Juliet and Kelly Starrett with The Ready State hosted Dr. Mary Claire Haver on their podcast. Dr. Haver is a board-certified Obstetrician and Gynecologist, LSU Medical Center alumna, and UTMB residency graduate. She’s also a Certified Culinary Medicine Specialist, Menopause Society Certified Menopause Practitioner, and an author. Dr. Haver is renowned for her insights and #1 New York Times Bestseller, The New Menopause, aiming to empower women and demystify menopause. Check out her educational Instagram account here.
I work with a lot of perimenopausal, menopausal, and postmenopausal women at Outshine and I took a lot of interesting insights away from this podcast. I hope you can as well!
Understanding Menopause
Menopause can be a confusing and sometimes scary time for many women. It’s something every woman will go through, yet so much about it remains misunderstood. We also have a long history of poor care, limited funding and research surrounding women's health and menopause. The podcast urges everyone listening to take the message seriously and use it to help either themselves, their family, or their patients.
What Is Menopause?
First, let’s talk about what menopause is. Menopause is when a woman stops having her period and can no longer become pregnant naturally. Menopause is a normal part of aging and happens because a woman’s ovaries stop producing the hormones estrogen and progesterone. These hormones are important for many of the body’s functions, so when their levels drop, it can cause various symptoms. Perimenopause is the time period leading to menopause, and post menopause is the time period after menopause. The average age for onset of perimenopause is 47.5 years, while the average age of menopause is 52.6 ± 2.5 years (Wright et al).
Well Known Symptoms of Menopause
In her podcast, Dr. Haver explained the common symptoms of menopause. These can include hot flashes, night sweats, trouble sleeping, fatigue and weight gain. She explained that these are the more well-known symptoms of menopause but there are many other symptoms that can be from menopause. Dr. Haver explained that most medical professionals do not have the knowledge needed to help menopausal women. She reported that she realized early in her career as an OBGYN that she did not know much about how to help women in menopause. Education and research are both lacking in this area. She is working to improve this problem.
Musculoskeletal Symptoms of Menopause
I listed the more common or well-known symptoms associated with menopause above. Dr. Haver surprised me when she mentioned that there are many other symptoms that are less obviously related to menopause that we should all be aware of.
A July 2024 study called, “The Musculoskeletal Syndrome of Menopause” found that more than 70% of women will experience musculoskeletal symptoms and 25% will be disabled by those symptoms during the transition from perimenopause to post menopause. Vonda Wright et al. comment that, “This often-unrecognized collective of musculoskeletal symptoms, largely influenced by estrogen flux, includes arthralgia, loss of muscle mass, loss of bone density and progression of osteoarthritis, among others”.
The role of decreasing estrogen has a huge impact on a woman's health. During perimenopause, women have an average reduction of 10% in bone mineral density. Furthermore, women have a reduction of 0.6% in muscle mass per year after menopause. These musculoskeletal issues can be attributed to the decrease in estradiol. Estradiol is the most biologically active form of estrogen, which impacts nearly all types of musculoskeletal tissue including bone, tendon, muscle, cartilage, ligament and adipose.
The decrease in estradiol levels leads to five primary changes:
1. An increase in inflammation
a. Signs are arthralgia, joint pain, joint discomfort, frozen shoulder
2. A decrease in bone mineral density leading to osteopenia/osteoporosis
a. loss of height, back pain, stooped posture, low-impact fracture
3. Arthritis
a. arthralgia, joint pain, joint stiffness
4. Sarcopenia (age-related loss of lean muscle mass)
a. Poor balance, falls, decreased muscle mass, loss of stamina, walking slowly
5. A decrease in the proliferation of satellite cells (muscle stem cells)
a. Decreased muscle mass, inability to gain muscle
Can your Musculoskeletal Symptoms be Caused by Menopause?
Treatments
While this blog isn’t going to cover treatment options in depth, I did want to touch on some of the recommended options.
1. Exercise, especially resistance training! Can I get a hell yes anyone?!
2. Dietary changes like increasing protein intake
3. Vitamin supplementation
4. Osteoporosis screening
5. Menopausal Hormone Therapy (MHT): potentially the next frontier of treatment for postmenopausal women
Why Understanding Menopause Is Important
For a long time, menopause hasn’t been talked about openly. Women often didn’t know what to expect or were given little information. Dr. Haver says that this lack of knowledge and understanding has led to many women feeling anxious or embarrassed about their symptoms. By educating women (and others!!) about menopause, she hopes to remove the stigma and help them feel more in control.
Understanding menopause is important because it’s a major change in a woman’s life. It’s not just about the physical symptoms—menopause can also affect a woman’s mental and emotional health. Dr. Haver emphasizes that women need to know that what they’re experiencing is normal and that there are ways to manage the symptoms.
One of the key messages of Dr. Haver’s from the podcast is that women don’t have to just "deal with" menopause. There are things they can do to feel better. For example, Dr. Haver talks about the importance of a healthy diet and regular exercise. She also uses menopausal hormone therapy aka hormone replacement therapy for many of her patients.
She reports that in the United States, it is estimated that less than 8% of eligible women are utilizing hormone therapy for the symptomatic treatment of their menopause.
Dr. Haver encourages women to talk to their doctors and ask questions. She says that women should feel empowered to take charge of their health and not be afraid to seek help if they need it.
I hope this information has been helpful!
Sincerely,
Dr. Sieara Hinshaw
828-808-3704
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