OBSAH

Urinary Incontinence and Lower Abdominal Pain After Age 40: A Common Problem with a Solution

Picture of tobe_admin

tobe_admin

After turning 40, many women begin to notice changes in their pelvic area and lower abdomen that seem to appear out of nowhere. More frequent urine leakage when laughing, sneezing, coughing, or during physical exertion, as well as pressure or pain in the lower abdomen—these are all signs that cannot be ignored.

These problems aren’t just “part of getting older” or perimenopause. They can be related to hormonal changes as well as a weakened pelvic floor. The good news is that they can be treated. One of the most effective options is gynecological physical therapy.

A Topic Women Often Keep Quiet About—Incontinence and Undiagnosed Pain

The myth that urinary incontinence is a normal part of aging is still widespread. Many women keep their difficulties to themselves—whether out of embarrassment or because they believe there is nothing that can be done about it.

“As we age, estrogen levels drop, metabolic activity decreases, and the pelvic floor muscles weaken. This is precisely what can cause urinary incontinence or pain,” explains physical therapist Katarína Hanuliaková, MSc. from the IntimFyzio.

Why does urinary incontinence occur after age 40?

Main Causes

  • Weakening of the pelvic floor muscles

  • Decline in estrogen and changes in the hormonal profile

  • Insufficient coordination of the deep stabilization system

  • Increased pressure on the bladder when coughing, laughing, or exercising due to a weakened pelvic floor

Lower abdominal pain with no apparent cause—what causes it?

Even if gynecological or urological examinations yield negative results, the pain may persist. This is often a functional issue, such as a chronically overworked or, conversely, weakened pelvic floor.

“From my perspective, this pain may be related to either significant weakening or overuse of the pelvic floor, which causes irritation throughout the entire system,” says Katarína Hanuliaková.

How does pelvic floor physical therapy help?

Intimate physical therapy focuses on restoring the function of the pelvic floor muscles, which support the bladder, uterus, and rectum. Properly conducted therapy:

  • Reduces urine leakage,

  • relieves pain,

  • restores the elasticity and strength of the pelvic floor,

  • improves posture and breathing.

The Physiotherapy Examination Process

What to Expect?

  • Medical history and consultation with a gynecological physical therapist,

  • assessment of posture, breathing, and movement patterns,

  • palpation of the pelvic floor while maintaining privacy,

  • developing an individualized treatment plan

Pads are not a permanent solution

Many women turn to incontinence pads as their only solution. However, these pads address the symptom, not the cause.

“With regular exercise and professional guidance, improvements can be seen after just a few weeks,” encourages patients Katarína Hanuliaková, a pelvic floor physical therapist.

Your body deserves some care

Urinary incontinence and pelvic pain after age 40 don’t have to be a permanent condition. With targeted gynecological physical therapy, you can feel good in your body again.

“The body has the ability to regenerate at any age. It just needs attention, support, understanding, and expert guidance,” concludes Hanuliaková, an expert in intimate physical therapy.

Are you interested in this topic?

Schedule an expert consultation at our IntimFyzio center.


Contact Us – Click Here


Check out the related article— click here

CITLIVÝ PRÍSTUP

Potrebujete viac?

Ak potrebujete vedieť viac, objednajte sa 

Objednať sa
SÚVISIACE TÉMY

→ Šestonedelie
→ Panvové dno
→ GravidityFyzio
→ KidsFyzio

The body does not need to be fixed. It needs to be understood.

I am a woman, wife, mother and physiotherapist. Over the years of practice, I have realised that health does not come only from eliminating symptoms or solving a specific problem. Real change comes when a person begins to better understand themselves, their body, and the way they live their life.

It was this idea that led me to create the space you know today as ToBe – a place where different areas of expertise, perspectives, and approaches to health are interconnected. A place that does not see a person only through a diagnosis or individual symptoms, but as a unique whole.

My professional journey began in physiotherapy and the musculoskeletal system. Over time, clients and their stories gradually led me deeper – from working with the body through the pelvic floor to understanding the meaning of emotions, the psyche, and the functioning of the nervous system. Today, I see the body as the bearer of a person’s story, and therapy as a space where we can get to know that story, understand it, and support its natural process of change.

