Musculoskeletal Syndrome of Menopause
We all know about how hormonal shifts cause hot flashes and mood swings etc, but your hormones are also closely related to your muscle strength, bone density, and even how your joints move and flow.
Do you feel like your once-strong body is now weak, stiff, or unrecognizable?
Do you get up from sitting, and – damn – your knees protest, your back feels like it aged a decade overnight, and your muscles… Why are they so stiff and why do you keep getting injured? What used to be effortless now takes work.
Your body isn’t broken, it’s not failing you– it’s speaking to you, calling you to rise and respond. It’s time to reclaim your strength and to recalibrate and/or start to develop healthy habits of good nutrition and daily movement.
Your new body physiology needs different care, different fuel, and a different strategy.
Musculoskeletal Syndrome of Menopause. This new terminology describes how the decline of hormones impacts your muscles, joints, and bones. And it’s why so many women in their 40’s start to suddenly find themselves battling pain, injury, and loss of mobility.
- Joint pain and Stiffness: Movements that once felt fluid start to feel rigid, like your body’s protesting every step.
- Muscle weakness: The strength you once took for granted? Suddenly, it’s slipping, and building or maintaining muscles feels harder than before.
- Bone density loss: Your skeletal foundation is shifting, making fractures and osteopenia a real concern.
- Tendonitis, bursitis and ligament issues: More aches, more injuries, and slower recovery times, even from things that shouldn’t be a big deal.
- Reduced flexibility and mobility: Your body feels tighter, less responsive, and not quite as capable as it used to.
- Increased risk of osteoarthritis: Less estrogen means less joint lubrication and collagen production, leaving your joints vulnerable.
Here’s why this is happening: Let’s begin with estrogen.
Estrogen has been silently working behind the scenes your entire life, keeping your joints moving smoothly, maintaining strong bones, and reducing inflammation. When levels drop during menopause, cartilage thins, joints become less lubricated, and inflammation goes unchecked. Who knew, or appreciated that estrogen stimulates cartilage synthesis and synovial fluid production. Now you do!
To summary the effect of estrogen on the bones: estrogen has been balancing bone building osteoblasts and bone-removing osteoclasts your whole life, favoring bone building in your younger years. But with estrogen loss, there is accelerated osteoclastic activity, which translates to more bones being broken down.
And before I leave the impact of estrogen loss on muscles and bones, I might also mention that as estrogen decline, cortisol levels rise, contributing to muscle breakdown and metabolic dysfunction.
Progesterone’s role:
Progesterone helps with muscle repair as well as inflammation regulation. As levels decline, muscles take longer to recover from activity, and minor aches and injuries take longer to heal.
Testosterone and DHEA:
Women need these anabolic (building) hormones (called androgens) to maintain muscle mass, tendon strength, and bone density. When levels decline, muscles weaken, making it harder to maintain strength and stability. And when you are feeling weak, it’s harder to stay active – creating a frustrating cycle that can accelerate joint and bone issues. I have a more detailed post about these hormones here.
Inflammation & Oxidative Stress
Without estrogen and progesterone regulating inflammation, your body becomes more vulnerable to chronic, low-grade inflammation and oxidative stress. Translation: whatever inflammatory stressors you are experiencing from day to day, whether it’s dietary, environmental or even exercise, what can happen is that your tissues can become more damaged and inflamed without our dear estrogen and progesterone to squelch that inflammation.
Insulin Resistance & Weight Gain
Abdominal weight gain can also add extra stress to your joints and increases overall inflammation – exacerbating muscle and joint pain. Much more about the metabolic effects from hormone loss here.
Here’s your action plan. While menopause changes your body, it doesn’t weaken it – unless you let it. But that means that you might need to change just about everything you’ve been doing from your 20’s and 30’s.
Nourish Your Muscles & Joints with the Good Foods
What you eat directly impacts inflammation, muscle recovery, and bone strength.
Adopt an Anti-inflammatory diet, with colorful fruits and vegetables, and anti-inflammatory culinary herbs.
Think lubrication. Use healthy fats liberally, especially the high omega 3 foods, such as salmon and sardines, avocado, seeds and nuts. My other favorite omegas 3’s are extra virgin olive oil and flax oil and seeds. Healthy omega 6’s include hemp and evening primrose oil. And don’t forget the hydration, try for 1/2 of your body weight in ounces.
Prioritize healthy vegetarian and non-vegetarian proteins
Protein is essential for maintaining muscle mass and keeping your blood sugar stable. My rule of thumb is to eat one gram of protein per body pound.
Try for 30-40 grams of protein[1] at each meal. I know that seems like a lot, but have you tried building muscle after menopause? I guarantee you it’s not easy, and that you will need this extra protein.
Support Your Bones & Joints with Nutrients that build connective tissues.
This is usually achieved by eating a healthy omnivorous diet. Nutrient testing is available, but at minimum, have your vitamin D checked annually.
Vitamin D & Vitamin K, Zinc and Calcium: Essential for bone strength and often need to be supplemented, as getting adequate dietary minerals can be challenging, even with conscious effort.
Magnesium: Helps with muscle recovery and relaxation. Found in leafy greens, nuts, and seeds. Magnesium glycinate is my recommended form for muscles.
Collagen: Supports joint and tendon health. Bone broth or a high-quality collagen supplement can help, but keep in mind that collagen is not a complete protein, so don’t rely too heavily on this.
And lastly, Movement is EVERYTHING when it comes to keeping your joints mobile and muscles and bones strong. Click here for my menopausal exercise prescription blog. [2]
link to the anabolic resistance blog
link to menopausal exercise prescription
