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The 'Pause
The menopause podcast with unfiltered conversations about the symptoms you hate, the changes you didn’t see coming, and the hilarious moments midlife can bring. You've got questions and we've got the experts to answer them.
The 'Pause
Why Your Joints Hurt More During Menopause
Women going through menopause often experience intense joint pain that differs from typical pain, now recognized as Musculoskeletal Syndrome of Menopause (MSM).
• MSM includes joint pain, frozen shoulder, back pain, loss of muscle mass, decreased bone density, and arthritis
• Estrogen acts as a gatekeeper for inflammation in joints, so declining levels increase pain dramatically
• Jaw clenching can directly impact pelvic floor function, affecting incontinence and sexual function
• Heavy weight lifting (not just cardio) is crucial for maintaining muscle mass and bone density during menopause
• Healthcare providers often lack training in menopause musculoskeletal issues, requiring patient self-advocacy
• Treatment options include hormone therapy, physical therapy, anti-inflammatory diets, and strength training
• Fascia health is critical - decreased estrogen affects joint lubrication and tissue function throughout the body
• Pelvic floor physical therapy can improve coordination and function beyond simple Kegel exercises
Join our Facebook group, The Pause Diaries, to connect with other women experiencing similar symptoms and access additional resources like UC's recommended fascia stretches for better sleep.
Welcome to the Pause, the menopause podcast, with unfiltered conversations about the symptoms you hate, the changes you didn't see coming and the hilarious moments midlife can bring. I'm your host, val Leggo, and I've been a dedicated health reporter for 25 years and I wanted to normalize something that every woman goes through menopause. So together we're going to talk about it the Perry, the Menno and the Post. Welcome to the Pause. Thanks for being here. I'm your host, val Lago.
Speaker 1:You know, about two years ago, I started noticing a change in my body. Okay, well, there were lots of changes happening, but one in particular was causing me intense pain, and it was my hip. I was constantly waking up in the middle of the night with a pain in my hip joint that radiated down my leg and it felt very different than any other pain I've ever experienced. It was almost like my body was like sucking the calcium right out of my bones. I know that's not what was happening, but that in my mind is what was happening the calcium right out of my bones. I know that's not what was happening, but that in my mind is what was happening. The only way I could go back to sleep was with about 800 milligrams of ibuprofen, which, if you know, that's like prescription level, and it was a lot. I was doing yoga, I was walking, I was doing some weightlifting. Nothing was helping. So then I started hearing similar stories of joint pain from my girlfriend. So I thought, nice, okay, it's not just me, it is a thing.
Speaker 1:And as I started developing this podcast, of course, I started researching this topic and I learned there's actually a name for it. It's called musculoskeletal syndrome of menopause. That's a mouthful, so we're going to call it MSM and it happens during perimenopause and menopause, and this topic is a really big discussion among the women in the Paws Diaries, which is our Facebook group community that supports this podcast. So, because I'm dedicated to finding answers for you, I found an expert to talk about it, alongside my regular co-host today, certified menopause practitioner, anisha McKensley. This episode features Dr Uchenna Osai, who isa pelvic health physical therapist and an advocate for whole body wellness during perimenopause and menopause.
Speaker 2:Thanks for being here, ladies, thanks for having us, val. Thanks for having me, thank you.
Speaker 1:Hey, uchenna, do you mind if I call you UC, because I think that's how a lot of people know you.
Speaker 3:Oh yeah, Everyone calls me UCussi. I love it. It's what my parents have been calling me since I was a wee young lady, so by all means call me Yussi.
Speaker 1:Awesome, then I will join the bandwagon. So let's just dive right into this topic. What is musculoskeletal syndrome of menopause that we're now calling MSM?
Speaker 3:Yeah, absolutely so. It's a term that well. Actually it was a term that was introduced last year by some amazing researchers and clinicians Vonda Wright, jonathan Schwartzman, raphael Itanoche and Jocelyn Whitstime. They published an article that was entitled the Musculoskeletal Syndrome of Menopause, and essentially it's a what I like people to understand it as a term that's describing the typical symptoms that occur around the menopause transition because of a decrease in estrogen, and those symptoms are related to the musculoskeletal system. So the way that they talk about it from a process standpoint, there is an inflammatory process, so that's where you're going to have your joint pain, your frozen shoulder issues, your back pain, what we call sarcopenia, which is the loss of lean muscle mass. Okay, so your ability to build strong, lean muscle.
