There are 3.5 billion women on the planet (almost) all of whom will go through the menopause at some stage in their life. In the UK The average age of menopause is 51 years old. A woman officially reaches the menopause when she has gone through 12 consecutive months without a period. The time leading up to this is called the perimenopause. During this transitional time, the levels of the hormones estrogen and progesterone fluctuate, giving rise to the symptoms of menopause that we are all more commonly aware of, irregular periods, hot flushes, night sweats and effect on mood.
Estrogen receptors are also found in the synovium of joints. It is this decline in estrogen in the run up to menopause that can give rise to joint pains and stiffness.
Osteoarthritis is the most common form of arthritis in men and women. It is usually related to wear and tear of our joints and ageing. It is more prevalent in women than men and increases in incidence from 50 years of age.
You can see that a woman heading into the menopause is therefore also on a fast track course to getting symptoms of arthritis. Often a woman in her mid 40’s will say that her joints feel stiff in the mornings and it takes about half an hour to loosen up.
In fact 25% of women over the age of 45 years will present to their GP with joint pains, usually in their neck, knees and hands and 50% of women over the age of 50 years will present with joint symptoms and associated menopause symptoms. Often some of these symptoms are self limiting and resolve within 2-5 years ie coinciding with their menopause symptoms.
It has been shown in trials that hormone replacement therapy can alleviate these symptoms so there is a clear link between arthritis around the menopause and oestrogen deprivation.
In summary, joint pain and stiffness in the menopause transition is a common problem and related to oestrogen fluctuation and decline. It can also be the early signs of inflammatory arthritis, endocrine issues and malignancy so it’s important to exclude these before considering hormone replacement therapy appropriate to the individual. If in doubt please see your doctor or rheumatologist.
References
Menopause and HRT are important aetiological factors in Hand Osteoarthritis, Results from a cross sectional study in secondary care, Professor Fiona Watt, Kennedy Instituteof Rheumatology, University of Oxford, UK
Menopause Arthralgia, Fact or Fiction , Maglorzata Magliano, Maturitas 2010
