The Menopause Gamechangers - Jennie Hughes, Womens Health Physio


Jennie Hughes Fourtherapy
My name is Jennie and I have been a qualified physiotherapist since 2013. Initally I specialised in musculoskeletal physiotherapy before specialising further into pelvic health. A pelvic health physiotherapist is someone who treats conditions that occur in the pelvic region in both women and men. These commonly include bladder, bowel and sexual function issues but also encompass all type of pain within the pelvis and musculoskeletal issues around the pelvis. A lot of women I see are either pregnant or post partum but pelvic health issues can affect anyone of any age of gender at any time in their life.

Pelvic health issues tend to occur around menopause because of the change in hormones. This can quite simply upset the dynamics within the pelvis affecting the muscle and tissue strength, mobility and flexibility. A lot of women can experience leaking because of a weakening in their pelvic floor but also a thinning of the tissue. This can also cause other problems like infections and pain with sexual intercourse.

I would definitely recommend completing pelvic floor exercises if it strengthening work you need. Some of the problems I see can be due to an overactive (tight) pelvic floor. So it is important to make sure this isn't the case before strengthening the pelvic floor. If it has been identified that you need to strengthen the pelvic floor I would start with finding your pelvic floor. For this you need to imagine you're stopping yourself passing wind. Practise holding for 10seconds (make sure your keep breathing) and then fully relax for 5 seconds, repeat this 10x. Then practise holding for 1 second and fully relaxing for 3 seconds, repeat this 20x. Aim to complete both long and short holds 3x daily. Ensure you don't hold your breath and ideally exhale as you lift and continue to breath whilst holding. To fully relax take a nice deep inhale.

With January looming and many women setting fitness goals, the best way to ease yourself back into exercise would depend on what your goals and fitness levels are. If you haven't been doing much exercise over the last few weeks I would definitely ensure you are doing low impact exercise on a daily basis like walking or cycling. Ease back into other exercise by reducing duration or weight to build up gradually to what you were completing before. It's important to gradually build up to what you were previously doing to avoid injury.

An initial appointment with me would be taking a full clear subjective history of what the problem is so we would cover lots of questions all things pelvic health.  The objective is individually designed from what has come up in the subjective assessment but typically would include a posture and musculoskeletal assessment, a strength check of specific muscles and a core cylinder check of rib cage/ diaphragm, abdominals and the pelvic floor. I would ensure you were comfortable with everything in the objective assessment by explaining it all before we begin and if there was any questions you had or concerns I would be more than happy to answer, explain and reassure. A priority of mine is to ensure you are comfortable and at ease during our appointments. We would set goals and identify areas that need specific focus and work on and come up with a treatment plan including exercises for you to complete. The follow up would be to check anything we had identified as a problem/ weakness and to progress your treatment plan. 
Jennie works at her own clinic in Balham on Thursdays. She also teaches Pilates privately in peoples homes mainly on Mondays and Wednesdays. Jennie can be contacted here: