Health • May 7, 2025

Understanding the connection between hormone shifts and pelvic floor changes can help you feel like yourself again.

Three people in athletic wear stand by a railing outdoors, talking while holding rolled-up yoga mats.

Most women might not know that perimenopausal symptoms can start to show as early as the late 30s. Issues that seem to pop out of nowhere are byproducts of declining hormones and could be responses to muscle dysfunction that already existed but was easier to bounce back from at a younger age.


As women, our bodies are constantly changing and sometimes it’s hard to pinpoint what those changes are and what they mean. As you get older, hormonal shifts can start to affect your mood and body in ways you have never experienced before, creating a sense of insecurity, feeling abnormal or feeling crazy. Maybe you started having prolapse, experiencing urinary leakage, have newfound digestive issues or are having pain with intercourse.


I’m here to tell you that you are not crazy—it’s very normal, and all these symptoms could be starting due to perimenopause. 


Most women might not know that perimenopausal symptoms can start to show as early as the late 30s. Issues that seem to pop out of nowhere are byproducts of declining hormones and could be responses to muscle dysfunction that already existed but was easier to bounce back from at a younger age. We know that a decrease in estrogen levels can affect muscles, tendons and even our heart. The vaginal tissue is particularly sensitive to estrogen, so when those hormones are taken away it can weaken the pelvic floor. 


At Kare Pelvic Health, we feel really privileged that we can help with the muscle system and help get rid of annoying symptoms, but we can also identify what else might be going on. Obviously, we cannot prevent menopause, but we can lighten the load a little and help you handle it in a way that makes your body feel good again.


If you are experiencing these pelvic floor symptoms during perimenopause, I would advise having your pelvic floor assessed to see the whole picture. It will keep you one step ahead of menopause while taking your mind and body back into your own hands. 


Kare Pelvic Health is located at 7575 Fredle Dr., Suite 202, in Concord. To learn more about Kare Pelvic Health, visit KarePelvicHealth.com or call 440-256-6268.



A person smiling while holding a model of a human pelvis toward the camera against a plain background.

Dr. Kari Craig


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