Speaker 3:What we're seeing is a decrease in muscle power or inability to gain muscle, so a decrease in satellite cell growth and activation, which I can talk about later which is directly related to estrogen. Decreased bone density, right. So we're seeing bone loss, but that's a process that occurs, you know, after we finish. You know our puberty and development. You see bone loss steadily decline over time, but there's an accelerated bone loss during the menopause transition and post-menopause because of the loss of estrogen and then finally arthritis. So that's going to be inflammation, like I said earlier, the joints and causing joint pain and joint stiffness, particularly joint stiffness and loss of joint flexibility.
Speaker 2:I'm so glad you brought up that study too. You see, because you mentioned last year. I just want to highlight that We've been going through menopause since the dawn of time, Since Jesus was a kid right, and just last year someone finally named it, so I just wanted to you know.
Speaker 3:Such great work and I think that you know it's. I think actually, it's pretty groundbreaking because it's naming it, because, as I was saying to you, to everyone, is that it's a cluster of symptoms that you see, you know where it's, like the joint issues, right, the, the fatigue, the loss of stability, like literally stability, so you're becoming frailer, you're noticing, ah, why is it? Why are these stairs that I climb every day seem to be getting harder and harder? Why is my hip doing that thing? Know, I used to have circuit hips and now I no longer have circuit hips. You know, like I used to have the show foot, much flexibility, and now it's gone. Like, what's that, what gives? And that's what we think about that cluster of symptoms that really need to be looked at and assessed.
Speaker 1:So why does it cause so much pain? Because this hip pain that was waking me up out of a sound sleep was so intense and, unlike really any other kind of pain that I had felt before, it's only on my right side. It's not both hips, just the right hip and it's just so. It's so painful and I'm just laying there. I'm not walking, I'm not stressing myself out, I'm just laying there asleep and it wakes me up.
Speaker 3:Absolutely so. Okay, so that's actually a very complicated, complicated question, right? Because, like, why is it so painful? And you know what I want people to understand. There's a kind of pain science approach that I'm going to answer and then I'm going to answer it from a musculoskeletal perspective. So when we think about the concept of pain, right, pain is processed in the brain. You're not making it up, right, but the experience of pain is highly contextual, in addition to the fact that it's also mechanical, right. So in your case, like you said a few years ago in your introduction, this hip pain started and what we think about that is it can be layered, right. So if you're going through the menopause transition, or perimenopausal or postmenopausal, right, you have that hormonal factor, but then you might actually have a mechanical issue in the hip joint.
Speaker 2:Right, so does that make sense?
Speaker 3:So it's so. It's hard to tell someone when they present to you I don't, this hip pain came out, came out of nowhere, and that's when it's people really want like if I were, if I were a patient. A lot of my patients are like, they want to know exactly what's going on, why and how, and I'm like, cool me too. I just there are so many other factors that I have to look at first to see. Okay, you actually are moving with a type of gait that is telling me there's something going on with the joint, the hip joint itself, but I don't know if that is because of the decrease in estrogen and the decreased joint lubrication, or if it's the joint itself. Then, on top of the fact, you have the decreased estrogen. I don't know which one is first, the chicken or the egg.
Speaker 2:Right, like you, were already that close to the threshold and then the estrogen started to leave and it just bounced it right over that threshold.
Speaker 3:You asked specifically about why is it so painful? So we have to remember that estrogen is an inflammatory mediator. So when you have less estrogen in your system, the inflammatory markers and the inflammation grows right. Estrogen is the gatekeeper of inflammation in your joints. So when you start to see that decline, the estrogen is like bye. Then your inflammation is going to be like party time client. That's just like bye. Then your inflammation is going to be like party time you. So you're going to see a lot more pain and then you're going to have less protection. Like your impact everything the fascia, the, the nerve sheaths, that it's like woof. So then everything gets impacted. So then you have this very specific sharp nerve pain that's hard to explain, right where you're just like, but then it also. But then again, like I said, it's also masked by the fact that is this a mechanical?
Speaker 2:issue with? Was there already something underlying?
Speaker 3:yeah, which can explain why some people might have issues despite initiating hormone therapy. All right they might feel better, they might start having, they might have hormone therapy, and they're feeling fabulous. And then, a few months later, they're like what the heck? That's when I'm thinking okay, so yes, there was a hormonal component to it, but now we're dealing with a biomechanical, like a mechanical, like a joint spinal joint issue.
