Muscle pain and menopause: what you need to know

In the years leading up to menopause, your ovaries gradually produce less oestrogen and progesterone. These changes are most dramatic during perimenopause, the first stage of menopause. As oestrogen levels drop, collagen production decreases along with it. Collagen provides structure and support to your whole body, from your skin to your muscles. 

Research has shown that oestrogen supports collagen production by binding to receptors in the skin known as fibroblasts. Fibroblasts need oestrogen to trigger collagen production. When your body has less oestrogen, its ability to produce collagen becomes compromised. This can affect your muscles (and also your skin), causing muscles to feel painful or tense.  

Oestrogen deficiency results in loss of muscle mass and elasticity: you’ll notice that your body is not as flexible as it used to be. You may also notice changes in your joints, such as stiff hands, sore knees and painful shoulders. Read more about joint pain and menopause here. 

Now let's talk about a hormone called leptin. Leptin is an appetite suppressant and mediates the regulation of muscle mass. It also makes your body feel satisfied after eating. Around menopause, the body may become resistant to the effects of leptin, a condition known as leptin resistance. Leptin resistance leads to inflammation, causing muscle pain.  

Many women experience a host of symptoms as they go through menopause, such as hot flashes, sleep problems and mood swings. 

Muscle tension is not only caused by menopausal hormone fluctuations. It can also be caused by other factors, or an interplay of factors. Menopause can make you more sensitive to stress and more prone to feelings of anxiety and agitation. A decrease in progesterone is partly responsible for this. Progesterone has a calming effect on both the body and mind. When levels of progesterone begin to drop prior to menopause, muscles tend to become tense. An inactive lifestyle, sedentary work, poor posture or injury can also cause muscle tension and muscle pain. Muscle problems can also be a side effect of medicines you're taking or a sign of an underlying health condition. Last but not least, other menopausal symptoms can also play a role in the development of muscle issues.

You probably think of your heart as an organ, but the heart is a muscle. This explains why many menopausal women experience palpitations: pounding or irregular heartbeats. The female sex hormone oestrogen protects the heart and the arteries. When oestrogen production decreases, the risk of heart palpitations increases. Read more about heart palpitations.

Research show that we start to lose muscle mass in our 30s at a rate of around 3 to 8 percent per decade. After age 60, we lose muscle mass more quickly. Losing muscle mass is a normal part of ageing. Most women notice their muscle mass declining around age 45. This is due to the sharp decrease in sex hormones at the onset of perimenopause.  

When you reach postmenopause, your oestrogen and progesterone levels are consistently low which increases the risk of muscle and joint problems. Mind you, each woman's body is different and no woman's journey through menopause is the same. Some women wake up feeling sore all over, while others jump out of bed in the morning like a kid on Christmas Day.  

The point is that loss of muscle mass cannot be avoided from a certain age. Even the most muscular athletes fall victim to muscle loss eventually – menopause or no menopause. Having said that, a healthy lifestyle and practising self-care can do a lot to keep your muscles and joints strong as you age. 

A healthy diet and lifestyle are the keys to supporting muscle health and preventing or reducing muscle problems. Here's what you can do. 

• Exercise daily. Being active may feel uncomfortable or tiresome at first, but it will keep your muscles flexible, strong and healthy. Tip: opt for low-impact activities such as swimming or strength training.  
• Avoid sugars and fructose, and eat more protein and healthy fats. This helps restore leptin balance in your body, which promotes muscle growth. Good fats have anti-inflammatory properties. Oily fish, nuts, avocado and olives are a great choice.  
• Pay attention to your posture. When sitting down, keep your chin parallel to the floor, your shoulders at even heights, and your knees and feet pointing straight ahead. Relax your shoulders and jaw. Investing in a good chair to support posture is always a good idea. Set an alarm to remind yourself to fix your posture. (Don't forget to take regular breaks, and stand up and move about.) 
• Make time to relax. Massage, mindfulness and breathing exercises are proven ways to release muscle tension and relax the body. Carve out moments in your day where you make a conscious effort to relax. Sit up straight and loosen your muscles. Breathe in deeply through your nose and out through your mouth. Relax and release any built-up tension in your body. Tiny changes can make a big difference. 
• Support your muscles with supplements. Some women benefit from collagen supplements. This dietary supplement can be added to tea or coffee. Vitamin C stimulates your body's natural collagen production. Adding magnesium to your diet helps muscles relax. Magnesium deficiency can contribute to muscle tension and pain. Taking a magnesium supplement can help you cover your magnesium needs.