Healthy bones, muscles, and joints are essential for an active life, but during menopause, it gets harder to maintain strength.

As an endocrinologist, I treat conditions related to hormonal imbalances. While menopause is a natural stage of life, it does impact your hormones. Specifically, estrogen levels drop.

Less estrogen can cause bones to become more porous, muscle mass to decline, and tendons to lose elasticity. There’s a name for it: Musculoskeletal Syndrome of Menopause. It raises your risk of fractures and can cause joint pain, poor mobility, and muscle weakness. All those things can keep you from doing what you want – so don’t ignore it!

Proper care starts with screening.

For bone density, a DEXA scan is recommended for women over age 65 and high-risk younger women. It’s quick, easy, and non-invasive, and it helps diagnose osteopenia and osteoporosis.

For muscle mass, we can use questionnaires, gait speed analysis, and CT and MRI to see where you stand.

Screening leads to proper treatment. We usually start with lifestyle changes, and sometimes, that is all you need.

Aim for 1,200 mg of calcium and 800-1,000 IU of vitamin D daily from diet, supplements, or both. Eat plenty of protein, like protein bars and shakes, and avoid smoking and excessive alcohol use. Collagen supplements can help with joint health.

Weight-bearing exercises like walking, jogging, and stair climbing help build stronger bones, and resistance training with weights or bands improves muscle strength. Core exercises enhance balance, and yoga is great for flexibility.

I encourage women to bank as much bone and muscle as possible in their 20s and 30s, but it’s never too late! Think of perimenopause as a call to action. It’s a window of opportunity to improve bone and muscle health through diet and exercise.

I also encourage women to address their fall risk. Remove clutter and tripping hazards like loose rugs, cords, etc., and have enough lighting to see where you’re going.

When lifestyle changes aren’t sufficient, medications and other treatments can help.

The most common option is medication to slow bone loss. For severe osteoporosis and fracture risk, there are medications to promote bone formation. Still, some of them can only be taken for a limited time and aren’t appropriate for patients with a high risk of stroke or heart disease.

I also talk to patients about hormone therapy. It isn’t approved as a first-line treatment for bone loss, but patients who are prescribed hormone therapy for other menopause symptoms, like hot flashes, may also see a benefit to their bone health.

For musculoskeletal pain, treatment options include acupuncture and physical therapy, and over-the-counter pain medications can provide symptom relief.

The bottom line is that finding a provider who will discuss your options is important.

When you bring up menopause symptoms, you should feel validated. It could be related to your hormone levels, and we can help!

Deirdre James, MD, is an endocrinologist at Regional One Health. For appointments, call 901.545.6969. Visit Regionalonehealth.org/womens-services/menopause-care for more information.

By Deirdre James, MD