Joint Pain Isn’t Just Aging

Introduction to Hotness and Menopause 0:00

Welcome to Hotness, the podcast that brings you practical tools to balance your hormones and rekindle connection, confidence, and desire in midlife and beyond. I'm your host, Dr. Liz Lister. Hotiness is a safe space for honest conversations about menopause, sex, identity, love, loss, reinvention,and desire, because you can embrace your hotness at every age. Welcome, Hot Ones, to episode two of Things No One Told You About Menopause, Joint Pain. That's right. If you've been wondering, why does my body suddenly feel older almost overnight, this episode is for you.

We're going to talk about your joints. First of all, let's jump in. Yes, joint pain can be hormonal. I am so bummed every time a woman comes to my practice and she's spent maybe a year, maybe longer, she has seen a rheumatologist for joint pains, an orthopedic surgeon for pain, may be even a pain doctor, when actually what's happening are those underlying hormonals shifts that we experience in midlife.

Why Joint Pain Can Be Hormonal 1:12

We'll also talk about the fact that bone loss accelerates as we approach menopause. And we'll talk also about how we need to adapt our workouts as get older and as arrive in this awesome, wonderful phase of life that I call midlife and beyond. So let's jump into my part that's my lane in all of this, which is the hormone balance. So yes, joint pain can be hormonal. Women are shocked by this. They get frozen shoulder, hip pain, plantar fasciitis, knee pain. That fun, exciting stiffness getting out of bed that did not used to happen.

And women say, I feel like I've gotten 20 years older in the last year or two. What is happening hormonally? As I've talked about in other videos and recordings and classes, et cetera, the first hormone that declines in midlife is progesterone. Progesteron can start to decline as early as our 30s, sometimes even younger. I'm seeing these hormonal declides earlier and earlier. And so what we're left with by the time we get to our 40s is an imbalance between estrogen and progesterone. Estrogen causes cells to hang on to fluid, which is a wonderful thing, until it's not balanced by progeterones, a natural diuretic.

So in the joint spaces, those cells are holding onto fluid that they can't release, and that can lead to joint pain. Then we start to lose our estrogen. Estrogen directly helps collagen usage by our tissues.

Hormones, Estrogen, and Joint Resilience 3:08

It affects inflammation, it affects joint lubrication, connective tissue building. it even affects pain perception. So as we have less estrogen, we just have more resilience. And even also less testosterone can lead to less stress tolerance. So the tissues themselves actually become less resilient and inflammation can increase and recovery slows down. So a lot of women think they're falling apart, but what's actually happening is that those hormones that were supporting your tissues, you didn't even realize that that's part of the role of those hormone.

Sometimes progesterone can just be a magic bullet to help relieve joint pain in midlife. The second important area that is changing in our bodies in midlife is our bone density. I talk about this a lot. The acceleration in bone loss actually starts to happen up to two years before that. So if a woman is just going along, she's trying to navigate all the other symptoms of perimenopause, and of course, the U.S. Preventive Services Task Force does not recommend a bone density scan baseline until age 65, which is absolutely insane.

It must be done much, much earlier. I like for women to have a baseline no later than age 50, maybe earlier if she's had any kind of fracture that was a low impact type of fracture. So we see that as we start to lose our estrogen in particular, the bone-density decline can really pick up speed. What's crucial about this is that you don't feel this. We do not feel our bones getting thinner. which of course can increase our fracture risk.

Bone Loss and Why It Matters in Midlife 5:20

Okay. Now, the good news is that as we build muscle, we're also helping our bones. So we'll talk about that in just a moment. But the point I want to emphasize right now is the bone is living tissue. Your body is constantly making bone and remodeling it based on the signals and the nutrients that you give to your body. Let's now say a little more about how do you need to update those workouts? I did fun cardio workouts all through my, well, really starting in my teens, but definitely in 20s. That was the high impact aerobics, which then later became low impact, aerobic.

