Understanding Musculoskeletal Syndrome of Menopause: Why Your Aches and Pains May Be More Than “Just Getting Older”

Why Your Aches and Pains May Be More Than “Just Getting Older”

Many women in perimenopause and menopause begin to notice persistent joint pain, stiffness, muscle weakness, or fatigue. Often, these changes are brushed off as ageing, but there’s more to the story. These symptoms are part of what experts now recognise as Musculoskeletal Syndrome of Menopause (MSM), a common yet often overlooked consequence of hormonal shifts during midlife.

What is Musculoskeletal Syndrome of Menopause?

MSM is a cluster of physical changes that affect the muscles, bones, and joints due to the sharp drop in estrogen during menopause. Estrogen plays a critical role in maintaining tissue health across the body. When levels fall, it sets off a cascade of effects that can affect everything from your posture and balance to your risk of fractures.

Key areas affected include:

• Muscle mass and strength

• Joint mobility and comfort

• Bone density and structural integrity

• Tendon and ligament function

• Body composition and metabolic rate

  
  

Symptoms: How to Know You’re Experiencing MSM

You might be dealing with MSM if you notice:

• Joint pain and stiffness, especially in the hands, shoulders, knees, and hips

• Muscle aches, weakness, or fatigue

• Decreased mobility or flexibility

• Frequent injuries or slow recovery from physical activity

• Back pain, changes in posture, or loss of height

• Tendon or ligament inflammation, like frozen shoulder or plantar fasciitis

• Balance issues or fear of falling

These symptoms can range from mild to severe, and they may flare up without an obvious cause. What’s important to understand is that they’re often hormonally driven, not just the result of overuse or age.

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Why It Happens: The Role of Estrogen

Estrogen isn’t just about fertility—it plays a protective role in nearly every tissue in the body:

• Muscles: Estrogen helps preserve muscle mass and repair after exertion

• Bones: It regulates bone turnover, keeping them dense and strong

• Joints: Estrogen maintains collagen in cartilage and supports joint lubrication

• Tendons & Ligaments: It enhances flexibility and elasticity

As estrogen declines, these systems lose support, leading to more inflammation, slower healing, and structural changes that increase the risk of pain, injury, and degeneration.

How to Manage MSM: A Holistic Approach

The good news? MSM can be managed and in many cases, reversed—through proactive steps. Here’s how:

1. Exercise is Medicine

The most powerful tool for MSM is movement. Sometimes it's hard to even think about exercise when you're in pain, but if you start slow and push through, you will start to see the benefits.

• Strength training (2–3 times per week) boosts muscle mass, protects joints, and supports balance and bone density.

• Weight-bearing cardio (e.g. walking, dancing, stair climbing) Promotes bone health and helps prevent fractures.

• Mobility and flexibility training Stretching, yoga, and Pilates keep joints supple and reduce stiffness.

• Balance and core stability work Helps prevent falls and enhances posture.

• Get a personal trainer who knows about MSM and work with them to avoid injury

  
  

2. Targeted Physical Therapy

Certain exercises can relieve common symptoms:

• Shoulder stretches for frozen shoulder

• Hip openers and back mobility work for lower back pain

• Grip and wrist strengtheners for hand and wrist pain

• Red light therapy

• Hot yin yoga

A physiotherapist familiar with menopause can customise a routine based on your needs

3. Nutrition for Bone and Muscle Health

Focus on foods that reduce inflammation and support recovery:

• Protein (chicken, fish, legumes, Greek yogurt)

• Omega-3s (salmon, flaxseed, walnuts)

• Calcium and vitamin D (leafy greens, fortified dairy, sunshine)

• Anti-inflammatory foods (berries, turmeric, olive oil)

Avoid excessive alcohol, processed sugars, and smoking—all of which can worsen inflammation and bone loss.

4. Hormone Replacement Therapy (HRT)

For some women, HRT or Menopausal Hormone Therapy (MHT) can significantly relieve MSM symptoms by:

• Preserving bone density

• Reducing joint and muscle pain

• Enhancing energy and recovery

Discuss the risks and benefits with a menopause-informed healthcare provider.

5. Supportive Therapies

• Cold/heat therapy for localised pain

• Massage or myofascial release to reduce stiffness

• Acupuncture for inflammation and joint discomfort

• Supplements: Calcium, magnesium, vitamin D, collagen, and omega-3s may help if the diet is lacking

Final Thoughts: You're Not Broken—You're Changing

Musculoskeletal Syndrome of Menopause is real, common, and treatable. The key is early recognition and a proactive, body-positive approach to midlife health. What may seem like small aches today could lead to injury or immobility later, so take action now.

This stage of life doesn’t have to mean slowing down. With the right support and strategy, you can build strength, flexibility, and resilience for years to come.

Understanding menopause and its implications is crucial for women during this transformative period. With the right information and a strong support network, women can approach menopause with resilience and positivity.

Written by The GCC Menopause Hub