Menopause, Weight Loss, and Pelvic Floor Changes: Clinical and Aesthetic Considerations
Varshita Chirumamilla, Kelly H. TylerBACKGROUND
Menopause is associated with hormonal, structural, and functional changes affecting the vulvovaginal tissues, pelvic floor, and urinary tract. Weight loss may further alter soft-tissue volume and body composition, although effects on pelvic floor function remain incompletely understood.
OBJECTIVE
The aim of this study was to review menopause-associated vulvovaginal and pelvic floor changes and discuss implications for dermatologic evaluation, weight loss, symptom management, and procedural counseling.
MATERIALS AND METHODS
A narrative review of literature addressing menopause, pelvic floor dysfunction, weight loss, glucagon-like peptide-1 receptor agonists, pelvic floor rehabilitation, and emerging vulvovaginal therapies was performed.
RESULTS
Menopause-associated tissue remodeling may contribute to genitourinary syndrome of menopause, urinary symptoms, sexual dysfunction, and pelvic floor disorders. Weight loss may improve obesity-associated urinary incontinence but can also reduce lean mass and external soft-tissue volume. Evidence regarding glucagon-like peptide-1 therapies and pelvic floor function remains limited. Pelvic floor physical therapy is an established treatment, whereas high-intensity focused electromagnetic therapy shows preliminary evidence of benefit.
CONCLUSION
Dermatologists should recognize functional symptoms, provide evidence-based counseling, and coordinate care with gynecology, urogynecology, urology, and pelvic floor physical therapy while approaching emerging procedural therapies cautiously.