The Musculoskeletal Syndrome of Menopause: Why 70% of Women Experience Joint Pain (And What You Can Do About It)
If you're in your 40s or early 50s and suddenly experiencing joint pain, muscle weakness, or unexplained stiffness—even though your doctor says "everything looks normal"—you're not imagining it. You're experiencing what researchers now call the Musculoskeletal Syndrome of Menopause, and you're far from alone.
According to groundbreaking research published in 2024, an estimated 70% of perimenopausal women experience musculoskeletal symptoms, with 25% suffering severe symptoms that significantly impact their quality of life. Perhaps most frustratingly, 40% of these women have no structural findings on imaging—meaning X-rays and scans come back "normal" even though the pain is very real.
What Is the Musculoskeletal Syndrome of Menopause?
The Musculoskeletal Syndrome of Menopause is a newly recognised medical term that describes the collection of musculoskeletal symptoms directly linked to declining oestrogen levels during perimenopause and menopause. This isn't just "getting older"—it's a specific physiological response to hormonal changes.
The syndrome includes:
Joint pain and arthralgia (generalised joint discomfort)
Loss of muscle mass and strength (sarcopenia)
Decreased bone density with increased fracture risk
Tendon and ligament injuries
Adhesive capsulitis (frozen shoulder)
Cartilage fragility and progression of osteoarthritis
Reduced flexibility and mobility
Why Does This Happen? The Oestrogen Connection
Oestrogen isn't just a reproductive hormone—it's a powerful regulator of your musculoskeletal system. When oestrogen levels drop during perimenopause, five critical changes occur in your body:
1. Increased Inflammation
Oestrogen acts as a natural anti-inflammatory. Specifically, 17β-oestradiol inhibits the release of inflammatory cytokines like TNF-α, which can degrade muscle proteins and promote fat accumulation. When oestrogen declines, inflammation increases, leading to generalised joint pain and stiffness—even without visible damage on scans.
This explains why more than half of perimenopausal women report arthralgia symptoms, with pain often peaking in early postmenopause.
2. Sarcopenia (Muscle Loss)
After menopause, women lose approximately 0.6% of muscle mass per year. This isn't just about aesthetics—it's about function, strength, and independence.
Oestrogen deficiency leads to:
Decreased mitochondrial function in muscle cells
Atrophy of fast-twitch muscle fibres
Increased intramuscular fat tissue
Impaired insulin sensitivity
Reduced muscle repair capacity
The result? You may notice you're walking more slowly, losing stamina, struggling with balance, or finding it harder to open jars or carry groceries.
3. Decreased Satellite Cell Proliferation
Satellite cells are muscle stem cells responsible for repair and regeneration. Oestradiol stimulates their activation and proliferation. Without adequate oestrogen, research shows a 30-60% reduction in satellite cells, particularly in muscles like the tibialis anterior (front of your shin).
This means your muscles become less able to recover from injury or respond to exercise—making it frustratingly difficult to build or maintain muscle mass, even with resistance training.
4. Bone Density Loss
During perimenopause, women experience an average 10% reduction in bone mineral density. This silent process increases your risk of osteoporosis and fractures—particularly in the hips, spine, and wrists.
Oestrogen deficiency accelerates bone breakdown, and without intervention, this can lead to:
Loss of height
Stooped posture
Chronic back pain
Low-impact fractures
5. Cartilage Damage and Osteoarthritis
Oestrogen helps maintain healthy cartilage and joint lubrication. When levels drop, cartilage thins, joint lubrication decreases, and inflammation increases—creating the perfect storm for osteoarthritis progression.
Women experience a dramatic increase in osteoarthritis incidence around menopause, particularly in the knees, hips, and fingers. Research also shows women experience more debilitating arthritic pain than men.
Why Your Doctor Might Miss This
Here's the frustrating part: 40% of women with Musculoskeletal Syndrome of Menopause have no structural findings on imaging. Your X-rays look fine. Your blood tests come back "normal." But you're in pain, you're losing strength, and you're being told it's just part of ageing.
