Menopause MOT: Pelvic and Musculoskeletal Physiotherapy in London
One 60 minute appointment that looks at your pelvic floor, your joints and your strength together, so you leave knowing what is going on and what to do about it. Seen in our Central London clinic by a specialist pelvic health physiotherapist.
Is the Menopause MOT right for you?
Most people book this because something has changed and they are not sure what is normal. It is worth booking if you have noticed any of the following.
- Joints that ache or feel stiff, especially first thing in the morning
- Feeling weaker, or unsure whether strength training is still safe for you
- Needing the toilet urgently, or leaking when you cough, laugh, lift or run
- A feeling of heaviness or dragging in the pelvis
- Pelvic discomfort, or discomfort during sex
- Not knowing what kind of exercise is useful at this stage
- Wanting to protect your bone and muscle strength for the long term
- Pelvic floor symptoms that started or got worse around perimenopause
This appointment is physiotherapy, not medical menopause management. Decisions about HRT and medication sit with your GP or menopause specialist, and we are happy to work alongside them.
What is the Menopause MOT?
The Menopause MOT is a single 60 minute assessment that looks at two things at once: how your pelvic floor is working, and how your joints, muscles and movement are coping with this stage of life.
Those two things are usually treated separately, which is part of the problem. Falling oestrogen can affect bladder control, pelvic floor support and comfort, and at the same time change how tendons, joints and muscles feel and recover. Assessing them together gives you one picture and one plan, instead of two appointments that never quite join up.
What happens in your 60 minutes
- 1Your story. What you have noticed, when it started, your medical and birth history, what you want to get back to.
- 2Musculoskeletal screening. Posture, spine, hips, shoulders and any painful areas you have flagged.
- 3Movement and strength. How you move, lift, balance and load, and where strength has dropped off.
- 4Pelvic health assessment. Bladder and bowel habits, pelvic floor function and any symptoms of heaviness or leakage. An internal examination is offered only where it is clinically useful, it is always optional, and nothing happens without your consent. You can have the appointment without one.
- 5Your plan. A personalised exercise and strength programme, plus pelvic floor work if it is relevant to you.
- 6Explanation and next steps. What is driving your symptoms, what you can change, and what to do if something needs a GP or specialist opinion.
What you leave with
- A clear explanation of what is going on, in plain language
- A personalised exercise and strength plan you can actually follow
- A pelvic floor programme, where it is relevant to you
- Practical changes for bladder habits, loading and daily activity
- A referral or signpost to your GP or a specialist if anything needs their input
Who you will see
Your Menopause MOT is carried out by Fara Sonday, a specialist pelvic health, oncology and musculoskeletal physiotherapist who qualified in 2005 and founded PhysioReform in 2018. She is registered with the HCPC and the Chartered Society of Physiotherapy, and is a member of POGP and The Pelvic Floor Society. Many people find pelvic health hard to talk about, and her clinics are run accordingly.
Menopause MOT price and booking
Payment is taken on the day. If you use private medical insurance, contact the clinic before booking.
Understanding perimenopause and menopause
What is perimenopause?
Perimenopause is the transitional phase leading up to menopause, when your oestrogen and progesterone levels begin to fluctuate. It typically starts around 45, though it can begin from the late 30s to early 50s, and can last months or several years.
- Irregular periods
- Hot flashes and night sweats
- Sleep disturbances and fatigue
- Mood swings and irritability
- Vaginal dryness and discomfort
- Brain fog and poor concentration
- Joint and muscle aches
- Reduced fertility, though pregnancy is still possible
What is menopause and postmenopause?
Menopause is diagnosed after 12 consecutive months without a period, not caused by another medical condition. The average age in the UK is around 51. Postmenopause follows and continues for the rest of your life. Symptoms often continue for a time, while bone thinning and cardiovascular risk can increase without proper management.
Why hormonal changes affect joints, muscles and the pelvic floor
Falling oestrogen does not only affect your reproductive system. It also influences bone density, muscle strength, joint flexibility, pelvic floor function, bladder control and sleep. This is why physiotherapy that looks at your joints and your pelvic floor together, rather than separately, can make a real difference.
Related support at PhysioReform
Frequently Asked Questions
Can physiotherapy help with menopause symptoms?
Yes, physiotherapy can help manage several menopause-related symptoms, particularly urinary incontinence, pelvic floor dysfunction, joint and muscle aches, and changes in pelvic organ support. Treatment includes pelvic floor rehabilitation, targeted exercise and education on hormonal changes affecting connective tissue and muscle strength. It works well alongside medical management, including HRT where appropriate for your circumstances.
What is the Menopause MOT?
A Menopause MOT is a comprehensive physiotherapy assessment covering pelvic floor function, bladder and bowel symptoms, joint and muscle health, bone density risk factors and general wellbeing during perimenopause and menopause. It identifies issues early and creates a personalised plan combining exercise, pelvic health treatment and lifestyle advice, informed by Pelvic Floor Society guidance on menopausal care.
Why do my joints and muscles ache more during perimenopause?
Falling oestrogen levels during perimenopause affect collagen production, tendon elasticity and muscle mass, which can increase joint stiffness, muscle aches and injury risk. Many people also experience reduced muscle strength and changes in bone density during this transition. Targeted strength training and physiotherapy input can help manage these symptoms and maintain long-term musculoskeletal health effectively.
Can menopause cause urinary incontinence?
Yes, declining oestrogen during menopause can weaken pelvic floor muscles and the tissues supporting the bladder and urethra, contributing to stress or urge urinary incontinence. This is common but not something you need to just accept. Pelvic floor physiotherapy, following POGP-recommended approaches, often significantly improves bladder symptoms through targeted muscle retraining and lifestyle strategies.
Do I need to be taking HRT to benefit from physiotherapy?
No, HRT isn’t required to benefit from physiotherapy, and treatment is effective whether or not you’re using hormone therapy. Pelvic floor exercises, strength training and symptom management strategies work independently of HRT, though the two can complement each other. Many people attend our Bloomsbury clinic for physiotherapy support before, during or instead of starting HRT.
