Facts about Menopause
PERI MENOPAUSE AND MENOPAUSE, WHAT’S THE DIFFERENCE?
PERI MENOPAUSE
Also called ‘second puberty’ - it is the period of time (anywhere from 2-10 years) before your final period occurs.
Symptoms are temporary during this time, however it can be a debilitating stage of life for some women.
Perimenopause is not about ageing. Instead, it’s an important (and unavoidable) recalibration of your hormonal and nervous systems.
Regardless of what you may read or be told - Perimenopause CANNOT be diagnosed through any lab testing / blood work. It is diagnosed by your symptoms and age.
According to Canadian endocrinology professor Jerilynn C Prior;
‘A midlife woman with regular cycles is likely to be in perimenopause if she notices any three of the following nine changes:
new-onset of heavy and/or longer flow shorter menstrual cycles (<26 days)
new sore, swollen or lumpy breasts
new mid-sleep waking
increased menstrual cramps
premenstrual night sweats
new or markedly increased migraine headaches
new or increased premenstrual mood swings
weight gain without changes in exercise or eating.
MENOPAUSE
Menopause is defined as the final menstrual period and is usually confirmed when a woman has missed her period for 12 consecutive months (with no other obvious causes). Menopause can be diagnosed through blood work (two high FSH readings (more than 40 IU/L) at least a month apart).
Roller Coaster ride of hormones.
During perimenopause, the first hormonal change is a drop in progesterone. Losing progesterone can contribute to anxiety, breast pain, heart palpitations, night sweats, frequent migraines and crazy, heavy periods.
Just as progesterone starts to drop away, oestrogen starts to spike up to three times normal. And that can contribute to an irritable mood, breast pain and heavy periods.
Physical symptoms of Menopause
The prevalence of musculoskeletal pain among perimenopausal women is approximately 71%, indicating that they are at a higher risk for such pain compared to their premenopausal counterparts. During perimenopause, women typically experience a 10% decrease in bone mineral density. Additionally, after menopause, muscle mass tends to decline by about 0.6% per year.
These musculoskeletal issues are largely due to decreased levels of oestrogen.
Oestrogen plays a crucial role in the health of various musculoskeletal tissues, including bones, tendons, muscles, cartilage, ligaments, and adipose tissue.
A decline in oestrogen leads to several key changes: increased inflammation, reduced bone mineral density resulting in osteopenia or osteoporosis, arthritis, sarcopenia, and a decrease in the proliferation of satellite cells (muscle stem cells).
Quite commonly women are unaware that their new onset of musculoskeletal symptoms could be related to hormonal changes.
Common conditions that present to Osteopath’s that could be related to perimenopause include but are not limited to:
Bursitis eg. hip, shoulder
Frozen shoulder
Tendon pain eg. plantar fasciitis, glute med tendinopathy, rotator cuff tendinopathy
Hip pain
Headaches / migraines
Brain fog
Arthritis like joint pain
Low back pain
How can Osteopaths help?
Osteopaths can provide valuable support for managing menopausal musculoskeletal pain through various strategies:
Education: Having knowledge of what is happening with your body is empowering.
Comprehensive Assessment; this will help provide a thorough diagnosis and understanding to how your body is moving. A comprehensive assessment is important to rule out any other influencing factors that could be contributing to your pain.
Manual Therapy: Using hands-on techniques to improve joint mobility and reduce muscle tension. This can involve gentle stretching, myofascial release, improving lymphatic drainage and joint mobilizations to alleviate pain and restore function.
Exercise Prescription: Recommending tailored exercises to strengthen muscles, improve flexibility, and support joint stability. These exercises are designed to address specific weaknesses or imbalances that may be contributing to pain.
Education and Lifestyle Advice: Providing guidance on lifestyle modifications that can support musculoskeletal health during perimenopause / menopause. This will include understanding your inflammatory lifestyle factors, quality of sleep, exercise routine, stress levels, diet and alcohol levels.
Support for Bone Health: Provide strategies to help maintain bone density and strength, including advice on weight-bearing exercises, and other lifestyle factors that influence bone health.