If you’re paying attention, you will notice that everyone and their cat is talking about perimenopause right now.
The topic is absolutely everywhere, and, honestly, this is a good thing.
Women need support, and the more quality information we can share and absorb, the better off we’ll be. Of course, we will always have to sort through inaccuracies, avoid fear mongering and throw out some garbage, but that’s par for the course with any subject.
I believe it’s positive to discuss perimenopause as candidly as possible. At 44, as I navigate this stage of my life and experience the changes my hormones are bringing, I am so grateful to have so much information available to reassure me that what I am feeling is normal, I am not crazy, and life is certainly not over.
What exactly is perimenopause? The word means “around menopause” and refers to the period when your body makes the natural transition to menopause, marking the end of your reproductive years. Perimenopause can also be called the “menopausal transition.”
Women will start perimenopause at different ages. Typically, you will notice changes in your 40s, but some women can experience the transition in their mid-30s. Some changes are subtle, and some women breeze through this stage of life with very few or very mild symptoms. Other women will experience debilitating symptoms and will need help to navigate the changes.
Most women are doing their absolute best to cope by relying on lifestyle habits that positively impact their experience. But still, some days can be tough.
Perimenopause symptoms are many, and some are more ambiguous than others. You will regularly hear women say, “Maybe it’s my hormones, but who knows?”
There is one symptom of perimenopause that I did not know about, and wish I had! It has definitely affected me and my clients, and it’s a tough one.
Musculoskeletal Pain in Perimenopause
Pain in muscles, bones and joints is a common yet often-overlooked symptom.
Many women in perimenopause will experience more soft-tissue injuries but won’t know they are connected to their declining estrogen levels. Frozen shoulder and plantar fasciitis are two very common examples.
Musculoskeletal pain affects the body’s muscles, ligaments, tendons and bones. The pain can be short lived and scattered or it can become chronic, lasting months and even years.
For women in perimenopause, hormonal changes play a pivotal role in the onset and intensity of these symptoms. Estrogen helps regulate the maintenance of bone and muscle health, and it helps control inflammation. As estrogen levels decline, women can experience osteopenia and osteoporosis, which can contribute to joint and muscle pain. It also becomes increasingly difficult to gain new muscle in this stage.
Because hormone levels fluctuate a lot during this transition, symptoms can be different every day. Some days you’ll be pain-free and full of energy, while other days you’ll weather entirely new symptoms that pop up. This inconsistency can be very difficult to navigate physically, mentally and emotionally.
I’ve experienced how challenging these symptoms are as an athlete and a coach.
I moved through my 20s and 30s with very few injuries. Sure, I had the occasional ding or dent, but for the most part I enjoyed all kinds of training without injury or pain.
That changed after I turned 40. I noticed that joint stiffness and tendon pain were more common. I had to be flexible with my training and adapt my workouts regularly to accommodate how I was feeling when I went into the gym. I also experienced the onset of plantar fasciitis in the middle of winter, with absolutely no running in my training. It was very frustrating.
My clients who are in their early 40s report similar experiences. Suddenly aching knees and wrists were more common. Low-back pain on certain days and slower recovery popped up, too.
Giving up on fitness is not an option for me or my clients. We had to look at how we could improve our symptoms.
Lifestyle Changes
You have options when it comes to treating pain during perimenopause.
Some treatments you can manage at home, but don’t be afraid to speak with a health-care professional as well. They can offer insight based on your specific symptoms and pain levels.
I can tell you this for certain: Good nutrition is critical. Focus on eating adequate amounts of high-quality protein to maintain lean muscle mass. Eat foods rich in calcium and vitamin D, such as leafy greens, beans, legumes, mushrooms and dairy products. The anti-inflammatory omega-3 fatty acids in chia seeds, flaxseeds and fish are also excellent. Alcohol? I cut back to almost nothing, and it was a great move for me.
Another truth: Regular physical activity is very important for managing musculoskeletal pain. Walking, running, hiking and skipping strengthen bones and muscles, while yoga and stretching can improve flexibility. Weight training is also wonderful, and a good coach can help you do it properly—especially if perimenopause symptoms flare up.
Women who are experiencing more joint/muscle and tendon pain might need to adjust the intensity and duration of their exercise and take more time to recover between workouts. Quality sessions with less volume and more intensity will feel better on certain days. On other days, lower-intensity movement will help with recovery.
The best plan: Focus on what you can do, not what you can do, and be kind to yourself. There are no “shoulds.” Do what you can and be proud of yourself.
Don’t Stop Moving
While it might feel like it’s time to pack it in because things ache on some days, this is the time of life to lean into movement and maintain your fitness habit. The preservation of lean mass is so important at this stage, so it’s a mistake to stop moving.
Instead, work with a coach who can help you adapt your training to recognize where you’re at, both overall and from day to day. And don’t hesitate to talk to your doctor about HRT and other treatments that might be helpful during this transition.
With the right guidance, you can navigate this stage of life and keep your body in great shape!
