Regular physical activity plays a crucial role in managing menopause symptoms, maintaining a stable metabolism, promoting a healthy weight and body composition, and lowering the risk of osteoporosis and joint discomfort.
Regular exercise enhances insulin sensitivity, controls inflammation, and fortifies bones, all of which support overall well-being.
However, as estrogen levels decline, many women experience musculoskeletal symptoms, including joint pain, stiffness, muscle weakness, and swelling. These discomforts can make it more challenging to stay active, creating a barrier to the exercise and movement that are essential for reaching and maintaining health and wellness goals.
Musculoskeletal Syndrome of Menopause
The musculoskeletal changes caused by the drop in estrogen during the menopause transition are collectively known as the "musculoskeletal syndrome of menopause," affecting approximately 70% of women in midlife. This syndrome often manifests as joint pain, muscle loss, bone density reduction, and an increased risk of osteoarthritis, all of which can significantly impact mobility and quality of life. Recognising these changes is crucial, as it enables women to take preventive steps and embrace natural solutions to feel their best during this phase.
Through my work as a nutritionist, and my background in remedial massage therapy, I’ve gained a deep understanding of how nutrition plays a fundamental role in supporting musculoskeletal health through the menopause transition, helping to counteract the effects of estrogen decline, and how targeted dietary strategies can support bone density, muscle strength, and joint function.
The Major Effects of Declining Estrogen on Muscles, Joints, and Bones
The decline in estrogen levels during perimenopause has profound effects on musculoskeletal health, triggering a range of symptoms and conditions that can impact daily life. These include:
Increased Inflammation: Menopause often triggers chronic low-grade inflammation, which can lead to joint pain and cartilage degradation. Estrogens anti-inflammatory properties help regulate the body’s inflammatory response, and as estrogen levels drop, inflammation can increase, exacerbating conditions like arthritis and joint discomfort.
Reduced Bone Mineral Density: Estrogen is crucial for bone remodeling, the process where old bone tissue is broken down and replaced with new tissue. When estrogen levels decline, bone resorption accelerates, and bone formation slows, leading to a reduction in bone density. This makes bones more fragile and prone to fractures, increasing the risk of conditions like osteopenia and osteoporosis.
Sarcopenia (Muscle Loss): Estrogen also supports muscle protein synthesis, the process through which the body builds muscle proteins from amino acids. As estrogen decreases, muscle mass gradually declines, resulting in sarcopenia. This reduction in muscle strength increases the risk of falls, frailty, and slower metabolism, ultimately limiting mobility and reducing physical performance.
Slower Muscle Repair: Estrogen affects satellite cells, which play a key role in muscle regeneration after exercise or injury. With lower estrogen levels, muscle repair slows, making recovery after physical activity or injury more difficult and contributing to muscle weakness.
Arthritis Development and Osteoarthritis Progression: Estrogen helps maintain cartilage in the joints by supporting synovial fluid production, which lubricates the joints and reduces friction. As estrogen declines, cartilage begins to deteriorate, contributing to the development and progression of osteoarthritis. This condition can cause joint pain, swelling, and reduced range of motion, particularly in weight-bearing joints like the knees, hips, and spine, and can lead to long-term disability if not properly managed.
The combination of these effects can lead to significant discomfort, reduced mobility, and a decreased quality of life after menopause. However, with proactive management through nutrition, exercise, and other health interventions, these impacts can be minimised, helping women maintain musculoskeletal health and reduce the risk of severe conditions.
How Nutrition Can Support Musculoskeletal Health
A targeted diet can help maintain bone density, muscle mass, and joint function.
My top strategies include:
Calcium and Vitamin D: Crucial for maintaining bone density and reducing the risk of osteoporosis, especially during and after menopause when bone loss accelerates. Good dietary sources of calcium include dairy products, leafy greens, sardines/tinned salmon (with bones), tofu, seeds and nuts, while vitamin D can be found in oily fish (salmon, tuna, trout, mackerel), fish liver oils , egg yolks and beef liver. Since natural vitamin D synthesis depends on sun exposure, individuals with limited sunlight access may benefit from supplements to ensure adequate levels for optimal bone health.
