Menopause and Your Muscles: A Guide to Staying Strong

Menopause is a natural stage of life, but it often brings changes that go beyond hot flashes and mood swings. Many women experience new aches, pains, and a feeling of weakness in their muscles and bones. If this sounds familiar, you’re not alone. An estimated 70% of women in midlife experience what’s known as the musculoskeletal syndrome of menopause.

This article will explore the physical changes that happen to your bones, muscles, and joints during this transition. More importantly, we will discuss how a physical therapist can be a powerful ally, helping you manage symptoms, regain strength, and move with confidence.

What is the Musculoskeletal Syndrome of Menopause?

As your body enters perimenopause and menopause, levels of the hormone estradiol decline. This drop has a significant effect on nearly every part of your musculoskeletal system, including your bones, muscles, tendons, and cartilage.

This can lead to a collection of symptoms often grouped together as the musculoskeletal syndrome of menopause. These symptoms can include joint pain (arthralgia), muscle aches, loss of muscle mass, and decreased bone density. For many, these issues can be severe, yet they often go unaddressed.

Key Musculoskeletal Changes During Menopause

Let’s break down the primary ways menopause can affect your physical well-being.

1. Bone Density Loss (Osteopenia and Osteoporosis)

One of the most critical changes is the loss of bone mineral density. Estradiol plays a vital role in keeping your bones strong. As its levels fall, your bones can become weaker and more fragile. During the perimenopausal transition alone, women can lose an average of 10% of their bone mass.

This condition is known as osteopenia in its early stages and can progress to osteoporosis, a serious issue affecting 200 million postmenopausal women worldwide. Weaker bones significantly increase your risk of fractures, with women suffering up to 50% of all clinical fractures in their lifetime.

2. Muscle Mass and Strength Reduction (Sarcopenia)

Have you noticed a decline in your strength? It’s not just in your head. After menopause, women lose muscle mass at a rate of about 0.6% per year. This age-related muscle loss, or sarcopenia, is accelerated by the drop in estradiol.

Specifically, there is a loss of type II muscle fibers, which are responsible for generating power and quick movements. This loss of power can make everyday activities, from lifting groceries to climbing stairs, feel more difficult.

3. Increased Joint and Muscle Pain

If you’ve started experiencing more aches and pains, you’re in good company. Over half of perimenopausal women report joint pain. The decrease in estradiol can lead to increased inflammation throughout the body, contributing to pain and stiffness.

This can also trigger or worsen conditions like osteoarthritis, the “wear-and-tear” form of arthritis. Studies show that the incidence of osteoarthritis in women increases dramatically around menopause, and women often report more debilitating arthritic pain than men. Other common issues include adhesive capsulitis (frozen shoulder) and an increased risk of tendon injuries.

How Can a Physical Therapist Help?

While these changes can sound daunting, there is good news. Physical therapy is a proven, non-controversial, and highly effective way to manage the musculoskeletal effects of menopause. A physical therapist can create a personalized plan to address your specific symptoms and goals.

A thorough clinical evaluation is the first step. Your therapist will assess your condition to rule out other structural issues and understand how hormonal changes are impacting you. From there, they will introduce you to a treatment plan focused on empowering you to take control of your health.

Tailored Exercise and Resistance Training

Exercise is perhaps the most critical tool for postmenopausal women. A physical therapist can guide you through the right types of exercises to build strength and protect your body.

  • Resistance Training: To combat muscle loss (sarcopenia), resistance training is key. Lifting heavier weights with fewer repetitions is particularly effective for building the power you need for daily activities. A therapist will ensure you use proper form to prevent injury and maximize results.
  • Strengthening for Bone Health: For osteoporosis, guidelines recommend strengthening the muscles around weaker bones. Exercises focusing on the back, hips, and lower legs help support your skeleton and reduce fracture risk.

Improving Balance and Preventing Falls

With a higher risk of fractures, fall prevention becomes crucial. Weaker muscles and changes in balance can make falls more likely. A physical therapist can design a program to improve your stability and coordination. These exercises are essential for decreasing your risk of falls and the potentially life-altering fractures that can result from them.

Nutritional Guidance and Support

Exercise works best when paired with proper nutrition. While a physical therapist is not a nutritionist, they can provide guidance on nutritional choices that support musculoskeletal health, based on established guidelines.

  • Protein Intake: Increasing your protein intake is vital for building and maintaining muscle mass.
  • Vitamin D and Calcium: Vitamin D is essential for bone health. It helps your body absorb calcium and has been shown to improve hip bone density and reduce the incidence of falls in postmenopausal women.
  • Creatine: Some studies suggest that creatine supplements, combined with resistance training, may help improve muscle mass and strength.

Your therapist can help you understand these nutritional components and encourage you to discuss them with your physician or a registered dietitian. Additionally, your PT has access to supportive professional connections they can recommend for this kind of collaboration in your personalized plan. Our marketing team has personally interviewed and vetted qualified health practitioners that align with our goals of care at Onondaga PT. Your therapist can provide contact information to professionals in many categories like nutrition, personal training, chiropractic care, massage therapy, acupuncture and so many more! Ask them about these other areas of support and which ones could be the best fit for you. This component could strengthen your action plan to manage your journey with completeness and confidence. 

Take Control of Your Health Through Menopause

Menopause doesn’t have to mean a future of pain and weakness. The musculoskeletal changes that occur are real, but they are also manageable. By understanding what is happening in your body and working with a physical therapist, you can build a strong foundation for an active and healthy life.

A personalized physical therapy program can help you increase bone density, build muscle power, reduce pain, and prevent falls. It’s about empowering you with the tools and knowledge to navigate this transition with strength and confidence.

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