How I work

Years of practice have taught me to slow down. To listen more. To place less emphasis on performance, results, or quick change.

In therapy, I strive to create a safe space where clients can become more aware of their bodies, their needs, and the connections between what they are experiencing and what is happening on a physical level. I don’t focus only on symptoms; I also look for their possible causes and the context in which they arise.

Over the years, I have become increasingly aware of how closely the body, mind, and nervous system are connected. This is why I naturally integrate a psychosomatic perspective and the principles of nervous system regulation into my work – gently, clearly, and always with respect for where each client is in their own process.

I believe the body has a remarkable capacity for healing and renewal. Sometimes it doesn’t need more pressure — it needs understanding, a sense of safety, and the right conditions to begin functioning in a different way.

What I can help you with

In my practice, I specialise mainly in:

  • urogynecological physiotherapy
  • pelvic floor dysfunction
  • incontinence
  • painful conditions after childbirth
  • preparation for childbirth and postpartum recovery
  • painful menstruation
  • pain during sexual intercourse
  • functional disorders of the musculoskeletal system
  • chronic pain without an organic cause
  • unintegrated scars
  • psychosomatic connections of health problems
  • regulation of the nervous system

Methods and approaches I use

In my work, I connect physiotherapy with knowledge from psychosomatics, work with the nervous system, and a holistic therapeutic approach. I mainly use:

  • urogynecological physiotherapy
  • pelvic floor therapy
  • diagnosis and therapy of functional disorders of the musculoskeletal system
  • visceral manipulation
  • osteopathic principles
  • craniosacral therapy
  • psychosomatic approach in physiotherapy
  • principles of nervous system regulation
  • knowledge from Somatic Experiencing® training

In therapy, I combine professional knowledge with a sensitive perception of the person and their story. My goal is not only to relieve the problem, but to support the client in better understanding themselves and their body.

ToBe – the concept

ToBe grew naturally out of the original IntimFyzio centre. Over time, I increasingly felt the need to bring different areas of expertise together and create a place where a person does not have to be divided into separate parts.

Today, ToBe is a multidisciplinary space where physiotherapy, psychology, psychotherapy, women’s health, traditional Chinese medicine, work with the nervous system, and other approaches come together – united by a common idea: to see a person in their entirety and create the conditions for health, growth, and a deeper connection with oneself.

Education and professional development

I studied physiotherapy at the Faculty of Medicine of Comenius University in Bratislava, and completed my master’s degree at the University of Brighton in the United Kingdom.

I have completed a specialisation in functional and structural disorders of the musculoskeletal system at the Slovak Medical University in Bratislava. I hold a licence for independent medical practice and am a member of the Slovak Chamber of Physiotherapists.

Training that has significantly shaped my therapeutic approach

  • Somatic Experiencing® (currently in training, Lilian Troost)
  • Psychosomatic approach in physiotherapy (CKP Edu, Prague)
  • Visceral manipulation and osteopathic approach (Inge Schuermans, MSc)
  • Birth trauma in physiotherapy and self-regulation tools in client practice (Mgr. Radka Tomášková)
  • Holistic approach to scar and pelvic floor therapy (PhDr. Michaela Prokešová, PhD.)
  • Traditional care for women and mothers (Angelina Miranda Martinez)
  • Osteopathic approach in pregnancy and gynaecological dysfunctions (Inge Schuermans, Jory Paul)
  • Ludmila Mojžišová method (Mgr. Jana Jedličková)
  • Physiotherapy of pelvic floor dysfunction and urinary incontinence (Prof. Magdaléna Hágovská, Mgr. Zuzana Woleková)
  • Craniosacral therapy (Mgr. Helena Toušková, Upledger Institute)
  • Certified DNS Therapist Diploma (Prof. Pavel Kolář)
  • Diagnosis and Therapy of Functional Disorders of the Musculoskeletal System (Eva Janíková)
  • Stott Pilates (Jitka Kadish)

I believe health is not a goal to be achieved. It is a relationship we build with ourselves, our bodies, and our lives – and it is a journey I love to accompany my clients on.