Musculoskeletal Syndrome of Menopause
Physical therapists and healthcare providers often hear midlife women describe muscle soreness and joint aches that can’t be explained with testing. Tests reveal no structural cause to explain the patient’s symptoms. A partial explanation of symptoms is sometimes provided if the muscles are found to be weak or the woman has a frozen shoulder, but often women with negative test results are told “You’re just getting older.” This is frustrating for many midlife women who don’t feel old, and especially for many who have prioritized their health for many years by exercising and eating nutritiously.
A recently published study may now offer some validation and explanation to the estimated 47 million women worldwide who enter the menopause transition annually. Musculoskeletal Syndrome of Menopause is a new term to describe the collective musculoskeletal signs and symptoms associated with a loss of estrogen.
Approximately 2 million women in the USA enter menopause annually.
The average age of perimenopause, when estrogen begins to slowly decline, occurs between the ages of 45-55 years, and these symptoms typically last 2-10 years duration. During this decline in estrogen, more than 70% of women experience musculoskeletal symptoms and for 25% these symptoms can be disabling.
Musculoskeletal syndrome of menopause includes symptoms of muscle and joint pain, loss of lean muscle mass, and loss of bone mass. These symptoms can lead to fracture, ligament and tendon injury, adhesive capsulitis, cartilage fragility, and progression toward osteoarthritis.
Patients depend on their healthcare providers to recognize this syndrome as a woman’s changing hormones impacts her musculoskeletal system. Proper recognition can then lead to effective prevention and/or treatment, preventing permanent and devastating consequences relating to bone loss, muscle loss, muscle weakness, frailty, fractures, and metabolic dysfunction.
On average, the onset of perimenopause is 47.5 years. The average age of menopause is between 50-54 years, with Hispanic and Black Americans having an onset 2 years earlier. During perimenopause, women on average lose 10% of their bone mineral density and a 0.6% loss of muscle mass annually after menopause. This can all be influenced by having the woman’s body produce less estrogen during this stage in life.
Physical therapists and clinicians have a role in providing an explanation for women seeking care of their musculoskeletal concerns during perimenopause. Recognizing and explaining to women that declining estrogen often results is a condition known as musculoskeletal syndrome of menopause will assist patients in not feeling dismissed and enable discussion that these changes are treatable and can prevent a further worsening of symptoms. Resistance exercise, good nutrition, and discussing a woman’s hormone status with her doctor can improve a woman’s quality of life during her transition to menopause.
