Understanding Muscle and Joint Pain in Midlife Women: The Musculoskeletal Syndrome of Menopause
Anna Harrelson • June 22, 2024
Managing Muscle and Joint Pain During Menopause: Understanding the Impact of Estrogen on Musculoskeletal Health
I am diving into a topic that is near and dear to me as it was, in hindsight, my bodies way of telling me I was in perimenopause. It's a topic that many women experience but often don’t discuss enough: muscle and joint pain during the menopause transition. This discomfort is part of what’s known as the musculoskeletal syndrome of menopause. Let’s explore the physiology behind this and how you can combat it effectively.
The Role of Estrogen in the Musculoskeletal System
Estrogen plays a crucial role in maintaining musculoskeletal health. Estrogen receptors are present in various tissues, including muscles, tendons, ligaments, and bones. These receptors help regulate:
- Collagen Production: Estrogen stimulates collagen production, maintaining the strength and elasticity of connective tissues.
- Bone Density: Estrogen helps maintain bone density by balancing the activity of osteoclasts (cells that break down bone) and osteoblasts (cells that build bone).
- Muscle Mass: Estrogen influences muscle mass and strength, which can affect overall physical function.
- Anti-inflammatory Effects: Estrogen has anti-inflammatory properties that help reduce inflammation in the joints and muscles. This can alleviate pain and stiffness associated with menopause.
During menopause, the decline in estrogen levels leads to several changes:
- Decreased Collagen: Reduced collagen production makes tendons and ligaments less elastic, leading to stiffness and pain.
- Bone Loss: Lower estrogen levels accelerate bone loss, increasing the risk of osteoporosis and fractures.
- Muscle Weakness: Muscle mass and strength decrease, contributing to overall musculoskeletal discomfort.
- Increased Inflammation: The anti-inflammatory effects of estrogen diminish, leading to higher levels of inflammation, which can exacerbate joint and muscle pain.
Prevalence and Diagnosis of Musculoskeletal Disorders
- Osteoarthritis (OA): OA affects more than 30 million adults in the U.S., with women being more likely to develop it after menopause.
- Inflammatory Arthritis: Conditions like rheumatoid arthritis (RA) often onset between ages 40 and 60, with women being more commonly affected.
- Fibromyalgia: This condition is diagnosed in about 2-4% of the population, predominantly women, often triggered or exacerbated by menopause.
- Frozen Shoulder: Also known as adhesive capsulitis, it affects 2-5% of the population, with a higher incidence in women aged 40-60. It is characterized by stiffness and pain in the shoulder joint, often linked to hormonal changes during menopause.
These conditions are frequently treated with medications that manage symptoms but may not address the root cause related to hormonal changes.
Combatting Musculoskeletal Pain in Menopause
- Hormone Replacement Therapy (HRT)
- HRT can help mitigate the decline in estrogen levels, supporting musculoskeletal health. Consult with your menopause doctor to see if HRT is right for you.
- Regular Exercise
- Strength Training: Helps maintain muscle mass and bone density. Focus on weight-bearing exercises like lifting weights, squats, and resistance band workouts.
- Flexibility Exercises: Yoga and stretching routines can improve flexibility and reduce stiffness.
- Cardio: Activities like walking, swimming, and cycling promote overall health and support joint function.
- Balanced Nutrition
- Calcium and Vitamin D: Essential for bone health. Include dairy products, leafy greens, and fortified foods in your diet.
- Anti-inflammatory Foods: Incorporate foods rich in omega-3 fatty acids (like fish and flaxseeds), antioxidants (berries and nuts), and whole grains to reduce inflammation.
- Supplements
- Calcium and Vitamin D Supplements: If dietary intake is insufficient, consider supplements.
- Magnesium: Supports muscle and nerve function, helping to reduce cramps and spasms.
- Hydration
- Staying hydrated is crucial for joint lubrication and overall health. Aim for at least 8 glasses of water a day.