Speaker 2:Something that might've continued to progress on its own anyway.
Speaker 3:Exactly Right. Exactly Like we took care of the hormone part, but we didn't address the mechanical part.
Speaker 1:Is it hard to diagnose musculoskeletal syndrome? Do you think it's like misdiagnosed a lot?
Speaker 3:Well, I don't think it's. I mean and again you know I'm speaking from a physical therapist perspective I don't think that it's a matter of saying, oh, you have musculoskeletal syndrome, of menopause. It's more about, okay, you are having these cluster of symptoms and here are some possible reasons why this is happening. We are going to closely monitor this. But I am going to push hey, let's talk about hormone therapy for you, right, if that's an option. Let's talk about getting you in with physical therapy, or let's talk about getting you with acupuncture or chiropractor or whatever. Let's talk about building up your healthcare dream team, because you're going to need it, moving forward to help manage these symptoms as a whole.
Speaker 3:And I think that's where the gestalt or the mindset of healthcare providers, particularly the first access healthcare providers or primary care providers. They unfortunately have this large, bigger burden now of asking these questions. So it's not just, it's not just the hot flash question, it's not just the fatigue, brain fog question, it's the. Okay, talk to me about your. You were mentioning you're having some back pain, you're having some shoulder pain, you're having some tailbone pain that just all of a sudden came up and you're, you're noticing you're more, you're not as strong or you feel less steady. Those are kind of the signs for them to say okay, like we're going to talk about what potentially is is on this list of differential or these diagnosis for you and what potentially might be part of your intervention planning. It might be hormone therapy in conjunction with physical therapy, in conjunction with all the other things that I talked about.
Speaker 2:I like that you said that too that it's not necessarily like we're trying to just pin a diagnosis on somebody, because this happens so often that people get a diagnosis and then they're just like say bye, but here's your diagnosis, bye. This happens often to women.
Speaker 1:Well, they check them off the list, like okay that one's done.
Speaker 2:Next, yes, yeah. So it's not just like that we're trying to give a diagnosis and then move on to the next. It's trying to help people understand that this can be all-encompassing from a decrease in estrogen.
Speaker 1:And I, absolutely I like that. That you, you went there, nisha, with the whole all-encompassing, because one of the big things for you, you see, is that you say the core strength is great, but that's not enough. You need to take it a little bit further for you, really big into the pelvic floor health.
Speaker 3:Yeah, absolutely so. It's all about what people define as core, right. If you're going to a Pilates instructor, they might say the diaphragm and the pelvic floor and the abs. If you go to a physical therapist, a pelvic PT, they're going to say you know, your your whole posture right, your paraspinal muscles, the glutes, the hips, the pelvic floor, the diaphragm, the abs, their TMJ, like everything. They're all synergist. And so what? When I have patients who present with incontinence in conjunction with low back pain that I think is associated with the musculoskeletal syndrome of menopause, I'm not just going to give them Kegels and I'm not just going to give them ab work. I'm going to give them a more, a better understanding of how to use their diaphragm, how to adjust how they move and how they move. Better understanding of how to use their diaphragm, how to adjust how they move and how they move from sit to stand, to strengthen their hips, to strengthen their paraspinals, to understand, hey, you're quenching your jaw all day, which is impacting how your pelvic floor is engaging.
Speaker 1:What? Wait? No, I'm going to back that one up for a second, because I am a jaw clencher. I have a jaw clencher and I have all the crowns to prove it. I get it. They're not the ones you wear on your head, unfortunately. So how does me clenching my teeth affect the fact that I laugh when I pee?
Speaker 2:I love that question.
Speaker 3:So oftentimes clenching your jaw can increase the tension in your pelvic floor, right, and this is talking about those fascial connective tissues. You know, when you're thinking about it, from an embryological development, the jaw and the pelvic floor develop pretty close to one another. And then when you're thinking about that functional relationship, right when it comes to, like, your postural connections with your pelvic floor, sometimes, when people like think about it, when you're getting up off the floor, when you're getting up from a slow chair, some people like grit their teeth and they bear down into their pelvic floor and they tense their back to get themselves up right. And then sometimes, when you're clenching your jaw, you're not. Your diaphragm isn't able to move as effectively because your jaw is clenched, they clamp down, which means if your diaphragm isn't able to move effectively, your pelvic floor isn't able to function the way that it should. And so oftentimes when I for my patients, like especially with peeing, I said unlock your jaw. Wow, mm. Hmm, relax, let your belly hang. You see, I wish you could see Val's face right now.
