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Functional Wellness and Its Importance for Menopausal Women

Learn how functional wellness can help manage symptoms and promote a healthier lifestyle during menopause.

Flourishing Through Menopause: A Comprehensive Guide to Functional Wellness, Chiropractic Care, and Integrative Therapies for Symptom Relief

Introduction: Understanding Functional Wellness During Menopause

Menopause is one of the biggest changes in a woman’s life. It ends her reproductive years and starts a new chapter in her health and well-being. For millions of women throughout the globe, this normal biological process comes with a lot of symptoms that may make life much worse, such as hot flashes, mood swings, joint pain, and musculoskeletal pain. During menopause, the therapeutic reason for functional health becomes more significant, since this method targets the underlying causes of symptoms instead of merely concealing them with pharmaceuticals. nourishhousecalls+1​

Functional wellness focuses on a whole-person, patient-centered approach that takes into account how bodily systems, lifestyle variables, and environmental factors all work together. This holistic view offers women many ways to manage menopausal symptoms while also improving their overall health. This is important because hormonal changes can have significant repercussions on the body. Functional wellness sees menopause as a natural process that may be helped by changes in diet, exercise, stress management, and other areas of life, rather than as an illness that needs treatment. clevelandclinic+2​

During menopause, the musculoskeletal system requires specific care, as lower estrogen levels may harm joints, bones, muscles, and connective tissue. Studies show that almost 71% of women going through perimenopause have musculoskeletal discomfort, which is one of the most frequent but generally ignored signs of this life change. Joint stiffness, muscular pain, and general body discomfort may make life much less enjoyable and make it hard to stay active, which is when exercise is most important for staying healthy. orthopedicsri+2​

Chiropractic care, acupuncture, and massage therapy are all non-surgical therapies that may help with menopause symptoms without the negative effects that often come with drugs. You may tailor treatment plans to meet each woman’s specific requirements and health objectives by combining these therapies with dietary changes, exercise regimens, and adjustments to daily living. dutchessbraincore+2


What is Menopause?

Menopause is a natural biological process that marks the permanent end of menstrual cycles and fertility. It is clinically defined as occurring after 12 consecutive months of amenorrhea (absence of menstruation) not linked to a pathological cause. While menopause itself is a single point in time—the moment when a full year has passed without a menstrual period—the transition encompasses several years of hormonal changes that can produce symptoms affecting virtually every system in the body. pmc.ncbi.nlm.nih+1

The average age of menopause for women in the United States is 51 years old, though this can vary significantly between individuals. Some women experience menopause in their early 40s, while others may not reach this milestone until their late 50s. The timing is influenced by genetics, lifestyle factors, and overall health status. myobgynvegas

The Biological Mechanism of Menopause

Menopause results from the natural depletion of ovarian follicles over a woman’s reproductive lifespan. Each woman is born with a finite number of eggs, and as these are gradually used during monthly ovulation or naturally degenerate, the ovaries’ capacity to produce hormones diminishes. The pathophysiology involves a rapid decline in the number of primary ovarian follicles, resulting in an inadequate number to respond to follicle-stimulating hormone (FSH). ncbi.nlm.nih+1

When the ovaries can no longer respond adequately to FSH signals from the pituitary gland, several hormonal changes occur: pmc.ncbi.nlm.nih+1

  • Estrogen production declines significantly, though small amounts may still be produced through conversion from testosterone released by the adrenal glands.
  • Progesterone production decreases and eventually stabilizes at very low levels.
  • FSH and luteinizing hormone (LH) levels remain elevated for years after menopause onset due to the lack of negative feedback from ovarian hormones
  • Testosterone levels do not change as dramatically early in menopause, leading to a relative increase in the testosterone-to-estrogen ratio (ncbi.nlm).nih

This hormonal shift affects virtually every organ system in the body, as estrogen receptors are present throughout tissues, including the brain, heart, bones, joints, skin, and reproductive tract. arthritis+1


