Declining estrogen weakens pelvic muscles, connective tissue, bladder & urethra — reducing collagen, tone & elasticity. This raises risks of stress urinary incontinence, urgency, mixed incontinence & pelvic organ prolapse. Proper pelvic floor training improves symptoms in up to 92% of women. 2025 AUA guidelines strongly recommend local vaginal estrogen. Pelvic floor physiotherapist assessment is essential to distinguish weak vs hypertonic pelvic floor. Early action yields bes

Perimenopause vaginal dryness is part of a medical syndrome called GSM — Genitourinary Syndrome of Menopause — that also affects your bladder, urethra, sexual function and tissue health. Unlike hot flashes, GSM does not improve on its own. It progressively worsens without treatment. The 2025 AUA guideline — the most comprehensive ever produced — confirms safe, effective treatments exist, from local vaginal oestrogen to pelvic floor physiotherapy. Most women are never offered