Why Does Musculoskeletal Syndrome of Menopause Occur?

As estradiol levels decline during menopause, five key changes can significantly impact muscles, bones, and joints:

1. 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).
2. 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.
3. 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.
4. 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. For more on this, see our "Building Bones of Steel" article.
5. 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.

Story:

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 cyclist who finds solace on the open road. Cycling 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 shoulder, 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 difficult to raise her arm, making even simple tasks like brushing her hair or reaching for a coffee mug a painful ordeal. Worst of all, cycling became excruciating. She could barely grip the handlebars, and the thought of giving up her rides was unbearable.

After weeks of pushing through the pain, Sarah finally went to see her doctor, who diagnosed her with frozen shoulder, a condition where the shoulder joint becomes stiff and painful, making movement difficult. For someone who relied on her strength and mobility not just for cycling but for navigating the challenges of life, this was a tough pill to swallow.

Unaware of the connection between perimenopause and frozen shoulder, the physician did not discuss the connection of estrogen decline or ask questions about her cycle or other symptoms. Sarah learned from PAUZ Health the connection between estrogen and the importance of strength training and hormone therapy. She accessed an expert and developed a personal plan to address her frozen shoulder and other issues.

Today, Sarah is back on her bike, stronger and more determined than ever. She still juggles her demanding career, the challenges of raising teenagers, and the emotional weight of her loss, but she does so with a renewed sense of confidence.

Empower Your Menopause Journey Today!