Inspired by my recent webinar with Julian Baker (BSc) from Touch Move Heal with all credits for the information shared.
Menopause is a natural biological transition, not a diagnosis related to muscles or bones. While hormonal changes can affect various body systems, they do not automatically explain every new symptom a woman might experience. Each woman’s experience of menopause is unique; some face significant physical and psychological challenges, while others have only mild symptoms. Hormones act as chemical messengers, but their effects depend not just on their levels but also on how cells, receptors, and signalling pathways respond to them (which is how the nervous system communicates to muscle tissue – if the cell machinery/ the receptor signalling is changed – the nervous system might not be receiving messages from the muscles in the same way as before).
The role of receptors is crucial because different tissues can react differently to the same hormones circulating in the body. The implication could be related to joint pain, collagen, muscle ,bone, inflammation, sleep and how we are experiencing pain so much so that authors are now considering to rename menopause with Muscular Skeletal Syndrome.
Perimenopause is a gradual phase, not an abrupt change; during this time, ovarian activity, ovulation, and hormone levels become increasingly unpredictable. Natural menopause is usually confirmed only after 12 consecutive months without menstruation, assuming there is no other reason for the absence of periods. It is common for women to experience musculoskeletal symptoms like joint pain, muscle discomfort, or changes in physical ability during menopause. These symptoms should be taken seriously, but it is important not to attribute them to a single cause automatically.
Estrogen plays a role in muscle function, and research indicates that changes in ovarian hormones can influence muscle strength and how muscles contract. It is important to understand that muscle size and strength are not the same; a muscle might look the same but perform differently in terms of force generation. A decrease in strength is not a sign of permanent weakness; the body can still adapt, even as hormone levels fluctuate. (How ever the explosive power the muscle might be able to preform with- might be affected).
Bone health is especially important during menopause because declining estrogen can speed up bone turnover, raising the risk of osteoporosis and fractures. However, bone loss does not affect everyone the same way, as genetics, medical history, physical activity, and other risk factors all play a part. Although estrogen interacts biologically with collagen and tendons, this does not mean hormonal changes are always the cause of tendon pain.Research on hormone therapy’s effects on tendons shows inconsistent results, so it is important not to confuse possible biological links with proven treatment benefits.
Pain is a complex experience that does not directly measure tissue damage. Changes in tissue and changes in pain perception are related but different issues. Good sleep and recovery are essential because poor sleep can affect how a person feels, functions, and copes with physical challenges. Life factors such as work pressure, relationships, emotional stress, and changes in activity also influence the menopausal experience and should be considered in care.
A medical diagnosis should not replace thoughtful, individualised assessment (for those massage therapists among us 😉 It is important to explore when changes occurred and what else was happening at those times…
Reduced physical activity can worsen problems by lowering confidence, strength, and overall physical capacity, especially when movement that used to be enjoyable is avoided. Resistance training is a practical and promising way to maintain or improve strength, though studies specifically on menopause are limited. Weight-bearing and carefully selected impact exercises are beneficial for bone health but should be tailored to each person’s abilities and risk of fractures.
No single type of exercise is best for all menopausal symptoms. Activities like resistance training, aerobic exercise, yoga, and others each offer different benefits. Gradually increasing the challenge in physical activity, rather than simply prescribing exercise, is most effective: Starting with manageable steps, monitoring responses, and slowly increasing the workload helps promote adaptation.
Manual therapy or touch may provide comfort, relaxation, and a sense of well-being, but there is no evidence that it can directly influence hormonal changes during menopause.
Ultimately, menopause does not eliminate the body’s ability to adapt. The goal is not to regain a previous version of the body but to support individuals in building confidence, capacity, and meaningful function as their bodies change.