Written by: Sarah Musleh, Endocrinologist at Anzara Health
Published: 20-05-2024
Understanding The Relationship Between Menopause and Joint Pain
In my day-to-day work as a women’s health endocrinologist, I’m often asked by patients about the relationship between joint pain and menopause.
Despite it being one of the less discussed aspects of menopause, it is common at this stage of life for women to experience some joint stiffness and even pain.
If you’re going through perimenopause or menopause and are experiencing joint issues, don’t worry. I’m here to explain the root causes, available treatments, and lifestyle adjustments you can make to live pain-free.
How Menopause Affects Joint Health
Fluctuations and declines in estrogen levels are the root cause of menopausal arthralgia (the medical term for joint pain rooted in menopause).
Estrogen plays a key role in maintaining joint lubrication, reducing inflammation, and promoting collagen production in the joints.
As estrogen levels decline with menopause, you may experience changes in joint structure and function, leading to symptoms such as joint pain, stiffness, decreased mobility, and injury proneness.
Common Symptoms
As mentioned earlier, it’s common for women to experience joint issues at this stage of life.
Symptoms may affect various joints, including the knees, hips, shoulders, and hands.
You may also notice swelling, tenderness, and reduced range of motion in affected joints while performing some of your daily activities.
This is because estrogen has anti-inflammatory properties, and tendons become less stiff as estrogen levels decline, leading to a higher injury rate.
How Many Women Experience Menopausal Arthralgia
Several studies report that between 40% and 50% of women have some degree of pain, stiffness, or discomfort in their joints during perimenopause and menopause.
It’s difficult to pinpoint the exact percentage of post-menopausal women with joint pain caused directly by lower estrogen levels, as this period also marks the onset of rheumatic disorders like osteoarthritis for the female population.
Nonetheless, there’s no doubt that joint pain becomes more prevalent the closer women are to menopause.
Menopause Joint Pain Treatments
Hormone replacement therapy (HRT) is the most effective treatment option to help relieve joint pain and stiffness associated with menopause.
HRT can support joint health and reduce inflammation by restoring estrogen levels to normal or near-normal levels.
Studies have shown that women who undergo HRT may experience improvements in joint pain, stiffness, and overall joint function when combined with other lifestyle adjustments like exercising and eating a balanced diet.
HRT can also help other menopause-related ailments like acne, as it also stems from hormonal changes.
Hormone Replacement Therapy (HRT) Options for Menopause Joint Pain
Hormone replacement therapy (HRT) can be an effective treatment for alleviating various menopausal symptoms, including joint pain.
Below, I’ll list and explain the types of HRT I most commonly prescribe.
Estrogen-Only Therapy
What It Is: Estrogen-only therapy involves the administration of estrogen without progesterone.
This type of HRT is typically prescribed for women who have had a hysterectomy (surgical removal of the uterus), as they do not need progesterone to protect the uterine lining from hyperplasia (excessive cell growth) or cancer.
How It Helps: Estrogen helps to maintain bone density and reduce the risk of osteoporosis, which can indirectly relieve joint pain. It also has anti-inflammatory effects that can reduce joint pain and stiffness.
Forms Available:
- Oral tablets: Taken daily.
- Transdermal patches: Applied to the skin and replaced regularly (weekly or bi-weekly).
- Topical gels or creams: Applied to the skin.
- Vaginal rings or tablets: Inserted into the vagina and replaced periodically.
Considerations: Certain types of oral Estrogen therapy can slightly increase the risk of certain conditions, such as blood clots, especially in older women or those with other risk factors.
Therefore, discussing personal and family medical histories with a healthcare provider before starting this therapy is important.
Combined Estrogen-Progestin Therapy
What It Is: Combined estrogen-progesterone therapy includes estrogen and progestin (a synthetic or natural form of progesterone).
This combination is essential for women who still have their uterus, as progesterone counteracts the risk of endometrial hyperplasia and cancer associated with estrogen-only therapy.
How It Helps: In addition to the benefits of estrogen, progestin can help regulate menstrual cycles and reduce the risk of uterine cancer.
This combination also helps to alleviate joint pain and other menopausal symptoms, such as hot flashes, night sweats, insomnia, and anxiety.
Forms Available:
- Oral tablets: Typically taken daily.
- Transdermal patches: Applied to the skin and replaced regularly.
- Topical gels or creams: Applied to the skin.
- Intrauterine devices (IUDs): Progestin-releasing IUDs can be used in conjunction with systemic estrogen.
Considerations: It’s crucial to thoroughly discuss with a healthcare provider to weigh the benefits and risks based on individual health profiles.
