Bone pain, breast tenderness, and migraine: signs that can indicate the menopause

Written by: Dr Taher Mahmud
Edited by: Emily Lawrenson

In the months and years leading up to the menopause, some symptoms may start to display, giving indication change is on the way. Dr Taher Mahmud, leading consultant rheumatologist of the London Osteoporosis Clinic, talks about the menopause, and how it can affect our bones and joints.

The menopause and bone loss

As we get older, generally the level of bone we have in our bodies decreases – we usually reach our peak bone mass in our thirties, after which the bone resorption rate begins to overtake the rate our bodies produce new bone. In the perimenopause (the menopausal transition) women can lose up to 5% of bone per year, and over a 4-5 year period they can lose up to 20-25% of their bone mass.

Menopause and the joints

At the midlife stage, women may experience joint aches and pain, with a reported prevalence as high as 50 to 60 percent, according to cross-sectional studies. As women enter the menopause, they can experience inflammation in the joints, pain, and a loss in range of movement due to joint stiffness.

Joint pain is relatively common in women approaching the menopause. It can affect any joint in the body, and be limiting, as it can make day-to-day tasks more difficult or unpleasant to perform.

Other common associated menopausal symptoms

Breast pain

Breast pain and tenderness are common in the early menopausal transition, but begin to diminish in the late menopausal transition. This is probably due to the fluctuations in oestradiol (the primary female sex hormone) concentrations. Fluctuating hormones are thought to be the reason behind many conditions and symptoms relating to the menopause.

Menopausal migraine

Menstrual migraines are migraine headaches that cluster around the onset of each menstrual period. In many women, these headaches worsen in frequency and intensity during the menopausal transition.

Treatment and diagnosis of bone and joint problems

Nowadays, there are tests that can be done to check a woman’s vitamin D (and other nutrient) levels, bone strength, and if the joint pain they are experiencing is related to arthritis. Blood tests, for example, can be taken to diagnose arthritis. These tests are easily performed and can give indication of general bone and joint health.

There are various ways to deal with the treatment of bone conditions or arthritis/inflammation in the joints. Many start with lifestyle changes, including optimal nutrition and encouraging regular exercise. A lack of exercise accelerates bone loss, along with other factors such as drinking excess alcohol and smoking. 

The course of treatment for each patient is different, but there are certain types of medication or drug available which can help to reduce the symptoms of arthritis or other inflammatory conditions.

If symptoms are troublesome, do not suffer in silence, and imagine they are normal. There are treatments and solutions available for both bone and joint pain. The earlier you seek help, the more chance you have of reducing or eradicating your symptoms. 

By Dr Taher Mahmud

Dr Taher Mahmud is a distinguished consultant rheumatologist based in central London and Tunbridge Wells. He is renowned for his expertise in osteoporosis, osteopenia, osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and inflammatory arthritis.

Dr Mahmud qualified in medicine from King's College London before undertaking training at various esteemed institutions including St Thomas', and Pembury Hospitals. He also completed an esteemed research fellowship at King’s College Hospital, also gaining an MD and a Master’s in biochemistry. He further honed his skills in rheumatology through specialist training at King's College, the Lupus Unit at St Thomas', and Guy's Hospital Rheumatology Units. Dr Mahmud has served as a consultant rheumatologist since 2000, and was awarded fellowship of the Royal College of Physicians in 2014. Boasting more than 30 years of experience, Dr Mahmud has held various prominent roles throughout his career, including as cofounder and clinical lead for osteoporosis at the London Osteoporosis Clinic, and has also received a Clinical Excellence Award in recognition of his excellence and dedication to his practice. He currently sees private patients at HCA UK, The Shard and 25 Harley Street.

Additional to his clinical practice, Dr Mahmud has held a number of esteemed positions in public associations throughout his career, with a particular focus on improving patient experience and outcomes, including as a member of the MTW Patient Experience Committee and as an organiser and chair of conferences on patient experience at the Royal Society of Medicine. In recognition of his commitment to drive improvement in this area, he was awarded an NHS Innovations award for patient feedback. He has also been actively involved in medical education throughout his career, having lectured and trained a wide range of medical students and fellow practitioners.

With a wealth of expertise and experience, Dr Mahmud continues to make significant contributions to the field of rheumatology. He has appeared in numerous peer-reviewed publications and has authored his own book on the subject of patient care and feedback. Dr Mahmud is passionate about raising awareness of the prevention of osteoporosis fractures and maintaining healthy bones. He has appeared on several podcasts as an expert speaker on bone health and osteoporosis and the menopause. Dr Mahmud is also a member of various professional organisations, including the American College of Rheumatology, British Medical Association, British Society of Rheumatology, General Medical Council and the Royal Society of Medicine.

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