Protein Intake: Adequate protein intake is essential for muscle repair, strength preservation, and preventing age-related muscle loss. High-quality protein sources such as lean meats, fish, eggs, legumes, tofu & tempeh, nuts and seeds provide essential amino acids necessary for muscle function. It may be necessary to supplement with protein powder to attain adequate protein, in this case I recommend a plant-based protein powder derived from pea or brown rice with as few additives as possible. Starting the day with a good (30-40g) serve of protein and then distributing protein intake evenly throughout the day can help optimise muscle synthesis, and support overall metabolic health.
Omega-3 Fatty Acids: Omega-3 fatty acids play a vital role in reducing joint inflammation, which can help alleviate stiffness and discomfort commonly experienced during menopause. These healthy fats are found in fatty fish like salmon, sardines, herring and mackerel, as well as plant-based sources such as flaxseeds and walnuts. Regular omega-3 intake may also help slow the progression of age-related joint degeneration, supporting long-term mobility and overall musculoskeletal health
Magnesium: Magnesium works opposite calcium to facilitate muscle relaxation after contraction, helping to reduce cramps and muscle tightness. It also plays a key role in bone health by supporting calcium absorption and bone density, which is crucial for reducing the risk of osteoporosis. Rich dietary sources of magnesium include nuts, seeds, whole grains, and leafy greens. It is worth noting here that magnesium is one of the most commonly self-prescribed nutrition supplements, however there are several different forms of magnesium which all have different benefits. Seek advice from your natural health practitioner as to the right supplement for you, as getting the right form of magnesium is key to getting results.
Anti-Inflammatory Foods: Incorporating anti-inflammatory foods into the diet can help manage symptoms such as joint pain, fatigue, and metabolic changes. Turmeric and ginger contain powerful compounds like curcumin and gingerol, which have been shown to reduce inflammation and support overall well-being.
Collagen and Vitamin C: Collagen is essential for maintaining skin elasticity, joint health, and bone strength, but its natural production declines with age, especially during menopause. Vitamin C plays a crucial role in collagen synthesis by supporting the body's ability to form and maintain connective tissue, making it important to include sources like citrus fruits, parsley, red pepper, and berries in the diet. Consuming collagen-rich foods such as bone broth or a good-quality collagen supplement, along with adequate vitamin C intake, can help support connective tissue repair, joint stability, and overall musculoskeletal health.
Probiotics: Specific probiotic strains interact with the immune system to moderate inflammation and support muscle recovery after exercise. Other strains can reduce bone loss in post menopausal women, reducing the risk of osteopenia and osteoporosis.
The Role of Physical Activity and Remedial Therapies
Physical activity is essential for preserving musculoskeletal health during menopause, helping to counteract the effects of estrogen decline. Regular movement supports muscle synthesis, maintains bone density, and reduces joint discomfort.
Incorporating a combination of resistance training, daily walking, and remedial therapies can enhance strength, mobility, and overall well-being:
Resistance Training: Working out with weights stimulates muscle protein synthesis, preserving lean muscle mass and improving bone strength, which is crucial for reducing the risk of osteoporosis and frailty.
Daily Walking & Movement: Weight-bearing activities like walking, hiking, and dancing help maintain bone density, improve circulation, and support joint health by keeping synovial fluid moving.
Yoga & Stretching: These practices enhance flexibility, joint mobility, and muscle recovery, reducing stiffness and improving overall movement quality.
Remedial Massage & Soft Tissue Therapy: Techniques such as myofascial release and trigger point therapy relieve muscle tension, improve circulation, and support recovery, making movement more comfortable and sustainable.
By combining strength-based exercise with daily movement and targeted physical therapies, women can support long-term musculoskeletal health, reduce pain, and maintain an active lifestyle well into midlife and beyond.
A Holistic Approach to Menopause Wellness
Understanding the musculoskeletal changes that occur during menopause is important for managing your health effectively.
By integrating evidence-based nutrition, exercise and physical therapies, midlife women can preserve their mobility, reduce pain, and maintain an active lifestyle through every stage of menopause and beyond.
If you're ready to take the next step towards achieving your goals, I invite you to book a discovery call with me today. Let's explore how we can work together to create a tailored plan that meets your needs. Schedule your consultation now!
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