Many people only associate menopause with hot flashes and vaginal dryness, but menopause affects so much more than just that. A recent study has introduced the term Musculoskeletal Syndrome of Menopause (MSM) to describe the effects of menopause on the musculoskeletal system, driven by the significant drop in estrogen levels during this transition. Each year, approximately 2 million women in the U.S. enter menopause, with 70% experiencing MSM and 25% suffering severe symptoms. With menopause occurring between ages 45-55, it’s crucial to understand the symptoms and treatment options to optimize well-being during this stage of life.
What is MSM?
MSM encompasses several musculoskeletal challenges, including:
- Musculoskeletal pain
- Joint pain (arthralgia)
- Loss of lean muscle mass
- Bone density loss, increasing fracture risk
- Tendon and ligament injuries
- Frozen shoulder (adhesive capsulitis)
- Cartilage fragility, contributing to osteoarthritis
These issues stem from a decline in estradiol, a key form of estrogen essential for maintaining healthy bones, muscles, tendons, ligaments, and cartilage.
Key Changes During Menopause
- Increased Inflammation
Estrogen plays a crucial role in regulating inflammation. Its decline can exacerbate joint pain and inflammation, making menopausal hormone therapy (MHT) a helpful tool in managing symptoms. - Sarcopenia
Menopause can lead to a loss of lean muscle mass, known as sarcopenia, often accompanied by increased intramuscular fat. Resistance training combined with proper nutrition—such as protein, vitamin D, and creatine—can counteract this condition. - Impaired Muscle Recovery
The decline in estradiol affects satellite cells, which are essential for muscle repair. Without adequate stimulation, muscle recovery slows, making injuries more challenging to heal. - Bone Density Loss
Osteoporosis, affecting 200 million women worldwide, is a major concern during menopause. Preventative measures like proper nutrition, resistance training, and MHT can significantly reduce the risk of fractures, chronic pain, and disability. - Cartilage Damage and Osteoarthritis
While research on the link between estrogen decline and osteoarthritis remains inconclusive, estrogen’s protective effects on spinal cartilage suggest its importance in joint health.
Conservative Approaches to MSM
For women unable to use MHT, several options exist to manage MSM symptoms, including:
- Nutritional Support: Vitamin D, magnesium, K2, creatine, and protein intake.
- Resistance Training: Progressive strength training is critical for maintaining bone density, muscle strength, and overall mobility.
The Role of Pelvic Physical Therapy in MSM
Resistance training is a cornerstone of MSM management, and pelvic physical therapy (PT) can be a vital part of this approach. A pelvic PT can:
- Assess strength, range of motion, and pelvic floor function.
- Identify imbalances or weaknesses that could lead to injury.
- Design a customized, progressive exercise plan tailored to your needs.
- Monitor your progress and safely guide you through strength-building exercises.
Pelvic PT ensures your resistance training program is both safe and effective, helping you avoid injury while building strength and resilience.
Take Control of Your Menopause Journey
Menopause is a natural phase of life that requires proactive care and management. With informed medical guidance and physical therapy, you can feel stronger and more comfortable in your body. We’re now spending up to a third of our lives in menopause—there’s no reason to suffer in silence.
Let us help you thrive in this phase of life! Call us today to schedule a FREE pelvic health discovery session with one of our expert pelvic physical therapists.
Resources:
Wright, V. J., Schwartzman, J. D., Itinoche, R., & Wittstein, J. (2024). The musculoskeletal syndrome of menopause. Climacteric, 27(5), 466–472. Read the full article.
