A Scary Skeleton Story

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You know that feeling when a good friend gives you the perfect gift – something you didn’t know you needed necessarily, but something that makes you feel seen and known? I haven’t met Dr. Vonda Wright (yet), but reading her scientific paper The Musculoskeletal Syndrome of Menopause felt like that. 

Now, why am I so moved by an article in a peer-reviewed journal? Because Dr. Wright, an orthopedic surgeon in Orlando, FL, has for the first time given a name to the collection of aches, pains, and serious medical issues 70% of women experience with declining estrogen levels, including musculoskeletal pain, joint pain, loss of lean muscle mass, loss of bone density, broken bones, tendon and ligament injury, frozen shoulder, and cartilage damage with osteoarthritis. 

This table Dr. Wright’s paper spells out the body processes and symptoms declining estrogen levels can cause in the musculoskeletal system. Download a PDF of the paper here.

I personally experienced joint pain so debilitating I had to quit training for, and competing in, long-course triathlons, a hobby and form of movement that I loved. (If you’re new, I’ve written about that experience and my solution here.) But the paper (published in print this month) and its subsequent social media buzz also validate what I’ve been teaching as a bodyworker and functional movement expert for 25 years. 

My clients – the vast majority of whom are women – typically come to see me between the ages of 50 and 85 to work through stiffness, regain mobility after an injury, recover after surgery, improve balance, or build strength to enhance their quality of life. Because many of my clients have been with me for over 15 years, this work has given me a front-row seat to the aging process. 

I see the same patterns over and over again — mostly active women with joint or muscle pain, which then can lead to more serious issues if not addressed. Slow, gentle movement that enhances your range of motion can be the key to alleviating these aches. (A little stiffness or a dull ache is common at the beginning, but if you’re experiencing sharp, stabbing pain, please see your doctor.) Over time, becoming less active can lead to more serious issues with tendons or ligaments, postural misalignment, joint replacements, and eventually the frailty that comes with loss of muscle mass and bone density. 

You may have seen this play out with your own mom or grandma — a once-active woman starts to lose steam in midlife, becoming a little more sedentary as the years go on until they require joint replacements and finally experience a bone-breaking fall. Or a bone-breaking fall requires a joint replacement. All of a sudden a fiercely independent person can no longer live independently.

It’s a vicious cycle: When you don't feel your best in perimenopause  — hello insomnia, joint pain, brain fog, and more – it’s tough to find the motivation to keep moving. But if you want to be able to travel into retirement, play with your kids and grandkids, keep enjoying the hobbies you love, and live independently for as long as possible, we now have the blueprint for taking care of your muscles and bones. 

Here are the basics widely agreed upon by menopause experts:

• Osteoporosis screening (usually a DEXA scan) for women aged 65 years or older and for those aged 50–64 years who have certain risk factors, including a positive family history of osteoporosis. Coincidentally I’m getting a DEXA today, though I’m in my late 40s. The more I read, the more I realize that by the time insurance covers a test, it may be too late to do anything about the diagnosis. This scan measures body and bone composition, is inexpensive (about $50), and results can empower you to tweak your nutrition and exercise plan. I’ll share what I learn in an upcoming newsletter.

• Getting enough Vitamin D and magnesium from whole food sources or supplementation (ask your doctor for labs to determine exactly how much). 

• Strength training: Resistance training 2-3 times per week with heavier weights and fewer reps is more effective than more reps with lighter weights.  

• Eating plenty of protein (1-1.3 grams of protein per kg of body weight) and loading up on anti-inflammatory foods like those found in the Mediterranean eating pattern.  

• Slow, gentle movements like those found in restorative yoga for days that achy joints would rather keep you on the couch.

• Weight-bearing activities like brisk walking, dancing, jumping on a rebounder trampoline or even climbing stairs to improve bone strength.

I used to only lift 3 pound weights, but I’ve slowly worked my way up to 15 pounds.

Back to the paper: Dr. Wright and colleagues felt compelled to name this collective of symptoms because even though 47 million women enter menopause annually, 70% percent of whom will experience musculoskeletal symptoms in menopause and 25% of whom will become disabled because of them in their post-menopausal years, most clinicians aren’t aware that these muscle and bone issues are intimately connected to declining estrogen levels. Yikes.
What’s in a name, you ask? In 2014, the Board of the North American Menopause Society and Board of Directors of the International Society for the Study of Women’s Sexual Health approved the name for the collective of estrogen-related genitourinary symptoms of menopause (dryness, burning, irritation, painful sex, and frequent UTIs) — the Genitourinary Syndrome of Menopause. This clarity and awareness has translated to more education for doctors, more comprehensive care, and the ability to self-advocate for women seeking a diagnosis. I’m hoping this paper helps shine a light on a series of symptoms that many women experience during perimenopause and menopause and encourages them to seek help. 

If you’ve made it this far – thank you! I can think of a few topics I’m more passionate about (skincare among them, of course). I’d love to know how you’re strengthening your muscles and bones as you age — and how you’re digging deep to find the motivation to move even when you don’t feel like it. Leave a comment so we can learn from each other.

Cheers to looking and feeling your best,
Susan Campbell
Founder & CEO, Phosis