Musculoskeletal Syndrome of Menopause: What You Need to Know

Written by PAUZ Health | Oct 23, 2025 7:51:22 PM

We Talk About Bones & Muscles, But What About Our Joints?

During menopause, women may experience a range of musculoskeletal issues, including muscle loss (sarcopenia), muscle weakness, pain and soreness, joint stiffness (arthralgia), accelerated osteoarthritis, loss of bone density, frozen shoulder, and more. This collection of symptoms is now recognized as the "musculoskeletal syndrome of menopause."

Approximately 71% of perimenopausal women are affected by these conditions due to a decline in estrogen (estradiol), and 25% may experience significant disability as a result.

These issues can severely impact quality of life, making everyday tasks—such as work, household chores, and family activities—challenging and uncomfortable.

Why Does Musculoskeletal Syndrome of Menopause Occur?

Estradiol, the most biologically active form of estrogen, plays a crucial role in maintaining the health of musculoskeletal tissues, including bone, tendon, muscle, cartilage, ligament, and adipose tissue. As estradiol levels decline during menopause, five key changes can significantly impact muscles, bones, and joints:

Increased Inflammation: Estrogen helps regulate inflammation in the body. Without enough estradiol, inflammation can rise, leading to muscle degradation, an environment conducive to fat gain, and joint pain (arthralgia).
Decrease in Muscle Mass (Sarcopenia): Sarcopenia, the age-related loss of muscle mass, is closely linked to declining estrogen levels, which affect muscle strength, insulin sensitivity, and protein synthesis. Postmenopausal women often experience a significant reduction in muscle mass and strength. Your muscle mass peaks at the age of 30 years, as you enter menopause, you can experience significant muscle loss.
Reduced Satellite Cell Proliferation: Satellite cells, which are stem cells on muscle fibers, play a vital role in muscle repair and regeneration. Estradiol promotes the activation of these cells, aiding muscle recovery and growth after injury. With lower estrogen levels, muscle strength diminishes, recovery slows, and the benefits of strength training can be hard to achieve due to increased weakness and fatigue.
Decreased Bone Density: Women typically lose about 10% of their bone density during perimenopause and an additional 0.6% each year after menopause. Low estrogen levels are directly associated with bone loss, heightening the risk of frailty and fractures.
Cartilage Damage and Osteoarthritis: Estrogen plays a key role in maintaining cartilage, which protects bones and allows them to move smoothly. For women with osteoarthritis, the disease often progresses rapidly around menopause, leading to increased joint damage and discomfort.

Does This Resonate With You?

Sarah is a 47-year-old professional with a full plate. She’s a dedicated mother to two teenage kids, a widow who lost her husband unexpectedly a few years ago, and a passionate runner who finds solace in the outdoor trails. Running isn’t just a hobby for Sarah; it’s her escape, her therapy, and her way of staying fit and connected to herself.

But lately, something has been holding her back. It started as a dull ache in her her, something she brushed off as just another sign of getting older. But the pain didn’t go away—it got worse. Soon, Sarah found it painful to run and uncomfortable to walk around for her activities of daily living. She was unable to fall asleep at night due to the aching pain.

After weeks of pushing through the pain, Sarah finally went to see her doctor, who told her she should stop running. Given this is a passion of hers, she pushed on. Unaware of the connection between perimenopause and joint pain, she found PAUZ and learned that an estrogen decline may be impacting her once healthy joints. She accessed an expert, received treatment, and developed a personal plan to get her back on the trails .

Today, Sarah is back running, her training looks a bit different now, she still juggles her demanding career, the challenges of raising teenagers, with a renewed sense of confidence.

Do you see yourself in Sarah?

Tips:

Incorporate Strength Training: Start small. There’s the ‘ideal’ routine, and then there’s real life. Set a measurable goal and work towards it. Once you’re consistent, build from there. Aim for 2 to 3 weeks of strength training/week.
Mind Your Protein: Pay attention to your protein intake. Plan to gradually improve both the quantity and quality of the protein you consume. Check out our Protein Blog for more.
Focus on Foundations: Don’t stress about finding the perfect vitamin or supplement. Instead, prioritize establishing solid exercise and nutrition habits as the foundation for your health journey.
Joint Mobility: Activities that can help with joint mobility such as Pilates can help with this as well as core strength and posture.

For help- Check out our PAUZ Weight Management & Vitality Program

Additional Resources:

Frontiers | Tissue-Specific Effects of Loss of Estrogen during Menopause and Aging

The Musculoskeletal Syndrome of Menopause

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