Pain and perimenopause: what’s happening, quick wins
It can feel like your body’s letting you down. So what’s really happening and what can you do?
Inflammation
More than half of perimenopausal and menopausal women have generalised joint pain, and this doesn’t necessarily correlate with joint issues on scans. Something else is going on.
Oestrogen helps regulate inflammation and has a role in preventing generalised joint pain. The most potent biologically active form of oestrogen (17 beta oestrodiol), inhibits release of inflammatory triggers (inflammatory cytokines). These can trigger or heighten inflammation, and diminish the muscles’ ability to respond to damage and function well, as well as promote accumulation of fat mass.
The result - women struggling to elevate their shoulders without pain, trouble sleeping on their side due to hip tendon changes, struggling with typing due to elbow, forearm and wrist inflammation and limping with heel pain.
5 quick wins for inflammation
Understand what’s aggravating your joint or muscle problem
Maintain gentle movement, stopping short of severe pain
Support the affected area. Physios can help you understand what is best (and what not to waste money on!) e.g. a support for the wrist for carpal tunnel pain, a pillow between the legs when sleeping for outer hip tendon problems
Nourish yourself to support healing. See Laura Clark @menopause.dietitian’s guidance on menopause and gut health here
Practice self care. Stress and anxiety worsens inflammation, so support yourself with coping strategies.
2. Muscle pain, reduced muscle mass
Women lose 3 to 8% of their muscle mass every decade after age 30, with this loss accelerating to 5 to 10% after age 50. In late perimenopause and post menopause, women are much more likely to have sarcopenia (involuntary muscle loss). Finding it harder to grip the kettle or a weight? A bit tougher running up the stairs or hills? Menopause is a potential contributor.
This matters because loss of muscle mass and strength impact not just how we move and feel, but our ability to burn energy and risk of conditions such as diabetes or heart disease.
Have good quality sleep over 7-8 hours and for the most active women, schedule rest and recovery.
5 quick wins for muscles
Add inclines to regular walks/runs
Focused resistance training, emphasising heavier resistance rather than lots of repetitions
Maintain flexibility
Ensure appropriate protein intake
Have 7-8 hours of good quality sleep, schedule rest and recovery
3. Bones can become less dense and less resilient
Women have an average reduction of 10% in bone mineral density during perimenopause and menopause. The fastest bone loss starts about a year before your final period, stays accelerated ~3 years, then slows but continues post menopause. Being more active, be it through housework, gardening or regular exercise, is associated with greater bone strength and density, both before and during menopause. This directly affects risk of osteopenia and osteoporosis.
5 quick wins for bones
Do weight bearing exercises, taking weight through arms and legs.
Lift heavier weights
Add impact. High impact exercise os better for bones, e.g. light jogging, adding vigour to a press up
Move in multiple directions, not just a straight line e.g. ball sports, tennis
Take Vitamin D in autumn and winter months. IT helps regulate calcium and phosphate uptake, and is recommended by the NHS.
4. Collagen, cartilage and connections
Oestrogen stimulates collagen production and turnover, helping to cartilage strong, and our ligaments (which support our joints) and tendons (which attach muscles to bone) resilient. As we get older and there’s less circulating oestrogen, the body is less efficient at repairing cartilage and tendon issues, which in turn can not only make women more prone to injury, but slower to recover. These changes also affect the pelvic floor, and can leave women more prone to leakage and other intimate issues.
5 quick wins for collagen, cartilage and connective tissue
Treat injuries quickly. Delays can weaken joints and muscles further
Strengthen stability muscles around joints. Each joint has muscles crossing it which give control and stability. e.g. rotator cuff muscles around the shoulder.
Move a little, often, to stop joints getting stiff. Getting up from the desk regularly helps!
Cycling keeps the legs moving and lubricates joints
Do pelvic floor exercises, see a Specialist Women’s Health Physio if you have leakage, pain or problems
5. Reduced balance
5 quick wins for balance
Practice standing balance in bare feet - eyes open or shut. Being bare foot allows us to use our feet in the way we were designed to
Yoga - I’m just about holding this pose for the picture but it can be hard!
Jump or hop. Remember skipping and hopscotch? They train us to be dynamic and respond to stumbles
Walk or jog on uneven paths
Try something outside your balance comfort zone. From dance to paddleboarding, there’s something for everyone. For more on this, see my blog on visiting a blue zone.
We talk about all these factors and how to help in our membership, The Anchor Collective, which I help run alongside Laura Clark, Menopause Dietitian. Click the button to learn more
References
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Douglas-Harris, M and Ramaskandhan, J. Menopause and plantar heel pain: a ppi and co production journey. 2024. Newcastle Biomedical Research Centre. https://www.researchgate.net/publication/393281614_Menopause_and_Plantar_Heel_Pain_A_PPI_and_co_production_journey
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