November 20, 2024, 4:56 pm | Read time: 7 minutes
Hormones are highly complex, regulate many tasks in the body, such as reproduction, metabolism, respiration, and bone growth, and have an influence on our daily well-being. A hormone deficiency, in particular, can have a significant impact on the entire body. A hormonal imbalance can lead to complaints and diseases such as obesity or diabetes.
For women, hormone production typically begins to decrease around the age of 40. This marks the onset of perimenopause when estrogen levels drop, and a range of symptoms may emerge. One of the complex symptoms before and during menopause is musculoskeletal syndrome. This manifests itself with joint pain, joint wear and tear, and loss of bone density. However, there’s encouraging news: women can combat this wear and tear by lifting weights! We spoke to Dr. Daniela Bach, an expert in women’s health, about how women can arm themselves against musculoskeletal syndrome from the age of 40 at the latest.
Table of Contents
- “Musculoskeletal syndrome and menopause is a huge topic”
- How does musculoskeletal syndrome manifest itself?
- Lack of estrogen stresses joints, muscles, and bones
- Lifting weights prevents bone fractures
- Strength training for peri- and postmenopausal women
- Short reps with heavy weights
- Ideal diet for muscle building
- Hormone replacement therapy
“Musculoskeletal syndrome and menopause is a huge topic”
Musculoskeletal syndrome has not yet received the attention it deserves in the field of women’s health. Gynecologist Dr. Bach also acknowledges: “The connection between restricted mobility and menopause is a huge issue, and we have not been vigilant enough so far.” Many orthopedists, often the first point of contact for muscle and joint complaints, are also frequently unaware of musculoskeletal syndrome issues.
How does musculoskeletal syndrome manifest itself?
Musculoskeletal syndrome describes a variety of complaints that lead to restrictions in the entire musculoskeletal system and chronic pain and can occur more frequently in women, especially with hormonal changes before and during menopause. Dr. Daniela Bach explains to STYLEBOOK: “Musculoskeletal syndrome is an umbrella term for the complex of symptoms associated with estrogen loss during peri- and postmenopause. This can be a combination of joint pain, loss of muscle mass, loss of bone density, progression of arthritis, i.e., joint inflammation, and much more. This also classically includes frozen shoulder, i.e., sudden, painful movement restrictions in the shoulder area.”
Musculoskeletal syndrome, therefore, describes not just one symptom but many possible symptoms that can manifest themselves due to the drop in estrogen in the musculoskeletal system. The reason for this is that estrogen also plays a key role in bone remodeling.
Lack of estrogen stresses joints, muscles, and bones
Bones are not a static construct. Bone formation is not complete after puberty. Quite the opposite: bones are continuously remodeled over the course of a lifetime. This is a constant process of building up and breaking down bone mass, which keeps bones stable and tissue vital. Hormones play a key role in shaping this process. “During periods of good estrogenization, bone formation outweighs bone resorption. This means that our bones remain stable. However, when we experience an estrogen deficiency, this balance shifts and bone resorption is greater than bone formation. The process of bone remodeling is no longer balanced, but suddenly, more and more bone is broken down. This first leads to osteopenia, i.e., a lack of bone, and then to osteoporosis. “The bone becomes really porous and brittle,” says the doctor, describing the effects of hormonal changes on the bone substance.
Estrogen also has essential functions in collagen synthesis. Dr. Bach explains further: “We need collagen in all our joints to keep them supple. To put it simply, estrogen provides synovial fluid. And with a lack of estrogen, collagen synthesis no longer takes place to a sufficient extent. The result: we grind our teeth, and our joints can ache. We also notice this with collagen synthesis in our skin. So, in times of high estrogen levels, for example, during pregnancy, we have a glow because our skin is well-plumped up. We glow from the inside out. When estrogen decreases, we tend to become wrinkled, as casual as that sounds now.”
Unfortunately, just like bone loss and joint wear and tear, skeletal muscles are also affected by falling estrogen levels during the peri- and postmenopause. This is because “our muscle mass decreases continuously from the age of 30, and to a considerable extent if we don’t challenge it,” continues Dr. Bach.
Lifting weights prevents bone fractures
But women can do something about the loss of muscle mass. This is because muscles can be specifically trained and thus strengthened. “We know from the data from scientific studies that something really exciting happens when muscles are strengthened with strength training because strong muscles also promote strong bones. This doesn’t only mean that we have better protection against bone fractures thanks to well-trained muscles that can support us better. Women also have demonstrably stronger bones when they do strength training.”
Strength training for peri- and postmenopausal women
Initial studies show that peri- and postmenopausal women mainly benefit from strength training. “And I’m talking about maximum strength,” emphasizes the expert. “That means picking up the weights and lifting and pushing heavier weights bit by bit to train the muscles.” Endurance training is not unimportant after the 40th birthday, as it strengthens the cardiovascular system. But before and during the menopause, women should work out with weights. Because strong muscles mean strong bones, and studies prove it: Up to 50 percent of all women suffer a bone fracture after menopause, usually caused by a fall.
However, using heavy weights in training from the age of 40 not only prevents hip fractures. A nice side effect of strength training is fat burning. Building muscle counteracts possible weight gain during menopause – also caused by a lack of estrogen. “By simply building up a lot of muscle, which burns fat, women stay in shape better, even though the estrogen in the body is decreasing. And no, don’t worry: you don’t have to suddenly look like Arnold Schwarzenegger to achieve these effects. It’s just a matter of specifically promoting and challenging your muscles,” says Dr. Bach.
Short reps with heavy weights
Unfortunately, there is currently no sophisticated training program for women in the peri- and postmenopause, but Dr. Bach is convinced “that a lot will be published in the coming years. What we already know, however, is that it is more about training with heavy weights, i.e., as heavy as possible, and with few repetitions, rather than little weight and many repetitions.” Try the classic bench press, squat, deadlift, and shoulder press workouts with appropriate weights and increase the weights in stages. Extra tip: Jumping exercises (jumping jacks, jumping on a box, etc.) are also good for bone density.
Ideal diet for muscle building
During menopause, many women notice weight gain, primarily in the abdominal region. This is due to hormonal changes in the body: less estrogen and more testosterone. However, countering this with a radical diet is “fatal,” according to Dr. Bach.
“Women need a good diet, especially during the peri- and postmenopause, in order to feed their muscles sufficiently.” This works with high-quality protein from animal and/or plant-based foods because “according to the data, a balanced protein intake is possible purely through food. This indicates that there’s no sudden need for protein shakes or mixing various powders,” explains the expert. While the German Nutrition Society recommends a protein intake of 0.8 grams per kilogram of body weight per day for adults, Dr. Bach would recommend a little more protein, especially for strength training: “For those in their forties, it’s recommended to consume 1.1 grams of protein per kilogram of body weight daily. And if you are very active in sports, you should take in more protein.”
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Hormone replacement therapy
One question remains at the end: If musculoskeletal syndrome, with all its facets from joint pain to bone loss, is caused by hormonal changes during menopause, can’t hormone replacement therapy help? Dr. Bach answers: “We know that many women who start HRT because they suffer from typical menopausal symptoms such as hot flushes also report an improvement in their joint pain. Here, replacing the decreasing estrogen seems to lead to an improvement in symptoms. But here, too, further studies are needed before a clear recommendation can be made. Nonetheless, practical experience already suggests its effectiveness.”