The Musculoskeletal Syndrome of Menopause: The Overlooked Impact on Muscles, Joints, and Bones

Menopause changes more than your hormones - it changes your bones, joints and muscles. 

If you’re feeling more achy, tired or noticing body composition changes, you are not alone. Over 70% of menopausal women experience musculoskeletal symptoms, and about 25% face severe or disabling impairments including:

• Joint pain and stiffness

• Muscle weakness and reduced strength

• Bone density loss

• Cartilage degradation

• Increased abdominal fat (“menopausal belly”)

So what is happening during menopause?

Menopause is marked by the natural decline in ovarian function, resulting in a significant drop in estrogen, progesterone and (to a lesser extent) testosterone. 

With a reduction in these hormones, we notice:

• Reduced bone mineral density and increased fracture risk

• Reduced joint lubrication and increased joint stiffness

• Increased inflammation and pain sensitivity

• Accelerated sarcopenia (muscle loss)

• Impaired fluid balance- ie bloating

• Dysregulated mood and reduced stress tolerance

• Poor sleep and increased fatigue

• Increased risk of insulin resistance

• Changes to fat distribution, “menopause belly”

The good news is that exercise can play a key role in improving how you feel.

Role of exercise

Incorporating different forms of exercise can offer a wide range of benefits:

• Strength training, especially weight-bearing and resistance exercises, supports bone remodeling and helps build muscle, which plays a vital role in maintaining metabolism.

• Cardiovascular exercise helps lower systemic inflammation, boosts metabolic health, and supports overall wellbeing. Hot tip: a walk after meals can be a simple but effective way to support blood sugar balance.

• Mobility and flexibility work can ease stiffness and promote better joint lubrication, making daily movement more comfortable.

• Balance and proprioception exercises are important for improving stability and reducing the risk of falls.

What to aim for:

Include strength training two to three times per week, along with at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity cardiovascular exercise each week.

Key Takeaway

Your physical symptoms are related to more than just your activity but also your hormonal context. Physiotherapists can help support you in staying fit, active, healthy and pain-free. 

You’re not too old, too stiff, or too tired to get strong. You just need the right movement plan. 

Trying one of our clinical exercise classes can be a great way to get started - click here to start your clinical exercise journey today!

References - Exercise beyond menopause: Dos and Don’ts (2011), N Mishra et al.

Author: Annie Cumming, Balance North Preston Physiotherapist