With out query one of the crucial frequent complaints I hear from midlife girls is that they really feel like they’ve aged a decade in a single day or that they’re falling aside. That they get up in the future and really feel like they’ve been run over by a truck. If this describes you, I see you. I hear you. I’ve been you.
Once I was about 47, I additionally felt like I’d been run over. My entire physique damage, and I felt like a shadow of the girl whose workplace is lined with athletic medals. I hobbled away from bed each morning. I’d additionally gained thirty kilos and, at 34 % physique fats, was technically within the hazard zone for metabolic well being.
When you consider menopause, you seemingly consider the stereotypical signs, like scorching flashes, night time sweats, mind fog, and temper swings. However from the place I sit as an orthopedic surgeon, one of the crucial devastating penalties of menopause is a cluster of signs I name the musculoskeletal syndrome of menopause.
Musculoskeletal syndrome of menopause is simply as frequent as scorching flashes and wreaks much more havoc on a lady’s well being. Proof reveals that greater than 70 % of menopausal girls will expertise musculoskeletal signs, and 25 % will probably be disabled by them by means of the transition from perimenopause to postmenopause.
Estrogen has a profound impact on the musculoskeletal system, and as talked about beforehand, until you’re taking motion, when it’s not being produced, you’ll be able to lose bone density (as much as 20 % within the years instantly following menopause), lose muscle, and have an increase in inflammaging.
This damaging syndrome reveals up, once more, as situations that we’ve got historically written off as “simply getting older,” like osteopenia and osteoporosis. Decrease ranges of estrogen imply that our osteoclasts, the cells that break down bone, work with out regulation and outpace our osteoblasts, the cells that construct and restore the skeletal system, leading to a internet lack of bone density. Osteoporosis nonetheless doesn’t get the eye that most cancers or coronary heart illness does, regardless of its affecting greater than 200 million postmenopausal girls worldwide.
Sarcopenia, or involuntary muscle loss, is one other musculoskeletal symptom that we used to simply chalk as much as getting previous. That is one thing we have to fight with each weapon accessible, as a result of lack of muscle robs girls of their energy and contributes to lowered bodily operate and elevated danger of falls.
Whereas some muscle loss is inevitable with age, what occurs round menopause isn’t. Estrogen receptors are current in muscle tissue; subsequently, estrogen influences muscle mass and energy. The decline in estrogen throughout menopause results in decreased muscle protein synthesis and elevated protein degradation. Girls will typically say it looks like they misplaced their muscle “in a single day,” and whereas it’s actually not in 24 hours, there generally is a comparatively speedy decline throughout the menopause transition.
Animal research bear this out. In a single experiment, 24 weeks of estrogen deficiency resulted in a ten % lower in energy that corresponded with an 18 % lower in what’s known as fiber cross-sectional space — a measure of muscle dimension. In one other experiment, with mice, the researchers steered that with out sufficient estrogen, muscle is extra liable to damage and development is proscribed.
It comes all the way down to muscle stem cells (additionally known as satellite tv for pc cells). Estradiol (our major type of estrogen) helps activate and develop satellite tv for pc cells in our muscle groups. These cells have estrogen receptors, and among the energy our muscle groups produce seems to return from estradiol binding to those receptors. After we lose that stimulation, our muscle energy and skill to restore our muscle groups is impaired. Once more, we see it in animal research, the place mice who had their ovaries eliminated had 30 to 60 % fewer satellite tv for pc cells; the quantity of discount was related to how lengthy they have been with out estrogen.
As a facet observe, as a result of many ladies are dropping muscle and gaining fats throughout this era, they’ll additionally begin dramatically limiting their meals consumption, which isn’t good for muscle groups or bones. Each want gasoline — particularly sufficient protein — to restore and rebuild. Denying them that protein makes issues a lot worse.
As we all know, estrogen has anti-inflammatory (and subsequently anti-inflammaging) properties, which suggests it additionally helps preserve the well being of joint tissues, together with cartilage. The decline in estrogen throughout the menopause transition can result in elevated irritation and degradation of joint cartilage. The speed of osteoarthritis will increase dramatically across the time of menopause. In a single complete overview, researchers steered a possible affiliation between menopausal estrogen decline and the frequency of knee, hip, and finger osteoarthritis in addition to the severity of hip osteoarthritis.
The influence of estrogen decline is one thing I see on daily basis. Many ladies report elevated joint ache, stiffness, and swelling throughout and after menopause, which may have an effect on the knees, hips, fingers, and different joints. For some girls this presents as whole physique ache, often known as arthralgia, in addition to frozen shoulder (which predominantly impacts girls between the ages of 40 and 60 — prime menopause transition time) and elevated arthritis.
Lively girls can discover themselves more and more sidelined with damage throughout the menopause transition as a result of estrogen influences the metabolism and mechanical properties of tendons and ligaments. As tendons and ligaments turn out to be much less elastic, they’re extra liable to accidents similar to tendinitis and ligament tears. It’s value noting that all the modifications and signs of menopause can result in pronounced weight acquire (once more, in my very own case 30 kilos) in a comparatively quick time frame, which locations extra load on the joints. By some estimates, each pound of extra weight we feature places an extra 4 to 10 kilos of stress on our knees. Meaning dropping simply 10 kilos for those who’re obese can take 40(!) kilos of stress off these joints and make you a lot much less more likely to expertise joint ache.
Placing all of it collectively, it’s no surprise so many ladies in menopause really feel like they’re falling aside! The lack of muscle clearly makes us weaker, so we transfer much less. The lack of bone makes us extra liable to fragility, so we’re afraid to maneuver. And the remainder of it places us in ache, so we don’t even wish to transfer as a result of it hurts! So, we acquire weight and transfer much less and damage extra, placing us within the path of these time bombs and resulting in shortened healthspan. I often see girls dwelling in ache who’ve gone to a number of medical doctors and been informed they’re “effective” as a result of all the pieces seems “regular” on an X-ray or an MRI (our analysis finds that 40 % of girls haven’t any structural abnormalities that present up in screening). In order that they go untreated, simply dwell in ache, and slowly however certainly recede from their energetic lives. It’s a vicious cycle.
What’s loopy is that the medical group typically wrings its fingers about how postmenopausal girls turn out to be extra sedentary. In truth, they’ve the audacity accountable these girls for not exercising sufficient and level to their “simply not shifting sufficient” as the explanation behind all their woes. However they by no means truly discover why. It’s not like midlife girls have all of the sudden turn out to be lazy! It’s that we are sometimes in ache as a result of we’re struggling musculoskeletal syndrome of menopause. That is all fully avoidable.
Most of the probably devastating finish phases of the musculoskeletal syndrome of menopause will be prevented if they’re acknowledged as actual early in menolescence — my title for the transition girls endure from their reproductive years into the remainder of their lives. We are able to proceed to be wholesome, very important, energetic, and joyful. We simply should be proactive. Meaning working towards the train, way of life, and vitamin recommendation discovered within the pages of my ebook. It additionally means attending to your hormonal well being, which I additionally tackle in my ebook.
I hope you at the moment are geared up with the data of why mobility is the important thing to healthspan and longevity and the motivation to behave. In case you are raring to go, you’re welcome to do it now! Take a stroll, raise a weight, after which flip the web page as we construct a mindset to your success.
Excerpted from UNBREAKABLE by Vonda Wright, MD. Copyright © 2025 by Vonda Wright, MD. Utilized by permission of Rodale Books, an imprint of Random Home, a division of Penguin Random Home LLC, New York. All rights reserved. No a part of this excerpt could also be reproduced or reprinted with out permission in writing from the writer.
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