Perimenopause is the Cause

Written by: Dr. Fiona Lovely, Chiropractor, Functional Medicine Practitioner and Menopause Doula at AST


Many times, I am asked by women feeling the impending menopause experience, “What can I do now to help myself” for those years?  It’s a great question and there is much you can do.  

First, let’s talk terms.  Menopause is the time when you have been 12 months without a menstrual period.  The 10-ish years before that are what is now referred to as perimenopause.  As the typical age for menopause is 52, it is likely you have entered perimenopause by the time you are in your early 40s.  For some women, it’s at 35. Let the math be fluid on this, as every woman is different.  

How do you know you are in perimenopause?  The early signs are the change in quality and length of sleep and a change in moods.  You may not be easily able to elevate your mood to match the environment.  Anxiety can show up or worsen.  Same with depression.   Perimenopause is a neuroendocrine transition which means the brain is signalling the hormones to create a new normal.  This transition can be long, so its helpful to know you can expect change. 

For many women in their late thirties and early forties, you may be in your child-birthing years and brush these early symptoms off as a lack of sleep, or the baby-blues or stress.  These things may in fact be caused by the hormonal shifts of perimenopause. Your levels of testosterone and progesterone do a slow decline towards menopause.  Estrogen levels can be quite high or low and can swing wildly.  You can feel moody, sleepy, less strong, less sharp mentally and your cycle can get shorter, meaning you can bleed every 25 or 26 days instead of 28-30 days.  

In the forties, women can experience the more classic signs of menopause like hot flashes, dryness, lack of libido, deepening insomnia, feelings of low self worth, low confidence, anxiety and/depression.  This is a delicate time for a woman as she can easily be misdiagnosed with a mental health disorder instead of being treated for perimenopause.   You may not have even had a hot flash or a skipped period at this point.  

On a list of the top ten most common symptoms of perimenopause, hot flashes are number 10.  Many women never have a hot flash, so please don’t wait to assume you are in perimenopause only when your periods change or you experience a hot flash! 

Reducing stress, recognizing your symptoms are a result of changing hormone levels, getting enough rest, nutritious food, outside light and daily enjoyable movement are important for preparing yourself for a gentle perimenopause.  Eating enough daily protein and strength training for maintaining muscle health is important too. 

In short, if you are a woman between 35-55 years of age and something recently has changed with your health, it’s likely related to perimenopause!   It begins long before you miss a period.  Look for great practitioners who can coach you through this transition.  Perimenopause can be a chaotic time where the help is thin on the ground. 

Have you considered speaking with a Menopause Doula?  We can help guide the way forward to better sleep, a peaceful mind and a calm and cool physical self.  

Contact AST Willow Park to schedule an appointment with Dr. Fiona Lovely today.

Not ready to make an appointment but want to learn more, head to Not Your Mothers Menopause Podcast. Hosted by Dr. Fiona Lovely.

Musculoskeletal Syndrome of Menopause

Written by: Dr Fiona Lovely, DC

Many women are arriving in clinic with complaints of stiffness, sore, achey muscles and joints without experiencing this previously.  These women tend to be 40+ in age and lack an injury to cause the discomfort.  It’s important to consider how your hormones at midlife may be affecting your body.  

Menopause is not only characterized by hormonal changes and reproductive system adjustments but also by various musculoskeletal symptoms that can significantly impact a woman's quality of life. This is called the Musculoskeletal Syndrome of Menopause (MSM).  This encompasses a range of symptoms affecting the bones, joints, and muscles, which can be attributed to hormonal fluctuations.  

One of the most common musculoskeletal symptoms experienced during menopause is osteopenia and osteoporosis, a condition characterized by decreased bone density and increased risk of fractures. Estrogen plays a crucial role in maintaining bone health by inhibiting bone resorption and promoting bone formation. However, during menopause, declining estrogen levels lead to accelerated bone loss, especially in weight-bearing bones like the spine, hips, and wrists.

Menopausal women frequently report joint pain and stiffness, commonly attributed to osteoarthritis. Estrogen has anti-inflammatory properties that help protect joint cartilage and maintain joint function. As estrogen levels decline, inflammation increases, contributing to the development and progression of osteoarthritis, particularly in weight-bearing joints like the knees and hips.

I like to say that estrogen is a lubricator of all tissues, this is especially true with joints.  For example: I see many women in their 40’s and 50’s with new shoulder complaints which can be attributed to the estrogen decline.  The shoulder is the most freely moveable joint in the body and when it isn’t working well, you notice!

Muscle weakness and decreased muscle mass, known as sarcopenia, are also prevalent musculoskeletal symptoms of menopause. Estrogen has anabolic effects on skeletal muscle, promoting muscle growth and strength. Declining estrogen levels during menopause can accelerate muscle loss and impair muscle function, leading to decreased mobility, flexibility and function.

Menopause-associated hormonal changes can trigger new onset musculoskeletal symptoms, including tendonitis and bursitis.

Understanding the musculoskeletal implications of menopause is crucial for implementing preventive measures, such as regular weight-bearing exercise, maintaining flexibility with daily stretching, keeping your spine healthy with regular chiropractic treatments, adequate magnesium glycinate and vitamin D intake, and hormonal therapy when appropriate, to mitigate the impact of these symptoms and promote musculoskeletal health and well-being in menopausal women.

Dr. Fiona Lovely is a Chiropractor at AST Willow Park and can help you with your perimenopause and menopause-related concerns. In addition to her practice at Active Sports Therapy Dr. Fiona Lovely is the host of the wildly popular podcast "Not Your Mother's Menopause" which can be found on all of your favourite podcast platforms.