Wait, What Is Musculoskeletal Syndrome of Menopause?

MSM isn’t just one thing. It’s a catch-all for symptoms like:

• Joint pain and stiffness (especially in the morning)
• Muscle aches and tension
• Reduced flexibility or grip strength
• Increased risk of injuries or slower recovery

And no, this isn’t just because you didn’t stretch after Pilates. It’s linked directly to declining estrogen levels, which play a surprisingly large role in maintaining collagen, cartilage, bone density, and muscle mass.

📊 Up to 50% of women in perimenopause and menopause report joint and muscle pain (Avis et al., 2001). It’s the second most common symptom after hot flashes.

Things You Didn’t Know About It (But Should)

🦴 Estrogen is your bone and muscle bodyguard: It helps regulate inflammation, supports collagen production, and keeps joints cushioned.

🧠 Pain perception increases after menopause: Studies suggest a drop in estrogen may lower pain thresholds (Craft, 2007). That means things that used to be "mildly annoying" now feel like a medieval torture scene.

💊 Menopause-related joint pain gets misdiagnosed a lot: Many women get sent home with NSAIDs, muscle relaxants—or told to "watch their posture"—instead of having hormones addressed.

🩺 Early-onset MSM is real: This can begin in perimenopause (as early as your late 30s or 40s), and often shows up as “nagging” pain, especially in the hands, hips, or neck.

👩‍👧 Your daughter might be next: MSM is under-discussed in families, meaning younger women often don’t get the heads-up. Joint health isn’t just for grandma—it’s a perimenopause prep course.

Five (Evidence-Based) Ways to Prevent or Reduce MSM

1. Prioritize Resistance Training
   Muscle mass drops by 1–2% per year post-menopause unless you fight back. Strength training improves joint stability and bone density. Bonus: It boosts mood and metabolism.
2. Increase Omega-3 Intake
   Studies show omega-3s may reduce joint tenderness and inflammation in postmenopausal women (Kruger et al., 2011).
3. Get Your Vitamin D and Calcium On Point
   You need both for bone and muscle integrity. Aim for ~1,200 mg calcium and 800–1,000 IU vitamin D daily unless otherwise directed.
4. Consider Collagen + Hyaluronic Acid
   Emerging studies suggest these support connective tissue and cartilage in menopausal women (Zdzieblik et al., 2017).
5. Talk to Your Provider About BHRT
   Bioidentical hormone replacement therapy (BHRT) can reduce pain and improve mobility, especially when symptoms are estrogen-related.

📊 One study found that HRT users reported significantly less back, neck, and knee pain than non-users (Tuomikoski et al., 2012).

What Not to Do If You’re Dealing with MSM

❌ Avoid staying sedentary – Sitting too long causes more stiffness, not less.
❌ Don’t skip protein – You need it more than ever to preserve muscle mass.
❌ Don’t overdo high-impact workouts – Yes, CrossFit queen, we’re looking at you.
❌ Don’t assume it's just “old age” – Normalize bringing up pain with your doctor (and asking about hormones).
❌ Don’t ignore stress – Chronic cortisol ramps up inflammation and can worsen joint pain.

Hormones, BHRT, and That Sweet Sweet Estrogen

Estrogen is a musculoskeletal multitasker. It regulates:

• Inflammation
• Cartilage turnover
• Calcium absorption
• Muscle fiber regeneration

BHRT (especially transdermal estradiol) can help reduce joint and muscle pain, particularly when combined with progesterone and lifestyle support. And it’s not just anecdotal—clinical studies back this up.

📊 In randomized trials, HRT users saw improvements in hand pain, stiffness, and physical function scores versus placebo (Kumru et al., 2009).

Just don’t DIY your hormones. Work with a provider who understands menopause-specific needs, testing, and dosing.

Early Signs to Watch For (or Warn Your Daughter About)

👟 You start waking up stiff or sore after normal days
✋ Your grip strength declines, or you notice hand pain
💤 You feel body aches after sleeping (yes, even in a luxury mattress)
🎾 You injure more easily or recover more slowly
🧠 You write it off as aging—but you're only 42

References (APA Style)

Avis, N. E., Stellato, R., Crawford, S., Johannes, C., & Longcope, C. (2001). Is there a menopausal syndrome?Menopause, 8(3), 186–199. https://doi.org/10.1097/00042192-200105000-00005

Craft, R. M. (2007). Modulation of pain by estrogens. Pain, 132(1), S3–S12. https://doi.org/10.1016/j.pain.2007.09.028

Kruger, M. C., Coetzee, M., Haag, M., & Weiler, H. (2011). Long-chain polyunsaturated fatty acids: selected mechanisms of action on bone. Progress in Lipid Research, 50(1), 72–80. https://doi.org/10.1016/j.plipres.2010.08.001

Kumru, S., Arikan, S., Yilmaz, B., & Adiguzel, H. (2009). Effects of hormone replacement therapy on clinical and radiologic parameters and quality of life in postmenopausal women with osteoarthritis. Archives of Gynecology and Obstetrics, 279(3), 391–395. https://doi.org/10.1007/s00404-008-0715-4

Tuomikoski, P., Savolainen-Peltonen, H., Mikkola, T. S., & Ylikorkala, O. (2012). Use of hormone therapy and risk of musculoskeletal pain: a population-based cohort study. Maturitas, 72(2), 181–185. https://doi.org/10.1016/j.maturitas.2012.03.010

Zdzieblik, D., Oesser, S., Gollhofer, A., & König, D. (2017). Collagen peptide supplementation in combination with resistance training improves body composition and increases muscle strength in elderly sarcopenic men: A randomized controlled trial. British Journal of Nutrition, 114(8), 1237–1245. https://doi.org/10.1017/S0007114515002810