The Phases of Menopause

The menopausal transition unfolds over three distinct phases, each characterized by different hormonal patterns and symptom experiences.columbusobgyn+3

Perimenopause: The Transitional Phase

Perimenopause represents the years leading up to menopause when the body begins its transition away from reproductive function. This phase typically begins 8 to 10 years before menopause, often starting in a woman’s mid-40s, though it can begin earlier. During perimenopause, hormone levels fluctuate unpredictably, creating a rollercoaster of symptoms that can be challenging to manage. mcpress.mayoclinic+2

The early perimenopause stage is characterized by: columbusobgyn

  • Shortened follicular phase leading to more frequent menstrual cycles
  • Occasional hot flashes lasting from seconds to minutes
  • Mild changes in skin elasticity and breast tenderness
  • Subtle mood variations and increased stress sensitivity

As perimenopause progresses into the middle and late transition stages, women typically experience: columbusobgyn

  • Menstrual cycles that vary by seven or more days from normal patterns
  • More frequent and potentially more severe hot flashes
  • Increased vaginal dryness and sleep disruption
  • Daily hot flashes and night sweats that may feel more intense and last longer
  • Heightened anxiety or mood fluctuations

Menopause: The Defining Moment

Menopause itself is not a phase but rather a single point in time—the day when a woman has gone 12 consecutive months without a menstrual period. At menopause, the body’s production of estrogen, progesterone, and testosterone is significantly reduced, while FSH and LH levels are elevated. samitivejhospitals+2

Postmenopause: The Years Beyond

Postmenopause begins immediately after menopause is confirmed and continues for the remainder of a woman’s life. Most menopausal symptoms gradually decrease in intensity during postmenopause, with some women experiencing significant relief within the first few years. However, certain changes require ongoing attention: joinmidi+1

  • Bone density continues to decline due to reduced estrogen’s effects on bone remodeling.
  • Cardiovascular health becomes more vulnerable as estrogen’s protective effects diminish.
  • Genitourinary changes may persist or develop, including vaginal atrophy and urinary symptoms joinmidi

Common Symptoms of Menopause

Menopause produces a wide spectrum of symptoms that vary dramatically between individuals. myobgynvegas+2

Vasomotor Symptoms

Hot flashes and night sweats are among the most recognizable menopausal symptoms, affecting approximately 75% to 80% of women with varying severity. Hot flashes typically begin as a sudden sensation of warmth spreading through the upper body and face, often accompanied by flushing, sweating, and heart palpitations. templehealth+2

Mood and Cognitive Changes

Hormonal fluctuations during menopause significantly impact brain function and emotional regulation: endocrine

  • Mood swings ranging from irritability to sadness
  • Anxiety and increased stress sensitivity
  • Brain fog is characterized by difficulty concentrating and memory lapses
  • Depression or persistent low mood

These symptoms result from estrogen’s relationship with serotonin and other neurotransmitters that regulate mood. endocrine

Sleep Disturbances

Sleep problems affect more than 60% of menopausal women: integratedchiropracticofboca+1

  • Night sweats interrupt sleep cycles
  • Insomnia may develop independently of vasomotor symptoms
  • Sleep apnea risk increases during and after menopause womens-health-concern

Genitourinary Symptoms

As estrogen declines, significant changes occur in the vulva, vagina, and urinary tract: ncbi.nlm.nih+1

  • Vaginal dryness and thinning of vaginal tissue
  • Increased urinary tract infections
  • Urinary urgency and incontinence

Musculoskeletal Symptoms

Nearly half of menopausal patients experience musculoskeletal symptoms like joint pain: tandfonline+1

  • Joint pain and stiffness
  • Muscle aches and loss of grip strength
  • Frozen shoulder
  • Loss of lean muscle mass

How Menopause Affects Hormones in the Body

Understanding the hormonal changes that occur during menopause provides crucial insight into why symptoms develop. samitivejhospitals+1

