Perimenopause, the transitional phase leading up to menopause, typically occurs in women between the ages of 40 and 50. During this time, women experience significant hormonal fluctuations, which can lead to various symptoms, including joint and muscle pain.
Keep reading to understand how these symptoms present and the strategies available for management that can improve your quality of life.
Understanding Perimenopause and Hormonal Changes
Perimenopause is characterized by a gradual decline in estrogen levels, alongside fluctuations in other hormones such as progesterone and testosterone. Estrogen plays a crucial role in maintaining bone density and muscle mass, as well as modulating inflammation. As estrogen levels decrease, women may experience increased susceptibility to musculoskeletal issues, including joint pain, muscle aches, and stiffness.
Prevalence of Joint and Muscle Pain in Perimenopausal Women
Joint and muscle pain are common complaints among perimenopausal women. Research indicates that up to 50-60% of women in perimenopause experience some form of musculoskeletal pain. This pain can affect various parts of the body, including the knees, shoulders, neck, and hands. The pain may present as stiffness, soreness, or a deep, aching sensation that can impact daily activities and reduce overall mobility.
How Joint and Muscle Pain Presents
1. Joint Pain:
Joint pain during perimenopause often presents as stiffness, particularly in the morning or after periods of inactivity. Women may notice pain in the knees, hips, and hands, with some reporting swelling or a sensation of warmth around the affected joints. Osteoarthritis, a condition where the protective cartilage that cushions the ends of bones wears down over time, can also become more pronounced or develop during perimenopause due to the decreased estrogen levels.
2. Muscle Pain:
Muscle pain can manifest as soreness, tightness, or cramping. It is not uncommon for women to experience generalized muscle discomfort, often described as similar to the feeling after an intense workout. This pain can affect the back, neck, and shoulders, and it may be exacerbated by stress or lack of sleep, which are common issues during perimenopause.
3. Fibromyalgia-like Symptoms:
Some perimenopausal women may experience symptoms resembling fibromyalgia, a condition characterized by widespread musculoskeletal pain, fatigue, and tender points throughout the body. This may be linked to hormonal changes, increased sensitivity to pain, and other factors such as stress.
Factors Contributing to Pain During Perimenopause
1. Hormonal Fluctuations:
The decline in estrogen during perimenopause is a primary factor contributing to joint and muscle pain. Estrogen has anti-inflammatory properties, and its reduction can lead to increased inflammation in joints and muscles.
2. Changes in Body Composition:
During perimenopause, women may experience changes in body composition, such as increased fat mass and decreased muscle mass. These changes can place additional strain on joints and muscles, leading to pain.
3. Reduced Bone Density:
Estrogen is critical for bone health, and its decline can lead to a decrease in bone density. This can increase the risk of osteoporosis and fractures, further contributing to musculoskeletal pain.
4. Weight Gain:
Many women experience weight gain during perimenopause, which can add stress to weight-bearing joints, such as the knees and hips. This additional stress can lead to pain and discomfort.
 Management and Treatment of Joint and Muscle Pain
1. Lifestyle Modifications:
Regular physical activity is essential for managing joint and muscle pain during perimenopause. Exercise helps to maintain joint mobility, strengthen muscles, and reduce inflammation. Activities such as swimming, walking, yoga, and strength training are beneficial . Maintaining a healthy weight through diet and exercise can also reduce stress on joints and improve pain symptoms.
2. Hormone Replacement Therapy (HRT):
HRT can be an effective treatment for reducing joint and muscle pain in perimenopausal women. By supplementing estrogen, HRT helps to reduce inflammation and improve bone and muscle health. However, HRT may not be suitable for all women, and its risks and benefits should be discussed with a healthcare provider.
3. Pain Management:
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can be used to manage pain and inflammation. Over-the-counter pain relief creams and gels may also provide temporary relief. In some cases, physical therapy may be recommended to improve joint function and reduce pain.
4. Nutritional Supplements:
Calcium and vitamin D supplements are important for bone health and may help to reduce the risk of osteoporosis. Omega-3 fatty acids, found in fish oil, have anti-inflammatory properties and may help to reduce joint pain.
5. Stress Management:
Stress can exacerbate pain and other perimenopausal symptoms. Techniques such as mindfulness, meditation, and deep breathing exercises can help manage stress levels and improve overall well-being.
6. Alternative Therapies:
Some women find relief from joint and muscle pain through alternative therapies such as acupuncture, massage, and chiropractic care. These therapies can help to reduce pain, improve circulation, and promote relaxation.
Conclusion
Joint and muscle pain are common and often debilitating symptoms of perimenopause. Understanding the hormonal changes and other factors that contribute to this pain can help women and healthcare providers develop effective management strategies. Through lifestyle modifications, medical treatments, and alternative therapies, women can find relief from pain and improve their quality of life during this transitional phase. At Sheddon Physiotherapy and Sports Clinic we offer massage therapy, chiropractic and physiotherapy which all can help with the joint and muscle pain experienced during perimenopause.
References
1. Mishra, G. D., Dobson, A. J., & Brown, W. J. (2003). Physical and mental health: changes during menopause. Quality of Life Research, 12(4), 405-412.
2. Greendale, G. A., & Gold, E. B. (2005). Lifestyle factors: Are they related to vasomotor symptoms and do they modify the effectiveness or side effects of hormone therapy? The American Journal of Medicine, 118(12), 148-154.
3. Nazarpour, S., Simbar, M., & Tehrani, F. R. (2016). Factors affecting sexual function in menopause: A review of the literature. The Journal of Menopausal Medicine, 22(2), 77-82.
4. Harlow, S. D., Gass, M., Hall, J. E., Lobo, R., Maki, P., Rebar, R. W., … & STRAW+ 10 Collaborative Group. (2012). Executive summary of the Stages of Reproductive Aging Workshop+ 10: addressing the unfinished agenda of staging reproductive aging. Menopause, 19(4), 387-395.
5. Ablin, J., Neumann, L., & Buskila, D. (2008). Pathogenesis of fibromyalgia–a review. Joint Bone Spine, 75(3), 273-279.
6. Prior, J. C. (2014). Perimenopause: The complex endocrinology of the menopausal transition. Endocrine Reviews, 26(5), 603-630.
7. Gallagher, J. C., & Tella, S. H. (2014). Prevention and treatment of postmenopausal osteoporosis. The Journal of Steroid Biochemistry and Molecular Biology, 142, 155-170.
8. Pal, L., & Santoro, N. (2002). Premature ovarian failure. The Lancet, 360(9341), 263-271.
9. North American Menopause Society. (2010). Estrogen and progestogen use in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause, 17(2), 242-255.
10. Burrows, M., Neveux, L., & Weaver, C. M. (2010). Calcium intake and bioavailability in adolescents. Nutrition Today, 45(6), 268-274.
11. Daly, R. M., & Gianoudis, J. (2014). Exercise for improving bone strength: the role of muscle in bone development and maintenance. Osteoporosis International, 25(2), 881-891.
12. Rossouw, J. E., Anderson, G. L., Prentice, R. L., LaCroix, A. Z., Kooperberg, C., Stefanick, M. L., … & Writing Group for the Women’s Health Initiative Investigators. (2002). Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA, 288(3), 321-333.
13. Shifren, J. L., & Gass, M. L. S. (2014). The North American Menopause Society recommendations for clinical care of midlife women. Menopause, 21(10), 1038-1062.
