How can I tell if I’m developing arthritis or musculoskeletal syndrome of menopause?

Q.
With menopause approaching, I’m noticing more joint aches. How can I tell whether they’re due to osteoarthritis or musculoskeletal syndrome of menopause?

A. It can be tricky to distinguish the difference, since joint pain in women in their 40s or early 50s might stem from either wear-and-tear arthritis (called osteoarthritis) or musculoskeletal syndrome of menopause. The latter is a newly recognized condition that links falling estrogen levels to widespread joint and muscle pain.

About one in seven Americans has osteoarthritis, which involves joint inflammation or structural damage. Symptoms commonly include stiffness or soreness in multiple joints, such as the hips, knees, or hands, as well as intermittent swelling and warmth. While people in their 40s or 50s may develop it, the vast majority are over 65.

On the other hand, musculoskeletal syndrome of menopause typically begins in the years before menopause — earlier than most cases of osteoarthritis. It’s usually also joined by other menopause symptoms such as hot flashes and brain fog. Unlike osteoarthritis, pain and achiness from musculoskeletal syndrome of menopause typically occur in multiple joints (and muscles) at once, or float around. There’s usually no joint swelling, either.

Sometimes arthritis and musculoskeletal syndrome of menopause occur at the same time. Make an appointment with your primary care doctor for an evaluation and discussion of therapeutic options, such as estrogen-based hormonal therapy; ibuprofen, naproxen, or another nonsteroidal anti-inflammatory drug (NSAID); or referral to a rheumatologist.

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