Estrogen: The Primary Change

Estrogen is the primary female hormone with receptors distributed throughout the body. During menopause, estrogen levels drop dramatically—often to less than 10 pg/mL—creating widespread effects. aarp+2

Estrogen’s decline affects multiple systems: pmc.ncbi.nlm.nih

  • Brain: Impacts mood regulation, memory, and cognitive function
  • Bones: Accelerates bone resorption, increasing osteoporosis risk
  • Heart: Removes protective effects on blood vessels
  • Joints: Reduces cartilage protection and synovial fluid production

Progesterone and Testosterone

Progesterone production decreases during perimenopause as ovulation becomes irregular, then stabilizes at low levels after menopause. Testosterone levels do not decrease as dramatically during early menopause, creating a relative increase in the testosterone-to-estrogen ratio. samitivejhospitals+1

FSH, LH, and Cortisol

FSH and LH levels increase significantly as the pituitary attempts to stimulate unresponsive ovaries. Cortisol levels may be elevated during menopause, contributing to sleep disturbances, weight gain, and mood changes. ncoa+2


How Fluctuating Hormones Affect the Musculoskeletal System

The musculoskeletal system is profoundly affected by the hormonal changes of menopause, yet these effects are often overlooked or misattributed to normal aging. Research has established what experts now term the “musculoskeletal syndrome of menopause.” dralisongrimaldi+2

The Role of Estrogen in Joint and Bone Health

Estrogen plays a vital role in maintaining musculoskeletal health through multiple mechanisms: jointrehab+2

  • Cartilage Protection: Estrogen helps keep cartilage flexible and supports the production of synovial fluid, which lubricates joints. As estrogen levels decline, cartilage may degrade more rapidly. orthopedicsri
  • Anti-Inflammatory Effects: Estrogen exhibits anti-inflammatory properties by inhibiting the release of inflammatory cytokines, such as TNF-α and IL-1β. When estrogen declines, inflammation increases throughout the body. pmc.ncbi.nlm.nih+2
  • Bone Remodeling: Estrogen deficiency leads to accelerated osteoclast activity and increased bone resorption, resulting in bone loss of up to 20% during the menopausal transition. puregym+1

Prevalence of Musculoskeletal Pain

The overall prevalence of musculoskeletal pain in perimenopausal women is approximately 71%. A study including more than 40,000 women found that osteoarthritis was more common among women who had undergone menopause at least one year prior, compared with those who had a recent menstrual period (31% vs. 24%). rheumatologyadvisor+2

Specific Musculoskeletal Effects

  • Joint Pain and Osteoarthritis: The decline in estrogen accelerates the progression of osteoarthritis, particularly in weight-bearing joints. pmc.ncbi.nlm.nih+1
  • Muscle Loss (Sarcopenia): Research indicates that compared to women in early perimenopause, those with menopause have 10% less muscle mass in their arms and legs. puregym
  • Bone Density Loss: Weakened bones are more prone to fractures, increasing the risk of injury in the spine, hips, and wrists. orthopedicsri+1
  • Weight Gain Impact: Many women experience weight gain during menopause, which can add extra stress to joints. Visceral fat increases from 5-8% to 10-15% of total body weight. puregym

Chiropractic Care for Menopausal Symptoms

Chiropractic care offers a safe, effective, and natural approach to managing menopausal symptoms, particularly those affecting the musculoskeletal system. accidentcarechiropractic+2

How Chiropractic Care Supports Menopausal Women

  • Hormone Regulation Through Nervous System Support: The spine houses the nerves that control the endocrine system. The hypothalamus plays a significant role in hormone production, and misalignments in the spine can interfere with its functioning. By correcting subluxations, chiropractic care can help regulate hormone production and improve menopausal symptoms. raleighchiropractic+3
  • Reduced Nervous System Stress: Chiropractic adjustments relieve pressure on the spine and restore proper nervous system function, supporting the body’s ability to regulate hormones more efficiently. familychiropracticcolumbus+1
  • Improved Circulation: Chiropractic adjustments improve circulation by freeing up restrictions in the spine, helping reduce hot flashes and night sweats. dutchessbraincore+1
  • Stress Management and Better Sleep: Chiropractic care promotes relaxation, stimulates the parasympathetic nervous system, and improves sleep quality in menopausal women. integratedchiropracticofboca+2

