Aches, pains and menopause

Women between the ages of 40 and 60 years of age can experience muscle and joint pains due to hormonal changes. This fact is often not appreciated by women, their doctors and other treating health care professionals and as a result unnecessary treatments are directed at the problem.

Hormones are chemical messengers that trigger and control cellular functions. Many tissues and cells in our body have receptors for oestrogen and progesterone, the main female sex hormones. A receptor acts like a lock with the hormone acting as its key.

Before we discuss body pain let’s take a look at the hormonal changes of menopause and the time leading up to it.



What’s happening during menopause?


Menopause is defined as the time 12 months after a woman’s last period. Hormonal changes and fluctuations however occur up to 10 years before this and can continue for ten years or even longer after. Hot flushes and night sweats are the most well-known symptoms of the menopause but well before these occur there are many other symptoms also due to hormonal changes.

The perimenopause is the time leading up to the last period and sneaks up on many women.

Symptoms during the perimenopause are due to falling progesterone and fluctuating or even high oestrogen. They include-


  • Insomnia
  • Mood changes
  • Palpitations
  • Aches and pains
  • Fatigue
  • Brain fog and
  • Irregular periods.


As the ovaries stop producing both oestrogen and progesterone the periods stop and both hormone levels ‘flatline’. In early menopause, hot flushes and night sweats occur more prominently. Low levels of oestrogen also cause vaginal dryness, bladder problems and reduced bone health.


As we mentioned many cells in the body contain oestrogen receptors, including tendon and bone cells. Oestrogen and progesterone also have quite powerful anti-inflammatory effects. it is For these reasons that the menopause is associated with problems in the musculoskeletal system.


Musculoskeletal symptoms many women experience through the perimenopause and especially the early menopause include general stiffness and aching of joints particularly hands, feet and also the back. There is an increased risk of tendon problems such as Achilles tendon pain, tennis elbow, and gluteal tendinopathy (lateral hip pain).


Other conditions affecting the body that can become worse during this time  are fibromyalgia, restless legs syndrome and any chronic pain situation. These are all exacerbated by another common menopausal symptom -insomnia. As everyone knows, not getting a good night’s sleep makes everything worse!



What can be done?


Many women find that their aches and pains improve after starting hormone replacement therapy.

Since tendon problems can hang around a long time once they are established, trying to avoid them is also worthwhile. During the menopause the tissues may require more time to recover than they used to so using slightly lighter loads (such as less weight, repetitions or training distance) and exercising a bit less frequently can help avoid tendon problems. This is a tricky balance as tendons, joints and muscles all need to be worked to remain healthy and of course our general health also benefits from regular physical activity.



Tips to prevent injury


  • Vary your activity – do a few things eg walking, weights, gardening, yoga, boxing.
  • Be consistent – avoid long breaks and restarts.
  • Introduce changes gradually – slowly build up your levels so your body has time to adjust.



Great activity choices for mid-life women


A good activity is one you enjoy!


The aim of being active during mid-life is to remain healthy, vital and full of energy! Any exercise that builds muscle and protects your bones and heart is good for you.


Here are some suggestions (of course there are many more!)


  • Walking
  • Running
  • Swimming
  • Weights
  • Boxing
  • Yoga
  • Dance
  • Heavy gardening
  • Cycling
  • Aerobic
  • Kayaking
  • Tennis
  • Pilates



150 minutes of huff and puff and 2 sessions of strength work a week is the recommended dose of physical activity for Australian adults.



Written by Dr Louise Tulloh



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