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Menopause is often associated with muscle pains and spasms. While muscle spasms can be caused by several factors, such as stress, reduced physical activity, and poor sleep, hormonal changes during menopause, including a decrease in estrogen levels, are believed to play a significant role in the onset and intensity of these symptoms. Estrogen has anti-inflammatory properties, and lower levels of estrogen during menopause are linked to increased inflammation, which may contribute to muscle aches and pains. Additionally, reduced estrogen levels can affect collagen production, impacting both cartilage and tendons, further influencing muscle health. While the evidence is mixed, some women have found relief from menopausal muscle symptoms through hormone replacement therapy (HRT), which aims to replenish estrogen levels.
| Characteristics | Values |
|---|---|
| Cause of muscle spasms | Menopause, perimenopause, hormonal changes, stress, anxiety, reduced physical activity, insufficient protein, insufficient electrolytes, osteoarthritis, osteoporosis, gluteal tendinopathy, fibromyalgia, hypokalemia, high BMI, smoking, aging, physical strain, injuries, autoimmune diseases |
| Treatment for muscle spasms | Hormone replacement therapy (HRT), anti-inflammatory medication, cognitive behavioural therapy, yoga, pilates, physiotherapy, weight-bearing exercises, deep tissue massage, mindfulness techniques |
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What You'll Learn
Hormonal changes during menopause
Menopause is a natural process that occurs when a woman's ovaries stop producing reproductive hormones, oestrogen and progesterone, and menstruation ends permanently. The transition phase before menopause is called perimenopause, during which the ovaries' production of these hormones decreases. This decline in oestrogen and progesterone causes most menopause symptoms, which can last for up to 10 years before and after menopause. Symptoms can be uncomfortable and include hot flashes, mood changes, night sweats, sleep disturbances, irregular periods, and muscle spasms and aches.
During perimenopause, hormone levels can fluctuate significantly. Follicle-stimulating hormone (FSH) levels increase in response to declining inhibin B levels, which reflect the fall in ovarian follicle numbers. Estradiol levels may also rise due to elevated FSH, but they eventually decrease during late perimenopause. Testosterone levels decrease during a woman's reproductive years but may rise after menopause. Dehydroepiandrosterone (DHEA) and its sulphate derivative, DHEAS, also decline with age, independent of menopause.
The drop in oestrogen levels during menopause can lead to a decrease in bone mineral density, resulting in osteoporosis, a condition characterised by severe bone thinning. This increases the risk of fractures, even from low-impact injuries or without any apparent cause. Oestrogen's anti-inflammatory properties also mean that lower levels can contribute to inflammation in the body, exacerbating medical conditions like osteoarthritis, which can cause muscle spasms and pain.
While muscle spasms and aches during menopause may be related to hormonal changes, they can also have other causes. For example, stress and anxiety can lead to muscle tension and cramps. Reduced physical activity and insufficient protein intake can affect muscle health and elasticity, contributing to cramping and twitching. Certain medications, especially statin-based ones, can also cause muscle issues due to decreased COQ10 levels.
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Osteoarthritis and osteoporosis
Osteoarthritis is generally considered an age-related wearing of the joints, often causing aches, pains, and muscle spasms. This is caused by changes to the bone and cartilage, and decreasing levels of oestrogen during menopause can have an impact.
Osteoporosis is a severe thinning of the bones, which can lead to fractures with low-impact injuries or even no injuries at all. This condition is also associated with menopause, as oestrogen plays a role in regulating osteoblasts, which are cells that make new bone. When a person has low levels of oestrogen, they have an increased risk of osteoporosis and fractures. The lack of oestrogen also increases bone turnover, meaning the body loses more bone cells than it can replace.
The link between osteoporosis and low oestrogen levels is clear. Studies have shown that the majority of postmenopausal women with osteoporosis have bone loss related to oestrogen deficiency. This is because oestrogen plays a role in regulating gut flora, and changes in oestrogen may lead to unfavourable changes in the microbiome that affect the absorption of calcium or inflammation levels. An imbalanced microbiome may also lead to lower oestrogen levels.
To prevent bone loss, some doctors prescribe hormone therapy to prevent or reverse osteoporosis. This involves taking oestrogen, or oestrogen and progesterone, to slow the decline of bone density. This treatment can also improve menopause symptoms, such as insomnia and hot flashes. However, there are some risks associated with hormone therapy, including a small increased risk of breast cancer for those taking combined hormone therapy long-term, and an increased risk of blood clots and stroke for those taking hormone therapy pills.
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Inflammation and pain
Oestrogen has anti-inflammatory properties, and lower levels of oestrogen are linked to increased inflammation in the body. This means that injuries and medical conditions caused by inflammation can take longer to heal and flare up more frequently and intensely.
Oestrogen affects the body's cartilage and bone replacement, and so plays a part in inflammation and pain. It also helps regulate inflammation and maintain muscle and joint health. When oestrogen levels drop, connective tissues weaken, making muscles more prone to soreness. This can lead to joint pain and stiffness, especially in weight-bearing joints like the hips. Low oestrogen can also cause muscle soreness, tightness, and weakness.