Evidence for Chiropractic Care

Studies published in the Journal of Vertebral Subluxation Research found that chiropractic care was effective in reducing hot flashes, night sweats, and mood swings in menopausal women. The Journal of Manipulative and Physiological Therapeutics reported improved sleep quality in menopausal women receiving chiropractic treatment. dutchessbraincore


Acupuncture Benefits for Menopause

Acupuncture, rooted in Traditional Chinese Medicine, involves inserting thin needles into specific points to stimulate energy flow and restore balance. pmc.ncbi.nlm.nih+1

Research on Acupuncture and Menopause

A study of Japanese women in menopause found that menopausal symptoms were significantly reduced with individualized acupuncture treatments, exclusively due to improvement of musculoskeletal symptoms. Participants experienced relief from fatigue, chronic neck pain, and low back pain. pmc.ncbi.nlm.nih

How Acupuncture Works

Acupuncture provides benefits through several mechanisms: pmc.ncbi.nlm.nih+1

  • Pain Modulation: Stimulates the release of natural painkillers (endorphins)
  • Inflammation Reduction: Decreases inflammatory markers
  • Hormonal Effects: May help regulate cortisol and melatonin
  • Nervous System Regulation: Activates the parasympathetic nervous system

The number of menopausal women is expected to increase from 467 million in 1990 to 1.2 billion in 2030, suggesting acupuncture’s role as an integrative therapy will continue to grow. pmc.ncbi.nlm.nih


Massage Therapy for Menopausal Relief

Massage therapy provides valuable benefits for both physical and emotional well-being during menopause. pubmed.ncbi.nlm.nih+2

Evidence for Massage Therapy

A randomized controlled trial found that both massage and aromatherapy were effective in reducing menopausal symptoms. Research demonstrates that therapeutic massage: pubmed.ncbi.nlm.nih

  • Decreases the severity of sleep disturbance related to menopause
  • Reduces insomnia and anxiety-depressive symptoms pmc.ncbi.nlm.nih
  • Improves overall mood through endorphin release and cortisol reduction westernregionhealth

Benefits of Massage During Menopause

  • Stress Reduction: Massage reduces stress and anxiety by promoting endorphin release and reducing cortisol levels. westernregionhealth
  • Muscle Pain Relief: Massage targets muscle knots and tension, providing relief from discomforts common during menopause. westernregionhealth
  • Sleep Enhancement: Massage significantly improves sleep patterns and reduces sleep disturbances. pmc.ncbi.nlm.nih+1

Physical Therapy and Exercise for Menopausal Health

Physical therapy and exercise represent cornerstones of managing menopausal musculoskeletal symptoms. resilienceorthopedics+2

The Importance of Exercise

Exercise is one of the best treatments for menopause and joint pain: resilienceorthopedics

  • Joint Health: Strengthens supporting muscles and promotes synovial fluid circulation.
  • Bone Density: Weight-bearing exercises stimulate bone building uclahealth+1
  • Muscle Preservation: Resistance training counters sarcopenia puregym

Types of Exercise for Menopausal Women

  • Resistance Training: The most recommended exercise for menopausal joint pain. Women over 60 with osteoporosis who participated in strength training showed significant improvements in bone density. uchealth+1
  • Weight-Bearing Exercise: Walking, dancing, and stair climbing promote bone strength. Specialists recommend at least 150 minutes per week of moderate cardiovascular activity. nyulangone
  • Mind-Body Exercise: Yoga, tai chi, and Pilates significantly improve bone mineral density, sleep quality, anxiety, depression, and fatigue in perimenopausal and postmenopausal women. pmc.ncbi.nlm.nih+1