Testosterone Replacement
What It Is: Testosterone replacement therapy involves the administration of testosterone, which can be beneficial for some menopausal women, especially those experiencing symptoms like fatigue, low libido, and possibly joint pain.
How It Helps: Testosterone is primarily known as a male hormone, but it is also crucial to female health.
It can improve muscle strength, energy levels, and overall well-being, which might indirectly alleviate joint pain by enhancing physical activity and muscle support around the joints.
Forms Available:
- Topical gels or creams: Applied to the skin.
- Patches: Applied to the skin and replaced regularly.
- Pellets: Implanted under the skin and replaced every few months.
Considerations: Similar to estrogen and progesterone replacement, testosterone therapy in women should be carefully monitored.
Excessive doses can lead to side effects such as acne, unwanted hair growth, balding and voice changes. Therefore, it’s essential to have close medical supervision while undergoing this therapy.
Choosing the right HRT option depends on various factors, including your medical history, symptoms’ severity, and personal preferences.
It’s important to thoroughly discuss your options with a healthcare provider to determine the most suitable and safe option.
Regular follow-ups and monitoring are also critical to ensure the therapy’s effectiveness and promptly address potential side effects.
Pros and Cons of Hormone Replacement Therapy (HRT)
Hormone Replacement Therapy (HRT) can be a valuable treatment option for alleviating joint pain associated with perimenopause and menopause.
However, it’s essential to consider both the benefits and risks to make an informed decision.
Pros of HRT for Menopause Joint Pain
- Reduction in Joint Pain and Stiffness: Estrogen has anti-inflammatory properties that can help reduce joint pain and stiffness and maintain joint and bone health.
- Improved Bone Health: Estrogen helps maintain bone density, reducing the risk of osteoporosis and related fractures, which can indirectly alleviate joint discomfort. Long-term use of HRT is associated with a reduced risk of osteoporosis and bone fractures.
- Relief from Other Menopausal Symptoms: HRT can also alleviate other common menopausal symptoms such as hot flashes, night sweats, and mood swings, improving overall quality of life.
- Enhanced Quality of Life: By reducing joint pain and other menopausal symptoms, HRT can improve sleep, mobility, and mood, contributing to a better quality of life.
Cons of HRT for Menopause Joint Pain
- Increased Risk of Cardiovascular Issues: HRT, particularly when started late after menopause, can increase the risk of blood clots, stroke, and heart disease. Research indicates that the timing of HRT initiation is crucial, with potential increased risks for those starting HRT more than ten years post-menopause.
- Higher Incidence of Certain Cancers: women with an intact uterus should not use Estrogen-only therapy as this can increase the risk of endometrial cancer. It is essential that women who still have a uterus use combined estrogen-progesterone therapy.
- Side Effects: Common side effects include vaginal bleeding, bloating, breast tenderness, headaches, and mood changes, which can affect compliance and quality of life. These side effects are generally mild but can be bothersome. Luckily, all of these side effects can be easily treated and resolved with simple adjustments to the dosing and route of administration of HRT.
- Not Suitable for All Women: Women with certain medical conditions, such as active breast cancer, cardiovascular disease, liver disease, or unexplained vaginal bleeding, may not be suitable candidates for HRT.
When prescribed and monitored appropriately, hormone replacement therapy (HRT) can be a safe and effective option for managing menopause-related joint pain.
However, it is not suitable for everyone.
Discussing the potential benefits and risks with a healthcare provider is essential to determining the best course of action based on your health profile and preferences.
Regular monitoring and individualized treatment plans can optimize the safety and effectiveness of HRT, ensuring better health outcomes and improved quality of life.
Strategies for Menopause Joint Pain Management
Musculoskeletal pain during menopause is a common ailment that can significantly impact your quality of life.
However, there is hope for relief, as hormone replacement therapy (HRT) is an effective treatment option that helps restore key hormone levels to alleviate joint symptoms.
At Anzara Health, our team of medical and wellness professionals can provide the medical treatment and professional support you need to improve your joint health holistically.
Our endocrinologists, dietitians, and coaches will help you determine an optimal treatment approach tailored to your individual needs and goals.
Find The Right Treatment For You
Musculoskeletal pain during menopause is a common ailment that can significantly impact your quality of life.
However, there is hope for relief, as hormone replacement therapy (HRT) is an effective treatment option that helps restore key sex hormone levels and alleviate joint symptoms.
At Anzara Health, our team of medical and wellness professionals can provide the medical treatment and professional support you need to improve your joint health holistically.
Our endocrinologists, dietitians, and coaches will help you determine an optimal treatment approach tailored to your individual needs and goals.
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