With the onset of peri-menopause and menopause, your estrogen levels begin to decrease and your period becomes less regular before you eventually stop menstruating. Many women at this phase of life may begin to see issues with pelvic floor function, since during menopause the pelvic floor muscles weaken (along with the rest of the muscles in the body). More than 50% of women will experience vulvovaginal problems such as urine leakage, prolapse, painful intercourse and/or vaginal and vulvar skin changes. All of these issues can impact lifestyle, emotion and sexual health. Although estrogen decline plays a role in vaginal and pelvic floor muscle tissue changes, many times the pelvic floor is weakened already, from pregnancy and childbirth, weight gain, lack of exercise and strength training, poor posture, and chronic constipation, among others. Learning how to connect to your pelvic floor and coordinate control to either strengthen or relax the pelvic floor muscles, accompanied with hands on treatment such as myofascial release and visceral manipulation, can help to balance muscle tone and restore tissue, improving stability and decreasing discomfort.