Speaker 2:She's, may I say, flabbergasted. She's that.
Speaker 1:Yeah, or I'm just trying to give my jaw some space, right, if I have my mouth hanging open.
Speaker 2:There's really cool data too that I know, you see, knows too that connects the people who clench their jaws or the shrimp people who also hold stress in their shoulders, right here in the tops of their shoulders, and who also hold all that that anxiety and stress and overwhelm in their pelvic floor. And if your pelvic floor is tense, then you're not going to have the normal movement that you see is talking about in order to allow for your urine to just flow when it needs to and not when it doesn't need to Does that cause constipation too it can yeah, it can, it can and cause what we call like outlet obstruction.
Speaker 3:So you know, if your pelvic floor is clenched all the time, also it messes with your proprioception. So your ability to kind of know what your body is doing in space, right, sometimes people have very poor awareness, like some people think they're aware of their pelvic floor but they're actually not and they don't have the best control, and so that can really be an impact. Like someone could be sitting on the toilet trying to have a bowel movement and they think they're relaxing their pelvic floor but they're just clenching and so then they're just like push, bearing down on a tight, tight, and then they get a hemorrhoid.
Speaker 3:And then they get those nasty hemorrhoids and that's like never fun, never fun.
Speaker 2:So let's do this. Everybody listening. You're probably holding your shoulders up. Go ahead and drop your shoulders. Okay, Now go ahead and drop your pubic ischiatus. What?
Speaker 1:is that Right?
Speaker 2:That's the level of connection we don't have with our pelvic floor. We don't have a good brain-body connection in general. None of us really do. But if someone says, hey, val your shoulders I see your right shoulder's a little bit higher, you look like you're clenching Drop your shoulders. We can do that. We have that level of connection. But if someone, if UC, says, hey, drop your obturator internus, everybody's going to go like what the nut are you talking?
Speaker 1:about. What is that?
Speaker 2:We don't have that level of connection, so those parts are just running rogue. That's where superheroes like UC come into play and help us make that two-way line of connection with our bodies.
Speaker 1:The other thing that you're really interested in, uc as well, is the fascia factor. You call it the silent player in musculoskeletal pain. Why is that?
Speaker 3:yeah, well, I mean okay. So it goes back to thinking about the role of estrogen, right, and so what estrogen is going to do, it impacts the joint tendons, the muscles and the fascia, right. And so when you have decreased estrogen, you have that decreased lubrication in the fascia right, you have a decreased movement in the fascia. Because what the fascia is going to do? It's going to help us. It attaches, it stabilizes, right. It helps support strength, it maintains our ability to move freely. And you have to remember that we have superficial fascia and we have deeper fascia, right. So we have the fascia that's under the skin and the fascia that's under what surrounds our organs, right, that surrounds the pelvic floor. And so when you have, when you're going through the menopause transition, the fascia isn't functioning the way it usually does. And then, remember, we talked about inflammation. When inflammation is present, when you have decreased muscle function and power, that fascia isn't going to be working optimally. So it's part of that group, of that cluster of issues.
Speaker 3:So it's part of that group of that cluster of issues, because you also see fascia that surrounds the nerve, the nerves you have it surrounding the viscera. So all of those, all of this matters. So when we talk about that hormonal management of the musculoskeletal syndrome, of the musculoskeletal issues associated with menopause, it's no joke. It's no joke. It touches every aspect of our body.
Speaker 1:Is there anything that women can do to minimize, like, the pain or the symptoms that they're having? And I do want to highlight, you know this can be joint pain, frozen shoulder I know that seems to be like one of the really big ones that a lot of women deal with is the frozen shoulder. Is there something that you can do to minimize that pain?
Speaker 3:Yeah, I mean. So first off and this is again I also want to say this that it's going to be a collaborative discussion and bidirectional relationship and communication with your healthcare providers and your team, particularly your healthcare providers, who are more informed on menopause care. I will say this that hormone therapy is going to be one of the stronger interventions to manage this year. When we can get you on hormone therapy sooner, the better. It is from the musculoskeletal perspective, especially when you're going through the menopause transition. So oftentimes these musculoskeletal syndromes are happening in the later end, the mid to later end of perimenopause and closer to approaching menopause, and then with post-menopause, that pain actually gets acutely higher because of the estrogen situation, right, the decreased estrogen. And if you can temper that with hormone therapy, that's great.
