A Health round one woman in two gets joint and muscle pain when they go through the menopause. As women get older, they become more prone to certain chronic musculoskeletal conditions, including arthritis, and may notice that existing conditions get worse. So, are your symptoms because of the menopause, or is there another cause? Changing hormones During the perimenopause (the transitional time around menopause), your levels of oestrogen and progesterone hormones fluctuate and eventually fall. Your testosterone levels may be lower, too. This can cause a range of symptoms, including hot flushes, night sweats and mood swings. Joint and muscle pain is the main menopausal symptom in around a fifth of women, although this can be higher in some ethnic groups. The symptoms may be worse first thing in the morning or if youve been sitting still for a long time. Theyre most likely to affect your neck, shoulders, hands and knees. Lower back pain can also be a significant problem. Joint and muscle pain can occur during the menopause because of declining oestrogen levels, says Dr Alison Macbeth, menopause specialist at Health in Menopause, based in Nottingham and Sutton Coldfield. Oestrogen helps to maintain the health of joints by reducing inflammation and assisting in maintaining elasticity in the soft tissues and joints. Some long-term joint and muscle conditions are particularly common in women in the menopause. Oestrogen and progesterone fluctuations may be partly to blame, but the exact links are still unclear. Other hormones, such as testosterone, may be important, too. If you have an existing joint or muscle condition, hormone changes at the menopause may make you more sensitive to pain. Weight gain at the menopause may put more pressure and stress on your joints, especially your ankles, knees and hips. If your joint and muscle pain is severe enough to affect your daily activities, its important to speak to your GP. Rheumatoid arthritis is more common in women than in men, and usually starts between the ages of 40 and 50. Signs to watch out for include having red, hot or swollen joints, stiffness, feeling generally unwell, or experiencing fatigue. Fibromyalgia, a musculoskeletal pain syndrome, is also particularly common in women and causes some similar symptoms to the menopause, such as pain, fatigue and poor sleep. Osteoarthritis affects around 18 in every 100 women over 60 worldwide and generally causes pain and stiffness in your knees, hips, hands, or base of your spine. Dr Fiona E Watt, researcher in rheumatology and honorary consultant rheumatologist at Imperial College London, says that osteoarthritis will usually cause some swelling and limitation of movement, as well as pain. This is different from someone just having jointbased pain because of the menopause. The symptoms may come and go more or be less severe in the menopause than in established osteoarthritis, though this really varies between people, she says. Muscle pain and sensitivity may be similar to that experienced in fibromyalgia. Widespread muscle tenderness may suggest fibromyalgia rather than menopause-related muscle pain. Dr Macbeth says that if youre getting joint pain for the first time during the menopause, try self-help techniques. Keep moving by doing some gentle exercise, she says. Simple painkillers, such as paracetamol or topical ibuprofen gel, can be helpful to manage pain. If your symptoms 14 versusarthritis.org PP13-15_Inspire_Winter 2023_Menopause.indd 14 14/11/2023 11:47