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Staying strong and independent after 50 depends on your pelvic floor as much as on your arms and legs. It's the base of your core, and it works under every stair you climb, every bag you carry and every time you stand up from a chair. Menopause changes the tissue that support is built from, which is often when women first notice heaviness or pressure low down. That support can be trained. I'm Isa Herrera, MSPT, CSCS, a pelvic floor physical therapist, and I've worked with 22,000 women over 21 years.
Key Takeaways
What topics does this guide cover?
Ask what it takes to stay strong after 50 and most advice answers with muscle. Legs for the stairs, arms for the groceries, a strong core.
That answer is right, and it leaves out the base those muscles push from.
Your pelvic floor sits at the bottom of your core. When its support changes, you tend to feel it in ordinary moments first: a heaviness when you've been standing, pressure when you lift, a dragging feeling low down.
Many women respond by quietly doing less. I'd rather explain what's changing, because independence and the pelvic floor are the same conversation.
Your pelvic floor is the base of your core, so it works in every lift, carry, climb and stand.
Your pelvic floor is a hammock of muscle and connective tissue across the bottom of your pelvis. It holds up your bladder, your uterus and your rectum.1
It doesn't work alone. It works with your deep abdominal muscles, your back and your breathing, which is why I teach it as the base of the core.
Every one of these everyday moves asks something of it:
Independence is built from those moments. Strong after 50 starts at the pelvic floor, and the rest of your strength stands on it.
Lower estrogen changes the tissue your support is built from, and many women first feel it as heaviness.
Menopause is usually described by its symptoms. Underneath the symptoms, it's a change in tissue.
That part is established. In 2014, two medical societies grouped the changes lower estrogen brings to the vulva, vagina and urinary tract under one name: genitourinary syndrome of menopause.2
Collagen is part of the picture. Skin can lose up to 30% of its collagen in the first five years after menopause.3,4 Those studies measured skin.
Separately, researchers have found estrogen receptors in human fascia, including the fascia of the pelvic floor muscle itself. That makes this tissue hormone-sensitive.5,6
Here's how I teach it. The connective tissue holding up your pelvic organs goes through a similar change, and I put it as 30% less collagen in the pelvic floor. That's my clinical framing, not a finding of those studies.
In my book Female Pelvic Alchemy, I list hormonal status among the factors behind prolapse, because women in menopause can develop it as estrogen levels fall.
I know this change from the inside. My own prolapse came at 41, after my daughter's birth, at the same time my menopause began early. When I teach this, I'm teaching something I've lived, not only something I've studied.
The tissue your support is built from changes with menopause. That support can be trained. The daily habits below are where that training starts.
When the hammock's support changes, an organ can drop and press down. That's pelvic organ prolapse.
Prolapse takes its name from the organ that's pressing down, but it's the same hammock and the same muscle group:
Women describe it as dragging, heaviness or a pressure that goes down. Other signs include a bulge at the vaginal opening, leaking, constipation and trouble fully emptying the bladder or bowel.
In my practice, I see menopause as one factor. Others add load over the years: childbirth, chronic coughing, long hours of standing, running, a hysterectomy and extra body weight.
A new bulge, any bleeding, or a sudden change in what you feel belongs with your doctor or clinician. Prolapse is diagnosed by an examination, and your clinician can tell you which organ is involved and what your options are. The daily habits below work alongside that care.
The dotted line in each panel marks where that organ normally sits. Compare each one with the normal pelvis, top left.
Fascia is the connective tissue that wraps your organs and links your bladder to your pelvic floor.
I teach fascia as a network of connective tissue that surrounds everything in the body. It's all connected.
Your bladder connects to the front wall of your pelvic floor through fascia, nerve and muscle. That's why strain in one place can show up somewhere else, and why a pelvic floor plan has to look at more than one muscle.
How fascia and your nervous system connect to your bladder and pelvic floor is one of the three discoveries I'm teaching live on November 14, in The Bladder Confidence Blueprint.
Stop the strain. Never push to empty, and exhale every time you lift.
Downward pressure is what a changing pelvic floor feels most. These habits take some of it away, and they count because you repeat them all day:
Nourishment works alongside the physical work. I made Total Fem Collagen to meet my standard for this stage.