Speaker 3:There are those of us, like myself, who can't do that, right, I can't take estrogen for my past medical history and the issues that I can't. I just can't do it. So I have to think about, okay, so I'm going to implement, you know, really, looking at my diet, what's going to be anti-inflammatory foods. Let me think about lifting heavy weights, right, and having a regular routine of heavy weight lifting. Walking is amazing. Cardiovascular stuff is amazing. Yoga is amazing. All of that is amazing and should be part of your routine. But you also need to lift heavy.
Speaker 1:Yep, that seems to be a common theme that I hear a lot. Is that super, super heavy? And you don't necessarily have to worry about the 15 reps or the 12 reps, it's more if you can do eight, six to eight reps, heavy, heavy, maybe you know two or three times through, like that's where you're supposed to be at heavy. I was at the gym the other day and I was doing a class and the instructor came over and handed me 12 pound dumbbells for my arms, which I've never used. It's always been 10, 8, 10, 8, 10, 5, 8, 10. And I was like I can't. And he's like, yes, you can, you can, and I mean I got through it and it wasn't pretty.
Speaker 3:But I was like, wow, he's right, I, I can do that and I can lift heavier, um, and so I don't challenge myself, I don't think enough to be able to do that, and it's so important, as you get older, to be able to do that Absolutely. And I think that too, when we think about weight training, we also need to think it's not just, it's not just abs, right, it's glutes, it's back, it's wrists, it's ankle, you know, it's, it's hips and pelvic floor and diaphragm. So you really you know, what I used to do with some of my patients was I would have them bring, bring me your sheet, bring me your workout sheet, or let me talk to your personal trainer, because we need to make sure that these all components are being considered and you're lifting heavy enough.
Speaker 2:And is that different than like heavyweights, different than doing high intensity workouts? Correct?
Speaker 3:Yes, very different. Yes, High intensity workouts are great. They're really great for fat, losing fat, but that's different. But also think about it Estrogen also disrupts our fat distribution, right, so that's huge. That's another thing that estrogen is protective of Like when you have more fat tissue, you have more inflammation. We have less fat tissue, you have less inflammation. So this is all the things that we have to think about.
Speaker 3:But weight lifting, like heavy weights, is like that's going to help improve your power, your muscle power, your balance, your confidence, particularly when it comes to sexy time. You know, I cannot say less under that enough, because it's not about, like, how you look, but it's like the confidence it's also the fact that your muscles are functioning better. Does that make sense? Like I don't think people realize like sometimes they're like, oh, I don't really feel much, and then I feel their pelvic floor and it's like it's it's not even a strength thing, it's like a coordination thing. Right, it's almost like they're like kind of stuck. They have like a weird contraction pattern where they like tighten like a little bit and then they like drop.
Speaker 3:And and when you exercise regularly, when you know how to move your muscles, and when you exercise regularly, when you know how to move your muscles. You know, like Nisha was saying earlier, when you have that coordination, you can have that coordination during arousal, right. You can have that coordination during sexy time play, whatever sexy time play you're into, right, it can build up your interest, it can build up your desire, it can build up your orgasm. Right, there's it, your satisfaction, your confidence, right. Like if you're lifting heavy and I'm like man, I just lifted like 200 pounds, like all right, boo, boo, I'm gonna climb on top of you and get it. If you get these hips moving like that's, that's a whole thingy thing and the muscles in the pelvic floor.
Speaker 2:You know, when you talk about orgasm with a, with a transcending, groundbreaking orgasm, will have contraction, relaxation that we're not controlling of our pelvic floor. But if you can imagine a pelvic floor that's stuck in a spasm, that's just like you see was just saying, like it goes up and it gets tight and it clenches and then it doesn't come back down. If it's stuck like that it can't pulsate Right. So that can interfere with the ability to have a great orgasm. You want it to pulsate, because that's what feels good, right, exactly.
Speaker 3:Absolutely, you want control of it. You want to control it, but then also think about it. If we had walked around with our hands clenched all day, we wouldn't really feel our hand, it would just be numb after a while.