Aligned & Empowered: Chiropractic Conversations on Women’s Health-Video


Nutrition and Diet for Menopausal Wellness

Nutrition plays a crucial role in managing symptoms and supporting long-term health. pmc.ncbi.nlm.nih+2

Anti-Inflammatory Dietary Approaches

An anti-inflammatory diet emphasizes: pmc.ncbi.nlm.nih+1

  • Vegetables: Leafy greens, cruciferous vegetables
  • Fruits: Berries, cherries, citrus
  • Fatty fish: Rich in omega-3 fatty acids
  • Nuts and seeds: Walnuts, flaxseeds
  • Healthy fats: Extra virgin olive oil, avocado
  • Herbs and spices: Turmeric, ginger

The Mediterranean diet has shown particular benefits for menopausal women, associated with better bone mineral density and improved symptoms. rebellehealth+1

Key Nutrients

  • Calcium: Recommendations of 1200-1300 mg daily for postmenopausal women. pubmed.ncbi.nlm.nih+1
  • Vitamin D: Intake between 800-900 IU daily, combined with calcium, increases bone mineral density and reduces fracture risk. frontiersin+1
  • Omega-3 Fatty Acids: Possess anti-inflammatory properties that reduce joint pain. Women who consumed more omega-3 fatty acids had fewer menopausal symptoms. goodrx+1
  • Protein: Higher intake (approximately 1.2 g/kg body weight) is associated with a 32% lower risk of frailty. pmc.ncbi.nlm.nih

Sleep Hygiene for Menopausal Women

Sleep disturbances affect more than half of menopausal women.swanstudy+1

Evidence-Based Sleep Strategies

Research emphasizes addressing sleep issues early during the menopausal transition. Recommended strategies include: swanstudy

  • Establish a Regular Sleep Schedule: Go to bed and wake up at the same time each day. womens-health-concern+1
  • Create an Optimal Sleep Environment: Keep the bedroom cool, dark, and quiet; use cooling sheets; consider a fan. healthline+2
  • Develop a Relaxing Routine: Allow time to unwind; avoid screens for at least one hour before bed. ncoa+1
  • Mind Dietary Habits: Avoid caffeine after lunchtime; limit alcohol; avoid spicy foods close to bedtime. swanstudy+1
  • Cognitive Behavioral Therapy for Insomnia (CBT-I): The most effective treatment for chronic insomnia during menopause. womens-health-concern

Lifestyle Changes for Managing Symptoms

Beyond specific therapies, broader lifestyle changes significantly impact the menopausal experience. whsobgyn+2

Stress Management

Effective techniques include: nature+1

  • Mindfulness meditation: Significantly reduces anxiety, depression, and menopausal symptoms
  • Yoga: Improves psychological symptoms, sleep, and musculoskeletal pain
  • Deep breathing exercises: Helps manage hot flashes

Smoking Cessation and Alcohol Moderation

Women who smoke experience more frequent and severe hot flashes. Alcohol can trigger hot flashes and disrupt sleep; limiting intake to no more than one serving per day is recommended. nyulangone

Weight Management

Maintaining a healthy weight reduces joint stress, helps manage hot flashes, and supports cardiovascular health. medlineplus+1


Dr. Alexander Jimenez’s Clinical Observations on Integrative Menopause Care

Dr. Alexander Jimenez, DC, APRN, FNP-BC, CFMP, IFMCP, based in El Paso, Texas, brings over 25 years of expertise in integrative medicine to menopausal care. His dual licensure as a Family Practice Nurse Practitioner and Chiropractor enables patient-centered care, bridging physical medicine, functional medicine, and advanced diagnostics. a4m+1

The Functional Medicine Approach

Dr. Jimenez’s practice emphasizes functional medicine principles, viewing the body as one integrated system. Key elements include: dralexjimenez+1