- Adequate Rest
- Ensure you get enough sleep to allow your body to repair and regenerate tissues. Aim for 7-9 hours of quality sleep each night.
- Professional Support
- Physical Therapy: A physical therapist can provide tailored exercises to improve strength and flexibility.
- Chiropractic Care: Can help manage pain and improve joint function through adjustments and other treatments.
Conclusion
Menopause brings various changes that can impact your musculoskeletal health, but understanding these changes and taking proactive steps can help manage and reduce muscle and joint pain. By incorporating a balanced approach of HRT, regular exercise, proper nutrition, and professional support, you can maintain your musculoskeletal health and improve your overall quality of life during the menopause transition and beyond.
Stay active, eat well, and take care of your body!
Dr. Anna
WonderCreek Health Blog
You’ve probably seen it popping up in wellness podcasts, health stores, or even your friend's supplement cabinet: bovine colostrum. Marketed for gut health, immune support, and recovery, this early-life nutrient source for calves is now showing up in adult wellness routines. But is it worth your time and money? As a lifestyle medicine physician focused on women’s midlife health and longevity, here’s what I want you to know before you jump on the colostrum bandwagon. Let’s Start With the Basics: What Is Colostrum? Colostrum is the first form of milk produced by mammals (including humans) in the first few days after giving birth. It’s loaded with antibodies, growth factors, and immune-modulating compounds designed to jumpstart a newborn’s immune system and line the gut. Bovine colostrum—from cows—is the form used in most supplements. It's freeze-dried and packaged into powders or capsules, and often promoted for: Gut barrier support ("leaky gut") Immune system priming Exercise recovery Anti-aging benefits But let’s be honest: just because something has growth factors doesn’t mean it belongs in your Amazon cart. Does the Science Support It? Evidence in humans is limited— but not nonexistent. Some small clinical studies have shown potential benefits: Gut health: In people with NSAID-induced intestinal permeability ("leaky gut"), bovine colostrum has been shown to reduce damage and symptoms. Immune function: Some data in athletes suggests reduced upper respiratory infections. Exercise recovery: A few studies report improvements in performance, gut comfort, or muscle soreness—especially in endurance athletes. But these benefits aren’t guaranteed. And the quality and dosage of colostrum varies widely, with no standardized formulation across brands. So Should You Take It? Here’s where my clinical voice kicks in: Before you reach for colostrum, ask yourself: Have you addressed the basics? Are you sleeping? Managing stress? Eating fiber and whole foods? Getting enough protein? Building muscle? Moving your body? Supporting your gut with real food (not just powders)? If the answer is no—then colostrum is not your next step. You’re throwing powdered fuel on an engine that’s missing spark plugs. Do you have dairy sensitivity? Colostrum is a dairy product. Even if it's low in lactose, it may not be tolerated by everyone. Are you already taking quality foundational supplements? Vitamin D, omega-3s, magnesium, creatine, iron (when needed), and probiotics have stronger bodies of evidence for many women in midlife. When Might It Be Worth Trying? Colostrum might be a reasonable add-on if you: Have mild gut symptoms (especially post-infectious or stress-related) Are recovering from illness or antibiotics Train hard and experience frequent upper respiratory issues Want to support your immune system during travel or stress Even then, I recommend: A 2–3 month trial only after dialing in basics Choosing a third-party tested brand Tracking symptoms and benefits Cost, Hype, and the Bigger Picture Many women I work with are overwhelmed by supplement costs. Colostrum can run $50–100/month —and that adds up. So here’s what I tell my patients: Just because something is trending doesn’t mean it’s essential. And just because it works for someone on TikTok doesn’t mean it’s the right tool for your body right now. Your body is an incredible machine. When you give it rest, movement, nourishment, and support—it can do amazing things. Colostrum is not magic. It’s just one tool in a very big toolbox. Bottom Line Colostrum may hality sources. You’re not broken. You might just need a reset—not another powder.
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