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Joint Pain

We describe the basics of menopausal joint pain - why it happens; how lifestyle changes help; and how medication can sooth your pain. It's really common but not always talked about. Don't let it drag you down.

Recap - what's happening during menopause.

During perimenopause your hormones bounce around - from high to low. But over time and as you pass through menopause your hormone levels drop. Oestrogen is one of those hormones.

Why does joint pain happen with menopause?

Oestrogen affects your joints because it provides them with lubrication. This lubrication eases movement - meaning there is little friction between the bones. No friction means easy, pain free movement.

When oestrogen drops during perimenopause joint lubrication can reduce too - causing joint aches and pains. Oestrogen also plays a role in reducing inflammation in your joints. As your hormone levels fall through menopause and after it joint pain is a common problem.

How common is joint pain?

Our assessment shows that up to 80% of women with an induced menopause have joint pain, and up to 70% for those with a non-induced menopause. Contrary to popular belief this would make it one of the more common symptoms.

What lifestyle changes can help?

Exercise is important. It helps to keep the joints mobile, keep bones strong and prevent osteoporosis. Menopausal age women should try to do 150 minutes of moderate-intensity activity each week. Some suggestions for exercise when you have stiff joints are:

  • Brisk walking as part of a daily routine can help to maintain bone and joint health.

  • Swimming because it's low impact and can help if your joint pain makes running and walking difficult.

  • Yoga can help increase strength, flexibility, improve joint mobilisation and prevent osteoporosis.

  • Cycling can also be a good way to get in aerobic exercise, without having too much impact on aching joints!

Diet is also important for bone health - in particular eating enough Calcium and vitamin D. Calcium is in dairy products, and leafy green veg. Vitamin D can is in oily fish and eggs, and is also made when the body is outside and getting enough exposure to the sun.

Getting enough sleep can also help to reduce tiredness and joint pain.

Do supplements help?

Evidence for supplements is a real mixed bag. There is one standout that's got a good evidence base and is important for bone and joint health - vitamin D.

The UK guidelines say that adults will benefit from taking a low dose vitamin D supplement (10mcg). This is especially true in autumn and winter when there's less sunlight. If you suffer with joint pain it's worth following this recommendation. For women of colour it's even more important as your skin naturally produces less vitamin D from sunlight.

If you consult a GP with joint pain, and they may give you a blood test for vitamin D deficiency. If it comes back positive, you may be recommended a higher dose supplement. Make sure you only take the higher dose supplements under the advice of a doctor.

Are there any medical treatments?

There are prescription and over the counter products that can help reduce joint pain.

Anti-inflammatory medication like ibuprofen can help ease joint pain. Gels which you can apply locally to the most painful areas can be very helpful. These are available through most pharmacies and supermarkets. No prescription needed.

Hormone replacement therapy reduces joint pain significantly. It also reduces the chance of osteoporosis (brittle bones) by up to 30% if taken within 10 years of your last period.

Remember, if your joint pain is severe take rest and seek appropriate medical advice. A doctor may recommend that you have a bone density scan (sometimes called a DEXA scan). This checks your bone density. A scan is more likely if you have recently been taking steroid medication for over 3 months, have broken a bone or show signs of arthritis. All of these impact the overall risk of fracture and can reduce bone density.

References:

1 Hillard T., et al. (2017). Management of the menopause. 6th edn. British Menopause Society. UK.

2 National Health Services Website (2018). *Menopause and your bone health * Retrieved 10 March 2020 from [https://www.nhs.uk/live-well/healthy-body/menopause-and-your-bone-health/].

3 Scientific Advisory Committee on Nutrition (SACN). (2016). Vitamin D and Health Retrieved 10 March 2020 from [https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/537616/SACN_Vitamin_D_and_Health_report.pdf].

4 Panay, N., Briggs, P., & Kovacs, G. (Eds.). (2015). Managing the Menopause: 21st Century Solutions. Cambridge: Cambridge University Press.