The Musculoskeletal Effects of Menopause
For a lot of women, menopause is a stone cold bitch.
Fifty-one percent of humans are born with ovaries. As they go through menopause, more than 70% of cis women will experience unpleasant musculoskeletal symptoms; 25% will be disabled by their severity. These symptoms include--but are not limited to--muscle and joint pain, increased tendon and ligament injury, loss of muscle and bone density, cartilage damage, and increased systemic inflammation. Despite these numbers, 40% will have no structural findings on imaging exams.
Estrogen impact nearly all types of musculoskeletal tissue, including bone, muscle, tendon, ligament, cartilage, and adipose (fat). During perimenopause, women lose an average of 10% of their bone density. After menopause, muscle mass in women decreases 0.6% every year. (Eek!)
Fifty-one percent of humans are born with ovaries. As they go through menopause, more than 70% of cis women will experience unpleasant musculoskeletal symptoms; 25% will be disabled by their severity. These symptoms include--but are not limited to--muscle and joint pain, increased tendon and ligament injury, loss of muscle and bone density, cartilage damage, and increased systemic inflammation. Despite these numbers, 40% will have no structural findings on imaging exams.
Estrogen impact nearly all types of musculoskeletal tissue, including bone, muscle, tendon, ligament, cartilage, and adipose (fat). During perimenopause, women lose an average of 10% of their bone density. After menopause, muscle mass in women decreases 0.6% every year. (Eek!)
Inflammation
More than half of perimenopausal women report symptoms of arthralgia (joint pain), even without corresponding MRI results as "proof." Decreased estrogen leads to an increase in inflammatory cytokines. These proteins can degrade muscle tissue and impair the body's ability to repair muscle damage from use or injury. These cytokines can also reduce muscle function and increase the accumulation of adipose tissue.
Sarcopenia
Sarcopenia is the age-related loss of muscle mass, strength, and function. It is most commonly characterized by muscle weakness. Postmenopausal women often experience a rapid decline in muscle mass and strength, leading to a higher likelihood of age-related frailty.
Muscle stem cell changes
Muscle stem cells (aka satellite cells) help repair muscle tissue after injury or use. They also contribute to muscle growth and power. Estrogen helps activate muscle stem cells' regenerative ability, as well as helping those cells multiply and grow. When estrogen decreases, muscle tissue is more prone to injury and slower to heal.
Osteopenia & osteoporosis
Estrogen decrease is associated with significant bone less, increasing fragility and risk of fracture. Seventy percent of hip fractures happen in women. Fractures due to osteoporosis are difficult to heal, and can lead to chronic pain, disability, or even death. Osteoporosis affects some 200 million postmenopausal women worldwide.
Osteoarthritis and cartilage damage
Osteoarthritis in women increases dramatically around menopause. Recent studies indicate that women experience a greater severity of arthritic pain than men do. Cartilage cells are partly regulated by estrogen; its decrease during menopause leads to changes in connective tissue, including the intervertebral disks of the spine.
Exercise as treatment option
Prevention and treatment options for the musculoskeletal symptoms of menopause vary. Although it can be extremely useful, hormone therapy is not suitable for everyone. Dietary changes and nutritional supplements are another option, but can be controversial and are in need of more study.
Out of all the possible modalities, exercise is the most widely agreed-upon for its postmenopausal health benefits.
Out of all the possible modalities, exercise is the most widely agreed-upon for its postmenopausal health benefits.
