The musculoskeletal syndrome of menopause
An evidence-based article outlining how estrogen decline contributes to joint pain, muscle loss, and osteoporosis in menopause.
Fifty-one percent of humans are born with ovaries. As the ovarian production
of estrogen diminishes in midlife and ultimately stops, it is estimated that
more than 47 million women worldwide enter the menopause transition annually.
More than 70% will experience musculoskeletal symptoms and 25% will be disabled
by them through the transition from perimenopause to postmenopause. This
often-unrecognized collective of musculoskeletal symptoms, largely influenced
by estrogen flux, includes arthralgia, loss of muscle mass, loss of bone density
and progression of osteoarthritis, among others. In isolation, it can be difficult
for clinicians and patients to adequately appreciate the substantial role of
decreasing estrogen, anticipate the onset of related symptoms and actively treat
to mitigate future detrimental processes. Thus, in this review we introduce a new
term, the musculoskeletal syndrome of menopause, to describe the collective
musculoskeletal signs and symptoms associated with the loss of estrogen. Given the
significant effects of these processes on quality of life and the associated
personal and financial costs, it is important for clinicians and the women they
care for to be aware of this terminology and the constellation of musculoskeletal
processes for which proper risk assessment and prophylactic management are of
consequence.
Keywords: Musculoskeletal system; estrogen deficiency; menopause; perimenopause.
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