  • Comprehensive health assessments evaluating genetics, lifestyle, and environmental factors
  • Personalized treatment plans tailored to individual health profiles
  • Integration of conventional and complementary therapies
  • Patient empowerment through education and active participation

Integrative Treatment Protocols

Dr. Jimenez’s protocols integrate multiple modalities: a4m+1

  • Chiropractic adjustments for spinal alignment and nerve function
  • Acupuncture and electro-acupuncture for pain and hormonal balance
  • Targeted exercise programs focusing on flexibility, mobility, and strength
  • Massage therapy for muscle tension and stress management
  • Nutritional counseling supporting hormonal balance and bone health

As Dr. Jimenez emphasizes in his clinical practice, addressing root causes rather than simply treating symptoms produces lasting improvement. His team at Injury Medical & Chiropractic Clinic in El Paso collaborates to deliver personalized treatment plans, ensuring each patient receives care tailored to their unique needs. dralexjimenez+1

For more information about Dr. Jimenez’s integrative approach, visit https://dralexjimenez.com/ or connect on LinkedIn.


Conclusion: Embracing Functional Wellness Through the Menopausal Transition

Menopause is a major life change, but with the right support, it can be well-managed. During this time, the case for functional wellness is especially strong because hormonal changes affect the body in many ways that require care for the whole person. +1 nourishhousecalls

Up to 71% of women going through menopause have the musculoskeletal syndrome of menopause. Integrative methods like tandfonline+1 work well for them.

  • Chiropractic adjustments help the nervous system and line up the spine
  • Acupuncture to balance hormones and ease pain
  • Massage therapy to help with stress and tight muscles
  • Exercise and physical therapy are good for your bones, muscles, and joints.
  • Foods that fight inflammation in the body to lower it
  • Keeping good sleep hygiene can help you heal and keep your hormones in check.

Mind-body methods for dealing with stress

Women can not only deal with the symptoms of menopause but also thrive during this normal life transition by using evidence-based integrative treatments and adopting functional wellness ideas. The goal is not just to treat the symptoms, but also to improve long-term health, energy, and quality of life.​

References

Perimenopause: Insights for a Better Journey


Empower yourself with knowledge about perimenopause. Discover essential tips for managing this significant life transition.

Introduction

Perimenopause is a critical—yet often overlooked—transitional phase in a woman’s life, bridging reproductive vitality and menopause. While the hormonal fluctuations during this stage are well-known for causing hot flashes, mood swings, and menstrual irregularities, they also have a profound impact on the musculoskeletal system. As a nurse practitioner with two decades of experience in physical and functional medicine, I’ve seen firsthand how these hormonal changes contribute to chronic joint pain, decreased bone mineral density, and muscle mass loss.

In this comprehensive article, we’ll explore the physiological changes that occur during perimenopause, how they affect the musculoskeletal system, and the best evidence-based strategies to manage symptoms through a functional, integrative approach.


What Is Perimenopause?

Perimenopause refers to the years leading up to menopause, during which ovarian function declines and estrogen and progesterone levels begin to fluctuate erratically. It typically begins in a woman’s 40s but may start as early as the mid-30s for some.

This transitional phase can last anywhere from 4 to 10 years and is defined by noticeable changes in the menstrual cycle. According to Lega & Jacobson (2024), perimenopause officially begins when there’s a persistent difference in menstrual cycle length exceeding seven days. The phase concludes 12 months after a woman’s final menstrual period.


