What it's called when it hurts all over

Why you need to know body pain is a perimenopause, symptom, why naming it changes everything, some things to consider about that + helpful tips

Photo by Romina Farías on Unsplash

One of the hardest perimenopause symptoms for me was body pain.

At one point I remember hurting so much that I’d stay in my car, avoiding getting out. I’d wince when my cat walked on me; just rolling over in bed hurt so much I’d wake up – my hips were that sore.

I was also struggling with yo-yo-ing weight, but it was the height of the ‘healthy at any size’ movement and I had decided that I wasn’t going to torture myself by hating my body anymore. So that wasn’t a priority.

But my aching body was. I was spending so much on massages, cryotherapy, gadgets, oils and balms, making appointments with this practitioner and that one, just trying to feel better, that I think I could have purchased a whole Bitcoin in 2018 prices and tripled my money by now.

I was wondering if should go get an arthritis diagnosis, or if, like my mom, I had developed fibromyalgia. All that pain made me pretty low too. I didn’t just feel crazy. I thought I might be dying. If only I could know of what.

A friend reminded me of this recently. She says I would often ask her, ‘doesn’t your body hurt?’ And keep in mind, I didn’t know I was in perimenopause.

By chance I picked up a copy of the bestselling Whole 30 plan book to have a look through somewhere around 46, at the height of all the hurt, and as I was flipping through it saw one of the use cases was to relieve body pain.

I went on it for that reason alone.

Photo by Maddi Bazzocco on Unsplash

Ten days later I woke up, got out of bed, and realized 90 percent of all that pain was gone.

It was like magic.

It’s not even like I had a bad diet – I’ve always been a healthy eater – but alcohol on the weekends, processed ‘healthy’ bars and takeaway with seed oils in it had done a number. And with the recession of hormones of perimenopause, what I’ve taken to calling ‘The tide goes out and reveals all garbage on your life’s beach effect’, I was vulnerable and inflamed.

That experience was the main reason I sought out Dr Vonda Wright on the Hotflash inc podcast last year. I had heard her say she was going to push for new nomenclature surrounding the muscle and joint pain that many women feel in perimenopause and menopause.

Dr Wright is like many of us who are doing work in this space: just drawing from her own terrible experience so that others who come after her won’t have to go through the same thing. Her first symptom? She couldn’t get out of bed in the morning (just how I felt!) and at 47 (the same age I was!) thought she was dying.

“I experienced it myself and I didn't know what it was,” she explains. “And then I figured it out…I needed to label this too. I kind of mastered this phase because I've done the hard work, right? I've researched it. I became a student of this and I lived through it.”

We all know that we face major risks later on if we don’t take care of our bones and muscles now. We don’t want to be breaking anything, anytime, but the ante ups a decade or two from now. A study published in the journal JBMRPlus in May found that less than half of women were alive five years after a hip fracture, compared to a third of men.

Dr Wright was obviously well on her way back then to the review article she and several co-authors published in the July 2024 issue of Climacteric, the journal of the International Menopause Society, which announced and widely shared this week: a seven-page paper called The musculoskeletal syndrome of menopause.

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The lowdown:

Musculoskeletal syndrome of menopause, or MSM, describes the “typical symptoms” women can experience in their joints, cartilage, muscles and bones due to the decline of estrogen during the menopause transition. Since estrogen is an inflammatory regulator, the paper argues, it is the cause.

The paper lists “musculoskeletal pain, arthralgia, loss of lean muscle mass, loss of bone density with increased risk of resultant fracture, increased tendon and ligament injury, adhesive capsulitis and cartilage matrix fragility with the progression of osteoarthritis”, but also allows that MSM could be related to many more issues.

Some stats:

• 70 percent of all midlife women will experience MSM

• 25 percent will experience it with severe symptoms

• 40 percent will be checked out and find nothing wrong structurally

The MSM review merges the pain and other issues in perimenopause created by the loss of estrogen, increased inflammation, reduced bone mineral density and reduced proliferation of satellite cells, aka muscle stem cells, with diseases including osteopenia, osteoporosis, arthritis and sarcopenia.

We know a name is good

The idea for MSM dates back to 2014, when the Board of Directors of the international Society for the Study of women’s Sexual Health and the Board of the North American Menopause Society approved the term genitourinary syndrome of menopause, GSM, to include the constellation of issues that can ensue in the vagina, vulva and urinary tract during the menopause transition. “It is evident that the precedent set by the genitourinary syndrome of menopause is that of increasing awareness of decreasing estrogen-related states to provide more comprehensive care for patients and give women a more encompassing term to understand their physiological changes,” the Climacteric paper says.

Women who are experiencing GSM can be told that it’s a normal part of the menopause transition, and why, that it’s treatable and there are steps to be taken. That wasn’t happening before – and many of the symptoms that fall under it’s umbrella were going undetected.

The same thing is happening with joint and muscle pain.