I teach strength after 50 in three parts: movement, mindset and nourishment. I call it Whole-Woman Fem Care™. This article stays with two of them: movement, in the habits above, and nourishment, here. Nourishment works in conjunction with the physical work, and it never replaces it.
Your pelvic floor is muscle and connective tissue, and both are built from protein. So here's what I look for in a collagen at this stage:
When I made Total Fem Collagen, I built it to those three:
It's unflavored, it dissolves easily, and every Rootganic product is triple-tested.
"Before starting this brand, I have used numerous other brands over the past two years. TF Collagen is easy to use and has no discernible flavor, so I can use it every morning in my coffee. I don't really know that it is in my drink. It dissolves easily with no clumping, and does not dilute my coffee. However, the greatest selling point is that it contains all of the collagen sources that I require for an appropriate supplement."
Linda P. (Verified Customer. Results May Vary.)
60-Day Money-Back Guarantee on every Rootganic product.
Joining is free, and it gives you first access to Black Friday prices plus three live experiences with me.
The habits in this article are where training your pelvic floor starts. My live class on November 14 is where I take that training further, live with you.
Joining the Queen Bee VIP is free, and it gives you both: a seat at that class and first access to Black Friday prices. Join now, and you're in before VIP prices open on Saturday, November 14, at 6 PM ET. Membership comes with the Queen Bee Royal Treatment.
Shop early, from Saturday, November 14 at 6 PM ET through Wednesday, November 18, at VIP prices on Rootganic supplements, serums and select wellness programs, before the public sale opens November 19. That includes the Total Fem Collagen you just read about. You can also opt in to VIP text alerts for Lightning Deals.
Q: Is the Queen Bee VIP free, and what comes with it?
A: Yes, joining is free. Membership comes with the Queen Bee Royal Treatment: early VIP shopping from Saturday, November 14 at 6 PM ET through Wednesday, November 18, before the public sale opens November 19, plus three live experiences with Isa. Join the Queen Bee VIP.
Q: What if I can't make the live class on November 14?
A: Join anyway. The replay of The Bladder Confidence Blueprint goes out at 6 PM ET the same day, so you can watch it that evening.
Q: What's in Total Fem Collagen?
A: Four collagen sources for all five collagen types: grass-fed bovine, chicken broth collagen, Naticol® wild-caught marine collagen and eggshell membrane. L-Tryptophan makes every serving a complete protein with all nine essential amino acids, and each serving has 10 grams of protein. It's made without added vitamin C, on purpose, and it contains eggs and fish.
Q: How do I take Total Fem Collagen, and does it have a taste?
A: It's unflavored and dissolves easily. The label directs one full scoop (11.5 grams) mixed with your favorite food or beverage, 1 to 3 times per day, or as directed by your healthcare practitioner. A pouch holds 30 servings.
Q: What does the 60-day guarantee cover?
A: Every Rootganic product comes with a 60-day money-back guarantee. If it isn't right for you within 60 days, contact our team for your money back.
Learn more about the author, Isa Herrera, MSPT, CSCS, at isaherrera.com.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. This content is for educational purposes only and is not medical advice, diagnosis, or treatment. Please consult your qualified healthcare provider about your individual symptoms and before making changes to your care.
Isa Herrera, MSPT, CSCS is a licensed physical therapist, international best-selling author, and a leading pelvic floor and women's health specialist.
She holds a BA in Psychology and Biology from Fordham University and a Master of Science in Physical Therapy from Hunter College.
Over the course of her career, Isa has helped more than 21,000 women heal from pelvic floor dysfunction, vaginal pain, incontinence, and intimacy challenges.
She pioneered integrative modalities including Maya Abdominal Massage, Low Level Laser Therapy, Sound Healing, and Andean Energy Techniques at Renew Physical Therapy, her NYC-based healing center, where she has practiced since 2005.
Isa is the author of five books on pelvic health, including the international best seller Female Pelvic Alchemy and Ending Female Pain: A Woman's Manual.
She is the founder of PelvicPainRelief.com, an online school dedicated to helping women and health professionals access evence-based pelvic floor education.