Recognizing the Symptoms of Perimenopause

Because estrogen plays a role in nearly every system of the body, symptoms are not limited to reproductive health. Many women report a constellation of systemic complaints that often go under-addressed:

Vasomotor Symptoms

  • Hot flashes
  • Night sweats

Neurocognitive and Mood Disturbances

  • Memory lapses (“brain fog”)
  • Difficulty concentrating
  • Irritability, anxiety, and depression

Sleep Dysregulation

  • Difficulty falling asleep
  • Early morning awakenings

Urogenital Changes

  • Vaginal dryness
  • Urinary urgency and frequency

Menstrual Irregularities

  • Heavier or skipped periods
  • Spotting between cycles

Musculoskeletal Complaints

  • Joint stiffness and pain
  • Muscle soreness
  • Increased risk for fractures

Importantly, many of these symptoms overlap with musculoskeletal disorders and inflammatory conditions, making differential diagnosis essential.


The Estrogen-Musculoskeletal Connection

Estrogen’s role in the musculoskeletal system is often underestimated. It is a key regulator of bone remodeling, collagen production, and muscle regeneration. As estrogen levels drop during perimenopause, several biomechanical and metabolic changes occur:

1. Decline in Bone Density

Estrogen helps regulate osteoclast and osteoblast activity. A decrease in estradiol leads to increased bone resorption and decreased bone formation, setting the stage for osteopenia and osteoporosis.

2. Loss of Muscle Mass (Sarcopenia)

Estrogen receptors are found in skeletal muscle. Declining estrogen impairs muscle protein synthesis, resulting in sarcopenia, especially in the lower extremities, leading to weakness and imbalance.

3. Increased Inflammation

Estrogen has anti-inflammatory properties. Its decline increases pro-inflammatory cytokines like IL-6 and TNF-α, which contribute to chronic joint pain, particularly in the neck, shoulders, and knees.

4. Altered Pain Perception

Estrogen modulates neurotransmitters such as serotonin and endorphins, which influence pain threshold. Fluctuating levels may lead to heightened pain sensitivity.

(Wright et al., 2024)


Common Musculoskeletal Conditions Exacerbated by Perimenopause

  • Osteoarthritis flare-ups
  • Fibromyalgia symptoms
  • Myofascial pain syndrome
  • Mechanical low back pain
  • Rotator cuff tendinopathies

Assessing Hormone Therapy- Video


A Functional Medicine Approach to Managing Perimenopausal Musculoskeletal Symptoms

Perimenopause is not a disease—it’s a natural biological process. However, its symptoms can be debilitating. A proactive, integrative strategy that combines conventional treatments with evidence-based complementary therapies can dramatically improve quality of life.


1. Bioidentical and Traditional Hormone Replacement Therapy (HRT)

HRT remains the most effective treatment for vasomotor and musculoskeletal symptoms in eligible women. Estrogen replacement helps maintain bone density, alleviate joint pain, and improve mood.

Options Include:

  • Oral conjugated estrogens
  • Transdermal estradiol patches
  • Bioidentical hormone creams or troches

Considerations:
Women with a personal history of breast cancer, thromboembolism, or stroke should be carefully evaluated. A risk-benefit analysis and shared decision-making approach are critical.

(Moustakli & Tsonis, 2023)


2. Nutritional Interventions for Hormonal and Skeletal Support

A nutrient-dense, anti-inflammatory diet can significantly reduce musculoskeletal pain and enhance hormone metabolism.

Key Nutrients:

  • Calcium: 1,200 mg/day (dairy, leafy greens, almonds)
  • Vitamin D3: 1,000–2,000 IU/day (sunlight, salmon, fortified foods)
  • Magnesium: Relieves muscle cramps and supports sleep
  • Protein: Vital for muscle preservation—aim for 1.0–1.2g/kg/day
  • Omega-3 Fatty Acids: Reduce inflammation (flaxseeds, fish oil)

Functional Foods to Include:

  • Tofu (phytoestrogens)
  • Cruciferous vegetables (detoxify estrogen metabolites)
  • Berries and turmeric (antioxidants)
  • Bone broth (collagen and minerals)

(Erdélyi et al., 2023)


3. Exercise and Physical Rehabilitation

Physical activity is crucial for preserving musculoskeletal health during perimenopause. Exercise stimulates bone formation, reduces stiffness, and alleviates mood disorders.