The truth is, standard blood tests and imaging often miss the hormonal and metabolic changes driving your symptoms. This is where functional assessments like Hair Tissue Mineral Analysis (HTMA) become invaluable—revealing mineral imbalances, stress adaptation patterns, and metabolic dysfunction that standard tests overlook.
What You Can Do About It
The good news? Research shows that the Musculoskeletal Syndrome of Menopause can be addressed through various approaches. Here's what the evidence suggests:
1. Chiropractic Care
Gentle, targeted chiropractic adjustments may help support:
Spinal alignment and joint mobility
Nervous system function
Posture and movement patterns
Whole-body function during hormonal transition
At Vitalia Health Chiropractic, we use a combination of manual diversified adjusting, drop-piece techniques, soft tissue therapy, and visceral techniques tailored to your unique needs and stage of perimenopause.
2. Nutritional Support
Research suggests key nutrients for musculoskeletal health during menopause include:
Vitamin D: Studies show associations with improved hip bone mineral density and reduced fall risk in postmenopausal women
Magnesium: Essential for calcium-phosphorus metabolism; research indicates it may reduce bone turnover markers and support vitamin D levels
Vitamin K2: Studies suggest associations with increased lumbar and forearm bone mineral density
Protein: Important for maintaining muscle mass
Creatine: Emerging research explores potential effects on bone mineral density and muscle power in postmenopausal women
3. Resistance Training
Research consistently shows resistance exercise may help:
Support muscle mass maintenance
Support bone density
Improve balance
Support insulin sensitivity
Support metabolic function
Combined with adequate protein intake and nutritional support, resistance training is an important component of musculoskeletal health during perimenopause.
4. Hormone Replacement Therapy (HRT)
For some women, menopausal hormone therapy may be appropriate. Research shows HRT is associated with:
Preservation or increases in bone mineral density at skeletal sites
Decreased incidence of osteoporotic fractures
Support for muscle mass and strength
Reduced inflammation markers
HRT isn't suitable for everyone. It's important to discuss your individual circumstances with a qualified healthcare provider who understands the musculoskeletal implications of oestrogen deficiency.
5. Comprehensive Functional Assessment
Understanding your unique hormonal, metabolic, and mineral status is key to developing an appropriate treatment approach. This is where our Perimenopause Clarity Assessment comes in.
The Perimenopause Clarity Assessment
At Vitalia Health Chiropractic, we've developed a comprehensive perimenopause assessment that combines chiropractic expertise, women's health medicine training, and advanced mineral analysis.
This 2-hour assessment includes:
Detailed health history and symptom analysis
Functional posture and movement assessment
Hair Tissue Mineral Analysis (HTMA) to reveal mineral imbalances, stress patterns, and metabolic dysfunction
Personalised treatment plan addressing your unique needs
Digital resources including symptom tracker, perimenopause guide, and wellness workbook
Investment: $497 (includes HTMA lab testing and all digital resources)
You Don't Have to Accept Pain as "Normal Ageing"
The Musculoskeletal Syndrome of Menopause is real, it's common, and research shows there are evidence-based approaches that may help. You deserve comprehensive care that addresses the underlying factors contributing to your symptoms—not just a dismissive "that's what happens as you age."
At Vitalia Health Chiropractic in Palmwoods, we specialise in helping women navigate perimenopause with clarity, support, and evidence-based care. Our unique combination of chiropractic expertise, women's health medicine training, and advanced functional testing means you get a thorough assessment and individualised care plan.
Ready to understand what's really happening in your body?
Book your Perimenopause Clarity Assessment today. Call 07 5221 5020 or visit www.vitaliahealth.com.au/perimenopause-clarity-assessment
Dr Laura Brooks holds a Master of Clinical Chiropractic and a Master of Women's Health Medicine (UNSW), and is currently completing a Master of Research at the University of Southern Queensland. She is the only practitioner on the Sunshine Coast offering this comprehensive integration of chiropractic care, women's health medicine, and advanced mineral analysis for perimenopause.
References
Wright, V.J., Schwartzman, J.D., Itinoche, R., & Wittstein, J. (2024). The musculoskeletal syndrome of menopause. Climacteric, 27(5), 466-472.