Speaker 3:Yes, no blood Sometimes, and sometimes people like what happens is I go through. They may be living like that, like this is one of the things I like to explain people. You might be living like that for years and then all of a sudden you start to enter perimenopause and you're like man, like my vibrator isn't working anymore. Is it because my vibrator and I, I, I, uh, you know, did I rub out my sensory?
Speaker 3:And I'm like nah like like you, you did that with your pelvic floor being quenched for 15 years right, and now you lost that protection of estrogen, so now it's really bugging you over the threshold again it would come and go yeah, you went over that threshold and before it was like sometimes it happened, but you would always get it back. This time you're like I don't know where it went.
Speaker 2:It's not the toy you don't need more batteries. It's not the toy.
Speaker 3:Right, it's, it's. It's more about let's get your muscles coordinated, let's see how this feels Right, and then your muscles can respond better, your tissues can respond better. It'll feel good to you, right. And that's that's only one piece of the pie.
Speaker 1:I'm going to wrap, wrap up this part of the conversation just by saying it's not like I use it. If you don't use it, you lose it. You can get it back. Right is what I'm hearing. You say A hundred percent. You say is that like? If you're like, my vibrator doesn't work, now everything's gone. You're like no, no, no, we can fix this.
Speaker 3:Yes, there's hope we can fix it. You've got to find a good pelvic floor PT.
Speaker 1:Oh, there's all the hope, absolutely. I do want to get to our questions from the women in our Paws Diaries Facebook group, because some of them had some really good ones. So Sabrina says that she's had neck and shoulder pain, shoulder blade pain, since December. She's doing PT, she's going to the chiropractor. It just won't go away. She did not reveal whether or not she's on hormone replacement therapy, so we don't know that part of the puzzle. But if she's doing the PT and the chiropractor, what are your thoughts? Yeah, what would be the next step?
Speaker 3:Yeah, so she's having and I apologize, I just want to make sure. Do you mind just repeating yeah, she had PT chiropractor neck and shoulder blade pain, so there is a, so I don't know if she, if she's having frozen shoulder or not. Um, because that sometimes that neck and shoulder blade pain is like leading to frozen shoulder, adhesive capsulitis, um as they call it typically um, there could be a factor of she might need to be put start on some hormone therapy or it could be, and, depending on what they're doing, the, the cause of that pain might be maybe lower in the spine or it could be. It could be more. Like she said, I'm having head and neck issues, there could be some diaphragm issues, there could be some issues. So there, it really just depends on you know how she's presenting.
Speaker 2:We need a lot more information, right? Is that what?
Speaker 3:you're saying we need a lot more information and I apologize, no.
Speaker 1:Yeah, a lot more information, but also a deeper confrontation with both her PT and her chiropractor about what's happening.
Speaker 2:I think that was a great answer, you see, and I think that the other thing to tell people is you know, if they're feeling like they're not, if they're feeling stuck or they're not getting answers, you line up 10 PTs. You're going to find 12 different ways to do things right. Not that one is wrong, necessarily, but maybe it's not resonating with your body or your life or something. So it's not, it's not a bad thing to go find something else. If you're stuck, then go and advocate for yourself.
Speaker 3:Can I just say one thing, too, about, like just healthcare providers in general. Like I was not taught this about menopause, like I was not given one lecture of menopause when I went to PT school, right, and a lot of our healthcare, our healthcare providers out there physicians, nurse practitioners, pas, our healthcare providers out there physicians, nurse practitioners, pas, and everyone we were not given a ton of this information, and so it's wild that now we are giving our students this information, but we're still learning, we're still figuring this out.
Speaker 2:And the people out there in the field don't all have it right now.
Speaker 3:Exactly, exactly so. The awareness of the hormone or the influence of hormones on musculoskeletal issues isn't widely received.
Speaker 2:It isn't or taught, no, and I do tell people give your practitioner the opportunity, go to them and say I'm stuck. I feel like what we're doing maybe helped a little in the beginning, maybe it didn't, but now I feel stuck. And I don't feel like I'm stuck. I feel like what we're doing maybe helped a little in the beginning, maybe it didn't, but now I feel stuck and I don't feel like I'm on the right trajectory. Here's what I'm hearing on this podcast. Here's what I'm reading in this. You know what? Do you know about this? Or do you? Can you send me to someone who does like give them, don't just leave Right, give them the opportunity to look into it, yeah, and to try to find an answer for you.