Recommended Modalities:

  • Weight-bearing exercises: Walking, resistance bands, light weights
  • Tai Chi & Yoga: Improve balance, reduce fall risk, enhance joint mobility
  • Pilates: Core stabilization and postural alignment
  • Chiropractic care and physical therapy: Address joint dysfunction and improve mobility

(Li et al., 2023)


4. Mind-Body and Integrative Therapies

Complementary modalities help regulate the nervous system and reduce systemic inflammation.

Effective Options:

  • Acupuncture: Modulates pain receptors and cytokine levels
  • CBT and mindfulness-based stress reduction (MBSR): For anxiety, depression, and sleep
  • Massage therapy: Relieves muscle tension and supports lymphatic flow
  • Gua Sha therapy: Stimulates microcirculation and reduces myofascial restriction

(Zhao et al., 2023)


5. Lifestyle Optimization and Preventive Screening

  • Sleep hygiene: Maintain consistent bedtime, minimize blue light
  • Avoid smoking and alcohol: Both accelerate bone loss
  • DEXA scans: Initiate baseline bone mineral density testing in mid-40s
  • Pelvic floor therapy: For urinary and pelvic musculoskeletal concerns

Final Thoughts: Empowerment Through Education and Prevention

Perimenopause is not just about hot flashes—it’s a full-body transformation that deeply affects the musculoskeletal system. As healthcare professionals, we must recognize and validate the diverse experiences of women in this phase. With the right blend of clinical care, lifestyle interventions, and holistic support, we can offer women not just symptom relief but restored vitality.

By addressing perimenopause through a physical and functional medicine lens, we empower women to take control of their health, stay active, and live pain-free throughout midlife and beyond.


Injury Medical & Functional Wellness Clinic

We associate with certified medical providers who understand the importance of assessing individuals dealing with musculoskeletal issues related to perimenopause. When asking important questions to our associated medical providers, we advise patients to incorporate numerous techniques to reduce pain-like symptoms related to the musculoskeletal system. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.


References

Erdélyi, A., Pálfi, E., Tűű, L., Nas, K., Szűcs, Z., Török, M., Jakab, A., & Várbíró, S. (2023). The Importance of Nutrition in Menopause and Perimenopause—A Review. Nutrients, 16(1), 27. https://doi.org/10.3390/nu16010027

Lega, I. C., & Jacobson, M. (2024). Perimenopause. CMAJ, 196(34), E1169. https://doi.org/10.1503/cmaj.240337

Li, J., Guo, J., Wang, X., Zhang, X., Zhang, Y., Bu, M., Yao, X., & She, Y. (2023). Efficacy and safety of tai chi exercise on bone health: An umbrella review. Osteoporos Int, 34(11), 1853-1866. https://doi.org/10.1007/s00198-023-06830-7

Moustakli, E., & Tsonis, O. (2023). Exploring Hormone Therapy Effects on Reproduction and Health in Transgender Individuals. Medicina (Kaunas, Lithuania), 59(12). https://doi.org/10.3390/medicina59122094

Priyanka, H. P., & Nair, R. S. (2020). Neuroimmunomodulation by estrogen in health and disease. AIMS Neurosci, 7(4), 401-417. https://doi.org/10.3934/Neuroscience.2020025

Wright, V. J., Schwartzman, J. D., Itinoche, R., & Wittstein, J. (2024). The musculoskeletal syndrome of menopause. Climacteric, 27(5), 466-472. https://doi.org/10.1080/13697137.2024.2380363

Zhao, F.-Y., Zheng, Z., Fu, Q.-Q., Conduit, R., Xu, H., Wang, H.-R., Huang, Y.-L., Jiang, T., Zhang, W.-J., & Kennedy, G. A. (2023). Acupuncture for comorbid depression and insomnia in perimenopause: A feasibility patient-assessor-blinded, randomized, and sham-controlled clinical trial. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1120567

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