During perimenopause, oestrogen levels begin to fluctuate and fall, remaining low as women go through menopause and beyond. This hormonal imbalance is the most common reason for muscle aches and pains. Oestrogen regulates the production of cortisol, the stress hormone. When oestrogen levels are low, cortisol levels rise, causing stress and anxiety, which are common symptoms of menopause. High cortisol levels can then cause muscles to tense up and become painful. Increased cortisol also makes the body more sensitive to pain.
There are several ways to manage inflammation and pain caused by low oestrogen:
- Consume foods with anti-inflammatory properties, such as omega-3s (found in salmon, walnuts, and flaxseeds), leafy greens, turmeric, and other colourful fruits and vegetables.
- Stay hydrated, as dehydration can worsen muscle cramps and soreness.
- Engage in regular gentle exercises like yoga, swimming, or walking to keep muscles strong and flexible.
- Manage stress through meditation, deep breathing, or gentle stretching, as stress increases inflammation and worsens pain.
- Take over-the-counter anti-inflammatory medication like ibuprofen or aspirin, but always check with a doctor or pharmacist first.
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Exercise and diet
While muscle spasms can be caused by many different medical conditions, low estrogen levels can be a contributing factor. Estrogen has anti-inflammatory properties, and lower levels of estrogen are associated with increased inflammation in the body. This can lead to muscle aches, joint stiffness, and even chronic pain conditions. Managing estrogen levels through lifestyle changes, diet, and medical support can help reduce inflammation and improve overall well-being.
Exercise
Gentle exercises such as yoga, swimming, or walking can keep muscles strong and flexible, helping to relieve muscle tension and pain. Stretching can also help ease tension, stiffness, and muscle pain. Some specific stretches that can be performed include:
- Medial leg lifts – 10 repetitions in 3 sets (10 x 3).
- Knee to chest raises – 12 repetitions in 2 sets (12 x 2).
Diet
A well-balanced, nutrient-rich diet can help relieve stress, anxiety, and muscle tension. Consuming foods rich in certain nutrients can also help manage muscle spasms. These include:
- Magnesium – found in nuts and seeds, dried fruit, dark leafy vegetables, and pulses such as beans and lentils.
- Iron – found in red meat, eggs, and dairy.
- Calcium – found in kale, broccoli, cheese, milk, and almonds.
- Potassium – found in avocados, sweet potatoes, spinach, and bananas.
Additionally, it is important to stay hydrated, as dehydration can worsen muscle cramps and soreness.
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HRT and other treatments
While muscle spasms and aches are common during perimenopause and menopause, they are not always directly caused by low estrogen or hormonal changes. However, hormonal fluctuations can be a contributing factor, and lower levels of estrogen after menopause are linked to increased inflammation, which can, in turn, cause medical conditions to flare up and injuries to take longer to heal. Osteoarthritis, for example, is a frequent cause of muscle spasms and is influenced by decreasing estrogen levels.
If you are experiencing muscle spasms, it is important to consult a doctor to determine the underlying cause and receive appropriate treatment. Some people have found hormone replacement therapy (HRT) useful for general aches and menopause muscle pain, but it is not a guaranteed solution, and more research is needed. HRT replaces the hormones that the body stops producing during menopause, primarily estrogen and progestogen, and can be administered in various forms, including tablets, skin patches, implants, creams, gels, vaginal tablets, pessaries, or rings.
HRT is not suitable for everyone, and it is important to understand the risks and benefits before starting treatment. Some alternative treatments for menopause symptoms include over-the-counter vaginal lubricants, antidepressants, selective estrogen receptor modulators (SERMs), and FDA-approved medications such as fezolinetant or paroxetine for hot flashes.
In addition to medical treatments, certain lifestyle changes can help manage muscle spasms and aches during menopause. These include improving posture, especially for those with desk jobs, reducing strenuous or repetitive activities, and ensuring adequate protein intake and electrolyte balance, including sodium and potassium, for muscular health.
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Frequently asked questions
Muscle spasms during menopause can be caused by many different medical conditions, some of which may not be directly related to bones and muscles. Menopause-related musculoskeletal pain can be caused by hormonal changes, ageing, physical strain, injuries, and autoimmune diseases. Hormonal changes can make you more prone to muscle spasms and can also cause joint pain due to thinning or roughening of the cartilage covering the bone surface in the joint. Osteoarthritis is a frequent cause of aches, pains, and muscle spasms. Treatments for muscle spasms include hormone replacement therapy (HRT), cognitive behavioural therapy (CBT), yoga, pilates, and anti-inflammatory medication.
Low estrogen can cause muscle soreness and fatigue after exercise. It can also make your body less efficient at producing collagen, which is an important component of cartilage and tendons. As estrogen levels drop during perimenopause, women may experience discomfort, including joint stiffness, muscle aches, and bone pain.
There are several ways to manage muscle spasms:
- Exercise: Weight-bearing exercises such as walking, running, hiking, and rope jumping can strengthen bones and muscles, while yoga and pilates can improve flexibility and posture.
- Massage: Deep tissue massage can reduce muscle pain and increase your pain threshold.
- Electrolytes: Ensuring adequate potassium and sodium intake can help regulate muscular contraction.
- Coenzyme Q10: This nutrient is important for muscle weakness or fatigue, especially if taking heart medication.
- See a doctor: If muscle spasms are severe or affecting your daily life, consult a doctor to rule out any underlying causes and determine the best treatment.
