Every woman (or person with ovaries) goes through menopause. That is a fact. Most of us associate menopause with hot flashes and weight gain which can occur. One common but often overlooked symptom is joint pain and that is what we are going to discuss today.
I recently read an excellent journal article talking about this topic. You can read the full article here:
Musculoskeletal syndrome in menopause
While many of us assume that aching joints are just a part of aging, the hormonal shifts during menopause—especially declining estrogen—can directly contribute to joint discomfort. In this post, we’ll explore the connection between menopause and joint pain. I will also offer you some solutions to help you manage and alleviate the symptoms so you can stay active and pain-free.
Prevalence of joint pain during menopause
Joint pain is a common symptom experienced by many women during menopause. Studies suggest that up to 50-60% of menopausal women report some form of joint pain or stiffness, often referred to as “menopausal arthralgia.”
The decrease in estrogen, which has anti-inflammatory properties, contributes to increased inflammation and discomfort in the joints. Although joint pain can be mistaken for general aging, it is often directly linked to hormonal shifts during menopause.
I practiced as a PA in family medicine for over 8 years and I recall that a lot of my female patients in peri and post menopause had joint issues. These often occurred “out of the blue” with no known trigger (i.e. trauma or overuse injury). At the time, I had no idea that declining estrogen was a potential culprit as I never learned that in my medical training. Looking back, I am realizing how much of a disservice this was to my patients and the lack of understanding the medical profession has about menopause.
Hormonal Changes and Joint Health
Role of Estrogen in Joint Health
Estrogen plays a critical role in maintaining joint health by reducing inflammation and supporting the production of collagen, which helps to cushion and lubricate our joints. Estrogen also promotes bone density which prevents excessive wear and tear on the joints.
Impact of Declining Estrogen Levels on Inflammation and Joint Pain
As estrogen levels decline during menopause, inflammation can increase, leading to joint pain and stiffness. The loss of estrogen’s protective effect on the joints results in a higher risk of conditions like osteoarthritis, causing discomfort in areas like the hands, knees, and hips. This hormonal shift causes joint pain (arthralgia) to become a common complaint of women in menopause.
Common Types of Joint Pain in Menopause
Frozen Shoulder (Adhesive Capsulitis)
Frozen shoulder is a condition where the shoulder joint becomes stiff, painful, and losses it’s full range of motion, hence the name, “frozen shoulder”. Women will often complain that they cannot reach back and hook or unhook their bra. Frozen shoulder may be linked to declining estrogen levels, which reduces joint lubrication and increases inflammation, making the shoulder joint more prone to injury and stiffness.
Plantar Fasciitis
Plantar fasciitis is heel pain caused by inflammation of the plantar fascia, which is the ligament that supports the arch of the foot. During menopause, hormonal changes can weaken connective tissue, contributing to this painful condition. Estrogen’s decline may reduce the elasticity and resilience of the fascia, leading to heel discomfort, especially in women who are active or overweight.
Contributing Factors to Joint Pain in Menopause
Weight Gain and Its Effect on Joints
During menopause, many women experience weight gain due to metabolic changes. Extra weight places added stress on our weight-bearing joints like the knees, hips, and spine. This extra stress accelerates joint wear and increases our risk of osteoarthritis and inflammation.
Sedentary Lifestyle vs. Activity Levels
Inactivity can lead to joint stiffness and muscle weakness, worsening joint pain. Regular movement helps to keep our joints flexible and strengthens the muscles that support them, while a sedentary lifestyle increases both stiffness and discomfort.
Stress and Cortisol’s Role in Inflammation
Chronic stress elevates our cortisol levels. Cortisol is a hormone that can increase inflammation in our body when it is elevated for long periods of time. This may contribute to joint pain, particularly in menopausal women who experience stress-related hormonal imbalances.
Poor Diet
Diets high in processed foods, sugars, and unhealthy fats can contribute to systemic inflammation, worsening joint pain. Conversely, an anti-inflammatory diet rich in whole foods, healthy fats, and plant-based proteins can help reduce joint discomfort.
For more information on an anti-inflammatory diet, check out this post:
Anti-inflammatory Diet in Menopause
Management and Treatment Options
Anti-Inflammatory Diet and Supplements
An anti-inflammatory diet as discussed above, can help alleviate joint pain by reducing systemic inflammation.
Omega-3 fatty acids (found in flaxseeds, chia seeds, and walnuts) reduce joint inflammation, while turmeric contains curcumin, a natural anti-inflammatory compound that may help ease joint discomfort.
Importance of Strength Training and Mobility Exercises
Strength training helps build muscle to support and stabilize joints, reducing strain and pain. Mobility exercises, such as stretching and range-of-motion activities, keep joints flexible and prevent stiffness.
Here are some helpful posts on strength training for women:
Strength Training for Women Over 40: A How to Guide
5 Quick Tips for Building Muscle After 40
Other Interventions
Yoga improves joint flexibility and reduces tension, while acupuncture may help alleviate joint pain by promoting blood flow and reducing inflammation. Both are natural, non-invasive approaches to managing discomfort. Yoga is also a treat stress management tool and natural way to calm both the body and mind.
Hormone Replacement Therapy (HRT)
HRT can help replenish declining estrogen levels, which may alleviate joint pain by reducing inflammation and improving overall joint health. Hormone replacement therapy has been found to be safe for most women, especially in those younger than 60 years of age and in the first 10 years from the onset of menopause. However, it’s important to discuss the benefits and risks with a healthcare provider before starting HRT.
Red Flags: When to Seek Medical Care for Joint Pain
Not all joint pain in menopause is from hormone fluctuations. It is important to discuss your symptoms with a medical provider to rule out other sources for your pain. Here are some red flags to watch out for:
- Severe or sudden joint pain that doesn’t improve with rest or over-the-counter medications
- Swelling, warmth, or redness around the joint, which could indicate infection or inflammation
- Limited mobility or difficulty using the joint or walking
- Joint deformity or noticeable changes in joint shape
- Persistent pain lasting more than a few weeks
- Unexplained weight loss or fever along with joint pain
- Recent trauma or injury to the area
If any of these symptoms occur, it’s important to seek medical advice to rule out more serious conditions.
Conclusion
I hope this article has helped you to understand the cause of joint pain in menopause and encouraged you to either seek the care of a menopause specialist or make adjustments to your lifestyle to help alleviate your pain. The important takeaway here is that you do not need to suffer, you are not alone, and there are treatment options out there to help you live a long and active life.
Comment below if you have any questions or concerns. I appreciate you taking the time to read this article, feel free to forward this on to a friend or family member you feel would benefit. Have a great week!
