Perimenopause and musculoskeletal health: what you need to know

This is a free preview of a paid episode. To hear more, visit mskmag.substack.com If you’re a clinician or working with active women, you’ll probably recognise this familiar picture. A woman in her mid 40s seeks your help with joint or muscle pains which are taking much longer to resolve than they used to. She’s picking up injuries more often, and with her busy life and poor sleep patterns, she’s struggling to find a way forward. Caring responsibilities are overwhelming her, and she doesn’t have much time to herself to stay active, which is important to her to maintain her weight and her sanity. We know there’s usually a physiological basis to most injuries and that other factors influence them, particularly when hormones are fluctuating…but what impact does perimenopause really have? **Menopause** is marked clinically by the day which is twelve consecutive months without a period**. Perimenopause** is the phase preceding this, when women experience menstrual cycle irregularities and, quite often, symptoms due to changing ovarian function and fluctuating hormone levels (oestrogen, progesterone and testosterone). While the average age of menopause in the UK is 51 (globally 49), the normal range is 45-55 years, and some women experience premature menopause due to premature ovarian insufficiency, cancer treatments (radiotherapy, chemotherapy), hormone medications or surgery. Screening for this is essential as early menopause carries greater risks for bone and heart health. **Time to reframe the conversation and giving everybody what they deserve** Recent media interest and women’s health campaigns have prompted health care and exercise professionals and researchers to rethink menopause and the potentially significant impact it has on MSK systems alongside the cardiovascular, metabolic and nervous systems. Our patients - rightly - expect us to be empathetic and well informed. Women, clinicians and exercise professionals have been underserved. From hushed discussion around ‘the change’, limited research and training, to mixed messages around what really helps, it’s a difficult space. Some women report that valid concerns have been dismissed. Whilst it’s great that there’s greater awareness of perimenopause, it’s no wonder women are scrolling through Instagram, taking cold plunges and scrambling for supplements looking for a magic bullet. We deserve better. We have an enormous opportunity not just to help manage current problems but anticipate and potentially mitigate the effects of future detrimental processes in order to help women manage their own health and wellbeing.