But nonetheless, it's really an emphasis on cardio and a lot of fun. However, those workouts don't work as well for us in midlife, depending on our goals, okay? Great for balance, great for fun, but not so much for building muscle or helping our metabolism. You also might notice more soreness or slower recovery or more fatigue after the same fun cardio workouts you've been doing all this time. You also might notice, and we talk about this in a lot of other videos, increased weight despite your very best efforts and all the efforts that up until

Updating Workouts for Midlife 6:54

now have worked just fine. You might also be getting injured, so that's incredibly important. We must avoid injury as absolutely much as we can at this point in life. Other hormonal changes are happening in our body. For example, our cortisol response, insulin sensitivity, With less estrogen, we have more resistance to insulin. So all these underlying hormonal changes. And by the way, I link to this in every episode, but I wrote a midlife guide just for you. We talk about all of this and more. How do we need to update our workouts in mid-life?

For one thing, this is something I often try to do, and that is to reframe exercise. Sometimes I call it the E word because it might be off-putting, especially if someone has not really exercised a lot in her life. And now she wants to get stronger, which is exactly the goal that I want you to have in midlife. So the gold has to shift from calorie burning to preserving muscle and also building muscle, and building bone strength. We're going to protect our bone. And this is also going help in the area of metabolism.

What do I want you to update with your workouts in midlife? In addition to the other segment that will be on this podcast with an exercise fitness trainer, where we will get her expertise, let me share with you the gist as we talk about joint pain in particular in this episode. We need to focus in midlife more on strength training, we've talked about that, mobility, recovery, giving our bodies enough recovery time. This is actually very important from a hormonal standpoint. When you workout intensively days and days in a row without a recovery day for your system, you are actually decreasing the hormonal benefits of the exercise that you're doing.

For example, growth hormone.

Recovery, Protein, Sleep, and Hormone Support 9:20

We release growth hormone after doing a really good workout, but not right away. It's really over the course of the next 24 to 36 hours. So you need to have something alternating with the intense workouts that you might be doing. Walking, of course, is very underrated and we want to be doing that. In making sure we have a lot of protein intake, making we protect our sleep. I talk about this a LOT and it's really sort of priority number one before we can do anything else with our health. And of course, the right hormone replenishment, right?

We talked about that a little bit earlier. And so that's one of my missions in life is for women not to be afraid of the. Right types of hormones, given the way can make a huge difference in particular in the area of joint pain. Again, a couple more points about the workouts. Really avoiding overtraining. This is some of my toughest women that I work with who love their intense workouts and they're doing six days a week. Not sure I've had anyone do seven, but even I'm trying to have them dial back from six a days week, that's a lot.

That does not give the body the recovery time that it needs. Also, this is sad for me to say because I love cardio, I loved my Zumba. I still go to one Zuba class a week because it's fun and I enjoy it and cardio is good for us. But I'm understanding that it is not really helping my muscle building and it not helping with my metabolism. It's helping me in other ways. Another really important reframe is your relationship to your body. Your body in midlife is not betraying you. It is changing and we need to adapt.

I recently was at a hormone conference and a lot of focus was paid to muscle. We've all heard about lifespan and then the new word that went in there is health span.

Mindset, Muscle Span, and Closing Thoughts 11:32

How long are we in good health? And the newest word on the scene is muscle span, how long we are maintaining good, strong muscles is also really important for longevity. And so it's very important from the mindset standpoint that we're cooperating in a loving partnership with our bodies, not trying to punish them into submission, trying get our body to respond the way they used to. Again, we are working out. Smarter, not harder, that's a phrase lots have used. We're building strength, we're getting stronger as we get older.

Were not punishing our body, were are supporting our bodies. If this episode has helped you realize that your body has been changing in ways that you didn't know about, you are not alone. Your body isn't weak, it is adapting and it needs new support for this new phase of life. In midlife we become very powerful in many ways and we need to work in, like I said, loving partnership with our bodies to have our body's keep up in that strength so we can live long, wonderful, healthy lives free of joint pain.

Take care and see you soon. Thanks for listening to Hotness. Help more women find these practical tools by liking, sharing, and following the show, as well as leaving a review. As a gift for listening, go to drlizmd.com forward slash hotness for your free midlife guide filled with powerful support for you mind, body and soul because you can embrace your hotnes at every age.