Speaker 1:Absolutely. We're going to move on to Jill, who says she has joint and muscle pain, she has no sex drive, she has fatigue and frozen shoulder syndrome. I'm so sorry, jill, it sounds like you're having a real rough time. She wants to know if all of these can be related to musculoskeletal syndrome to musculoskeletal syndrome.
Speaker 2:Sure yes there's a short answer yes, jill, jill, go find yourself a menopause practitioner.
Speaker 3:I mean, and just to like answer that specifically so, jill, yes, you were checking the boxes of joint and muscle pains, arthritis and inflammation, check, check. You're also describing the frozen shoulder um issue, which can be also related to, like you know, satellite cell stuff, sarcopenia. So yeah, I would, I would say that that might be, might be what's going on always worth ruling out other things we have to do that process, but but yes, this could all be part of menopause.
Speaker 1:Right, and the good thing is hopefully Jill's armed with a little bit more information that she can go now to her provider and say, hey, whatever it is, hormone replacement therapy, or what can we do about this? I'd like to check into this musculoskeletal syndrome.
Speaker 2:Absolutely.
Speaker 1:And now Jen is curious if rheumatoid arthritis can be a misdiagnosis when going through menopause. Maybe it's MSM instead?
Speaker 3:So you know, Jen, thank you for this question. You know, here's what I can say. I'm not a rheumatoid arthritis specialist, but rheumatoid arthritis is definitively an autoimmune disease. Msm is not. Msm is not With rheumatoid arthritis.
Speaker 3:When they're doing the diagnosis workup, they're doing specific labs that are looking at a lot of inflammatory markers that you won't necessarily see in MSM, Because MSM as itself is almost like a cluster of symptoms, Whereas when you're doing a blood test, you're looking at the rheumatoid factor, you're looking at the anti cyclic and I can't say it's like citrulline, it's called CCP, anti CCP, right. You're looking at, like you know, the a lot of the inflammatory markers that are associated with rheumatoid arthritis. What I can tell you is that, because inflammation is a key part of MSM, because sarcopenia is a huge, huge point of MSM, because arthralgia is a huge part of MSM, it can present similarly from a like, from a symptom presentation. But I think the diagnosis, especially when you're looking at RA, they're going to be doing a lot of blood work for that. With the MSM people. You don't necessarily, you're not going to see this on an imaging.
Speaker 2:Right, and if you have MSM, your rheumatoid factor is not going to be positive. So if you have a positive rheumatoid factor, you could have both. You could have rheumatoid arthritis and MSM. But if you have a positive rheumatoid factor, that's not strictly MSM, yeah that's a good point to make for sure.
Speaker 1:All right, you see, this has been an amazing conversation. It's been enlightening. I've learned about clenching my teeth and peeing when I laugh and how it all is connected. It's been fantastic. You're awesome at what you do. I just I'm hoping that maybe you can like wrap it up with like one thing you wish all women knew about musculoskeletal health and menopause.
Speaker 3:I want all women and people who are going through this to know that you have the power, you have the ability to continue to have a healthy life. This hormone shift, this menopause shift, does not mean your life is doomed. It really is an opportunity to learn about your body. It's really a great opportunity to learn about your body and what your body needs and to get those needs addressed with hormones, without hormones but there are beautiful options out there for everyone. So good luck. And you got this. Oh, thanks UC. I love that.
Speaker 1:That is a great way to wrap this up. I'm so excited that you joined us. I'm going to include UC's contact information and our Facebook community group, the Pause Diaries. If you have not yet, I encourage you to join. These women are awesome and they're all going through the same journey that you are, so that is something that really helps you realize you're not alone and, oh, somebody else has these symptoms, these conditions as well. I'm also going to share a simple fascia stretch that you can do before bed, that UC recommends, and so hopefully that will help some of you sleep a little bit better.
Speaker 1:And while Nisha is a menopause practitioner and UC is an expert in her field, this is a big reminder that they are not your medical provider in this setting. The information shared on this podcast is for educational, informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Please consult your own healthcare provider for personalized medical guidance. Until next time, please consider joining our Facebook group, the Pause Diaries. Thanks for joining us. Remember this isn't the end of anything. It's the beginning of the rest of your life, and we're going to talk about it.
