Menopause marks the time in a woman’s life when menstruation stops. This also means that there is a change in ovarian function and there is no longer reproductive potential. The average age that a woman can go through menopause is 45-50 years; however, some women can see changes happening in their mid-30’s.

During menopause, there is a decrease in estrogen production from the ovaries. This does not affect just the reproductive system. Estrogen receptors have been found in many other organs such as the skin, heart, brain, blood vessels, bone, and the urinary bladder. Within the reproductive system, a woman may notice atrophy of the breasts, vagina, and uterus. The pelvic floor muscles also lose tone and strength. This is why the symptoms of menopause are so varied and not just within the reproductive system. Some of the common symptoms include the following: hot flashes, sweats, insomnia, decreased libido, short term memory loss, headaches, anxiety, vaginal dryness and burning or itching, and urinary incontinence. Even though the ovaries no longer produce estrogen, they will continue to produce testosterone. This is to help prevent bone loss, decreased muscle mass, and can help relieve some of the symptoms of menopause.

There are two ways that a woman can go through menopause: natural or surgical. Natural menopause is a gradual decrease in estrogen production. It can start many years before a woman goes through menopause and can be labeled as perimenopause. During this time, a woman may experience irregular periods and spotting, the number of days between periods can shorten or lengthen, hot flashes can be present, and there can be vaginal dryness and pelvic floor muscle weakness. There is potential for any of the symptoms of menopause to be present during perimenopause. Surgical menopause occurs when a woman has a hysterectomy, with or without the removal of the ovaries. The symptoms of menopause can start immediately following surgery.

Do you wonder what you are able to do to help with the symptoms of menopause? Strengthening your pelvic floor muscles is the best way a woman can independently address her menopause symptoms. Stronger muscles can help prevent urinary incontinence and pelvic organ prolapse. There is also evidence that performing kegel exercises can help with sexual function. Using the Joy ON Kehel can help you strengthen your pelvic floor muscles.

When you insert the Kehel be sure to use plenty of water-based lubricant since decreased vaginal dryness may occur with menopause. If you are not having penetrative intercourse with your partner, then it may be uncomfortable to insert the Kehel initially. Insert the Kehel slowly into the vagina, using plenty of lubrication and while breathing deeply and relaxing. You should not feel pain when you insert the Kehel. If you do, please stop and consult your physician or pelvic health physical therapist.

Once you have inserted the Kehel, you may begin by performing an assessment to determine the initial strength of your pelvic floor muscles. Be sure you are signed into your account so you can use the My Calendar part of the app to track your progress. After doing the assessment you may proceed to the grip exercises or the contraction speed exercises. The grip exercises are for strengthening the pelvic floor muscles and the contraction speed exercises are for improving your timing and strength. Most of your initial questions about the Kehel can be answered at this link:

The grip exercises on the Kehel app where you contract to lift the weight from the floor is an excellent exercise for improving muscle strength. To perform this exercise, you must be able to contract your pelvic floor muscles and keep the dumbbell in the air by holding the contraction for six seconds without using your stomach, buttocks, or leg muscles. If you can do this, then continue the exercises progressing from 10 to 30 to 60 to 100 repetitions. If you can’t do the exercise without straining or using your stomach of buttocks muscles, follow these links for more instructions on using the Manual Training mode for strengthening:

As always, if you have any questions or concerns, please email us at

Elizabeth Bell

Clinical Specialist in Women’s Health

Lola Rosenbaum

Doctor of Physical Therapy

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