menopause and pelvic and rectal pain

As women pass through perimenopause and menopause and enter their postmenopausal years, they typically experience various aches and pains. Among them may be the presence of pelvic and/or rectal pain.

What are pelvic pain and rectal pain?

Pelvic pain is characterized by discomfort or pain in the base of the abdomen and pelvic region. The sensation may range from a dull ache to a sharp jabbing pain. Pelvic pain may be caused by a wide range of conditions ranging from constipation to menstruation, a full bladder, pregnancy, trauma to the abdominal or pelvic region, of sexual activity.

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How are pelvic and rectal pain associated with menopause?

As women's estrogen levels decline significantly with the arrival of menopause, the pelvic floor muscles tend to get dryer and thinner. These changes are often accompanied by the development of sensitive areas or trigger points inside the pelvic floor, which then can manifest as pelvic pain.

Pelvic and rectal pain is also associated with pelvic organ prolapse. This condition occurs when the pubococcygeus muscles (PC), which are located at the base of the abdominal cavity, become weak. This can result in a shift in the position of the uterus, rectum, bladder, intestines, and/or vagina. If any of these organs shift lower in the abdominal cavity, it results in pressure or heaviness in the area and may cause problems with urinating or having a bowel movement.

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According to the Association for Pelvic Organ Prolapse Support, about half of women age 50 and older experience pelvic organ prolapse. However, studies show a range between 3 percent and 68 percent.

How can you manage pelvic and rectal pain naturally?

One of the most interesting and effective ways to manage pelvic and rectal pain associated with menopause is with Arvigo massage. This is a form of massage that can help heal the body and restore balance and wholeness. According to its practitioners, the technique allows the chu'lel (a Maya word that means life force energy) to flow freely through the body.

Arvigo massage reportedly can strengthen pelvic health by stimulating the flow of energy, blood, and lymph. According to naturopath and Arvigo practitioner Christine Matheson, this massage method can minimize perimenopausal and menopausal symptoms by "ensur hormones reach where they need to go leading to a feeling of vitality while the body undergoes changes."

A correction we owe you. This page used to say that Arvigo massage can align the pelvic and abdominal organs if they have shifted. We have taken that out. Pelvic organ prolapse is a loss of support in the pelvic floor. It is graded by examination, and the treatments with evidence behind them are pelvic floor physical therapy, a pessary, and surgery. Massage can be pleasant and relaxing, and it does not move an organ back into place. If you have been relying on massage for prolapse, ask your doctor for a referral to a pelvic floor physical therapist. Most women have never been told that pelvic floor physical therapy exists, and it is the thing that actually helps.

A second correction. This page used to recommend licorice, dong quai and willow for pelvic and rectal pain, and it sourced part of that list to WebMD. We have taken the herbs and the citation out. None of the three has good evidence for this kind of pain, and each carries a real risk. Licorice contains glycyrrhizin, which raises blood pressure and lowers potassium. Dong quai has anticoagulant activity and should not be combined with blood thinners. Willow bark is a salicylate, so it carries the same cautions as aspirin, including for anyone taking an anticoagulant or with an aspirin allergy. If you have been taking any of them, tell your doctor or your pharmacist, particularly if you also take a blood thinner or blood pressure medication.

Some other approaches to relieving pelvic and/or rectal pain are offered here.

• Sitting in a warm bath, using a heating pad or hot water bottle on the affected area, or enjoying a hot whirlpool can be helpful.
• It's important to consume enough fiber to keep your bowels regular and healthy so you don't need to strain when defecating. The Institute of Medicine (Dietary Reference Intakes, 2005) sets an adequate intake of 25 grams of fiber a day for women aged 19 to 50, and 21 grams a day from age 51, from fresh fruits and vegetables, whole grains, beans, and seeds.
• Pelvic floor physical therapy. A pelvic floor physical therapist can assess the muscles directly and work on the trigger points, the muscle tone, and the coordination that sit behind a lot of pelvic and rectal pain. Ask your doctor for a referral, or look for a physical therapist with pelvic health training.
• Stress relief. Practices such as meditation, progressive relaxation, visualization, deep breathing, and yoga may relax muscles and offer overall relief from tension and pain.
• Exercise. Brisk walking or other moderate exercise for 30 minutes most days of the week may be one of the best ways to shake off the discomfort. Exercise boosts blood flow, relieves tension, and releases endorphins, which help with pain relief.

when to see your doctor

Although pelvic or rectal pressure and pain usually are not serious, you should consult your doctor if any of the following occur:

• Sudden or severe pelvic or rectal pain
• Fever
• Vaginal bleeding
• Rectal bleeding, or blood in your stool
• A change in your bowel habit that lasts more than a few weeks, such as new constipation, new looseness, or stools that have changed shape
• Weight loss you cannot explain
• The pain or pressure disrupts your lifestyle
• Pressure or pain gets worse over time

bottom line

Pelvic and/or rectal pain or pressure is common among women in the menopausal years. Natural techniques can be effective in providing relief.

Related perimenopause and menopause symptoms

If you're experiencing this symptom, you may also find these related guides helpful: constipation, gas and bloating, urinary incontinence, and joint pain. You can also browse our full guide to other perimenopause and menopause symptoms.

Frequently Asked Questions

Can menopause cause pelvic and rectal pain?

Yes. Declining estrogen thins the tissues of the vagina, vulva, bladder, and rectum (genitourinary syndrome of menopause), which can cause aching, pressure, or sharp pain in the pelvis and rectal area.

What does menopause pelvic pain feel like?

Women describe dull aching, cramping, pressure, or sharp jabs. Rectal pain is often described as pressure, stabbing, or burning, sometimes worsened by sitting or bowel movements.

Is pelvic pain in menopause always hormonal?

Not always. Fibroids, endometriosis, pelvic floor dysfunction, and prolapse become more noticeable around menopause. Rectal pain can also signal hemorrhoids or other conditions. Persistent pain should always be assessed by your doctor.

What can help with pelvic and rectal pain in menopause?

Pelvic floor physiotherapy is one of the most under-used and effective tools many women haven't tried. For treatment options, speak with your doctor or a pelvic health specialist about what's appropriate for you.

Morphus shares educational information, not medical advice. Speak with your doctor about what's right for you.