Joint pain in menopause: causes, relief, and how you can take charge

Joint pain during menopause is something that many women struggle with – and it can significantly affect daily life. The good news: There are many ways to alleviate the symptoms. With the right combination of exercise, a balanced diet, stress reduction, and medical support if needed, you can do a lot to feel better and improve your quality of life. But what exactly is behind joint pain during menopause, and how can you best alleviate it?

What is joint pain during menopause?

Joint pain during menopause often presents as pain or stiffness in areas such as the knees, hips, or shoulders. The joints, which are the areas where bones meet and allow movement, are particularly affected. Often, the symptoms are caused by inflammation and a breakdown of joint cartilage and fluid. However, it is important to note that joint pain is not always linked to menopause. Other causes, such as osteoarthritis or inflammatory joint diseases, can also trigger the pain. Therefore, a thorough evaluation of the causes is particularly important.

Why does joint pain occur during menopause?

Hormonal changes during menopause play a central role in the development of joint pain. The declining estrogen levels have a direct impact on joint health:

  • Estrogen deficiency: Estrogen has anti-inflammatory effects in the body and supports the regeneration of joint tissue. During menopause, estrogen levels drop, reducing the protection of the joints. Without this anti-inflammatory protection, inflammation in the joints can occur more frequently, leading to pain and stiffness. Estrogen is also involved in regulating joint fluid, which is important for joint mobility and shock absorption.

  • Collagen breakdown: As we age, collagen levels in the body also decrease. Collagen is an important component of tendons, ligaments, and cartilage. A lack of collagen can lead to reduced flexibility and elasticity of the joints, thereby worsening symptoms. Estrogen deficiency during menopause can further accelerate this process.

  • Joint fluid: Estrogen also contributes to moisture regulation in the body. An estrogen deficiency can lead to a decrease in joint fluid, which restricts mobility and causes pain. This dryness in the joints can lead to increased friction, further damaging the joints and causing pain.

What factors worsen joint pain?

In addition to hormonal changes, there are other factors that can increase the risk of joint pain:

  • Weight gain: Many women gain weight during menopause. Excess weight puts additional pressure on the joints, which can worsen pain. The joints of the lower extremities, such as the knees and hips, are particularly affected.

  • Lack of physical activity: Those who are less active risk weakening the muscles that support the joints. Strong muscles are essential for reducing joint stress. A lack of exercise can therefore lead to worsening symptoms.

  • Stress and lack of sleep: High stress levels and lack of sleep can increase inflammation in the body and heighten pain perception. Stress negatively affects hormones and can indirectly impact joint health.

Diagnosis of joint pain during menopause

The diagnosis of joint pain during menopause begins with a comprehensive medical history and physical examination by a doctor. The exact location of the pain, its course, and influencing factors (e.g., physical activity, rest periods) are discussed. Further evaluation may involve imaging techniques such as X-rays, ultrasound, or magnetic resonance imaging (MRI) to identify possible structural changes in the joints, such as cartilage breakdown or inflammation. Blood tests can also help identify inflammatory processes (e.g., elevated inflammatory markers like C-reactive protein, CRP) or rule out rheumatic diseases. Differential diagnosis is important to exclude other causes of joint pain, such as osteoarthritis, rheumatoid arthritis, or gout, which can also occur during this stage of life.

Tips for alleviating joint pain

  • Regular exercise: Physical activities such as swimming, cycling, or yoga help keep joints mobile and strengthen muscles. Especially joint-friendly sports can help reduce pain and promote joint health. However, overuse of the joints should be avoided to prevent inflammation.

  • Weight reduction: Maintaining a healthy weight can relieve the joints and reduce the risk of joint pain. A balanced diet and regular exercise can help shed excess pounds and protect the joints.

  • Anti-inflammatory diet: A diet rich in omega-3 fatty acids can have anti-inflammatory effects. Fatty fish such as salmon, walnuts, or flaxseed oil are ideal sources of these healthy fats. At the same time, you should avoid inflammatory foods like sugar and saturated fats.

  • Adequate hydration: Joints need moisture to stay supple. Make sure to drink enough water to keep your joints well hydrated and alleviate symptoms. Dehydration can make joints more susceptible to wear and tear.

  • Stress management: Since stress can increase inflammation, it is important to learn appropriate stress management techniques. Meditation, breathing exercises, or progressive muscle relaxation can help lower stress hormones and thus reduce joint pain.

  • Physiotherapy: Targeted physiotherapy exercises can promote joint mobility and relieve pain. Physiotherapy can help strengthen muscles and stabilize the joints.

The decline in estrogen levels during menopause can lead to inflammation and joint pain. Around 30-50% of women report joint pain during menopause. An active lifestyle and healthy diet support joint health. Additionally, Menopausal Hormone Therapy (MHT) can help alleviate symptoms.

What role do hormonal and non-hormonal medications play?

If symptoms severely affect daily life despite all measures, there are also medical treatments that can help. The use of medication should always be done in consultation with a doctor to understand the benefits and risks and to find an ideal solution together with medical experts:

  • Menopausal hormone therapy (MHT): Hormone replacement therapy can be useful for severe joint pain. It compensates for estrogen deficiency and can reduce inflammation and pain. The use should be individually weighed, and the response, i.e., the success of the therapy, should be closely monitored.

  • Pain medications: For acute pain, anti-inflammatory medications such as ibuprofen or paracetamol can be helpful. However, in the long term, a balanced treatment approach should be pursued to address the root cause of the pain rather than just alleviate the symptoms.


Sources:

  • Santoro N, Epperson CN, Mathews SB. Menopausal Symptoms and Their Management. Endocrinol Metab Clin North Am. 2015 Sep;44(3):497-515. doi: 10.1016/j.ecl.2015.05.001. URL

  • Watt FE. Musculoskeletal pain and menopause. Post Reprod Health. 2018 Mar;24(1):34-43. doi: 10.1177/2053369118757537. URL

  • Magliano M. Menopausal arthralgia: Fact or fiction. Maturitas. 2010 Sep;67(1):29-33. doi: 10.1016/j.maturitas.2010.04.009. URL

  • Talaulikar V. Menopause transition: Physiology and symptoms. Best Pract Res Clin Obstet Gynaecol. 2022 May;81:3-7. doi: 10.1016/j.bpobgyn.2022.03.003.URL

  • Martínez-Jauand M, Sitges C, Femenia J et al.Age-of-onset of menopause is associated with enhanced painful and non-painful sensitivity in fibromyalgia. Clin Rheumatol. 2013 Jul;32(7):975-81. doi: 10.1007/s10067-013-2212-8. URL


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