Menopause Can Cause Pain But it Doesn’t Have to

Because a picture tells a thousand words let me show you this 👆🏽STRAW+10 System that illustrates women’s stages of reproductive aging.

And this how our oestrogen levels decline as we age.

The reason why menopause can bring on joint pain, frozen shoulder and plantar fasciitis is because oestrogen receptors are in all of our soft tissues. Oestrogen acts as a natural anti-inflammatory and helps lubricate our joints. As levels drop our tissues become stiffer. Oestrogen and progesterone also play a role in regulating the maintenance of bone and  muscle health. As our hormone levels drop the loss of muscle mass (sarcopenia) and bone density (osteopenia) accelerates. The decline in oestrogen also correlates with joint tissue degradation paving the way for osteoarthritis. Oestrogen and progesterone also modulate pain perception. Sleep disturbances linked with menopause symptoms (dropping progesterone levels) are also linked with increased pain sensitivity and the exacerbation of existing pain conditions.

And it's our dropping progesterone that we can blame for our hot flashes.

Anyway, these factors combined means that we have to work at keeping our muscles and bones strong. We have to move in ways that keep our joints lubricated. We might also choose to use Menopause Hormone Therapy (MHT).

We also have to think about our diet. The strategy of eating less and reducing carbs doesn’t work so well for menopausal women. Stacy Sims explains here that exercising in a fasted state or cutting carbs can exacerbate menopausal symptoms, disrupt thyroid function, and increase belly fat storage in active women. Instead she encourages us to have 35-40g of protein per meal and to eat lots of fruit and vegetables. She is a marvellous resource. You should visit her website  or read her books if you haven’t already.

From an exercise standpoint our approach also needs to change.

A menopause exercise plan needs:

Ten minutes of impact three times a week.

This could be anything from heel drops to running to box jumps. Impact exercises generate ground reaction forces which, send vibrations to our bones that trigger bone growth and increase bone density.

Grip strength training

If you don’t know which cardio machines to use at the gym try the ski erg or rowing machine. Both of these will raise heart rate while also strengthening grip. Grip strength will decline if you don’t train it. Typical exercises that improve grip strength are farmers walks (carrying heavy kettlebells) or hanging from a bar for as long as you can. I also do lots of weighted wrist exercises.

Sprint Interval Training (SIT)

When doing cardio include 20 second bursts of sprinting in with your usual pace - building up to 8 bursts. This is thought to help pull glucose from the bloodstream and reduce insulin sensitivity. It is also thought to improve mitochondrial function and increase testosterone.

Heavy Lifting

Your weight should be heavy enough that you can only do 5-6 reps of an exercise. High-intensity resistance training stimulates muscle stem cells and builds bone density.

And finally,

Joint Mobilisation

Make sure that you keep your feet and ankles strong with foot exercises, keep your shoulders and hips well oiled with large circles. Ideally do these standing and incorporate some kind of banded or weighted resistance to challenge your core.

It is not guaranteed that we will live with pain as we age but we will need to work harder to keep it at bay. Our wise elders tell us that menopause is the period of life when we learn to stop people pleasing and step into our own power. Getting physically strong, eating well and (possibly) taking MHT are steps that will help us in this direction.