How to Manage MSM

You don’t have to wait for symptoms to start. The best “medicine” is building strong, resilient tissues now. Here’s a simple, evidence-informed plan you can tailor with your physiotherapist or GP.

1) Lift weights—progressively

Strength training tells your muscles, tendons and bones to adapt. Aim for 2–3 sessions per week, covering push, pull, squat, hip-hinge and calf work. Use a load that feels hard by the last 2–3 reps, and increase slowly over time. In supervised studies of post-menopausal women, brief high-intensity resistance and impact training improved spine and hip bone density and functional strength.

Starter ideas: Sit-to-stand from a chair holding a backpack, wall or bench push-ups, step-ups, supported deadlifts/hip hinges, and calf raises. Add impact only when your clinician says it’s safe (e.g., small jumps or hops) to stimulate bone.

2) Mind your tendons

Tendons like consistent, gradual loading. If you get shoulder, hip or Achilles niggles, avoid complete rest. Instead, use slow, heavy exercises (e.g., heel raises, side-lying hip abduction, rowing/pulling) and pace increases week to week. Tendons have oestrogen receptors and may be stiffer after menopause, so a steady plan beats boom-and-bust bursts.

3) Balance, mobility and everyday movement

Add balance practice (single-leg stands, heel-toe walking) and short movement breaks across your day. High-challenge balance training helps prevent falls—a major cause of fractures in later life. Australian resources emphasise pairing balance with strength and impact for bone health.

4) Eat to support muscle and bone

• Protein: Many mid-life women benefit from >1.0–1.2 g/kg/day (higher with illness or heavy training). Spread across meals with a protein source at each.
• Calcium & Vitamin D: Aim for food-first calcium (e.g., dairy, calcium-set tofu, leafy greens). Vitamin D may require safe sun or supplements if levels are low. Follow Australian guidance and talk to your GP or dietitian before supplementing.

5) Consider medical options

Menopausal hormone therapy (MHT) can prevent bone loss and reduce fracture risk for suitable women starting near menopause; it may also help some musculoskeletal symptoms as part of a broader plan. Decisions depend on personal risks and preferences—discuss with your GP using current guidance (RACGP/NAMS, Monash Toolkit).

6) Screen and monitor

Ask your GP about bone density (DXA) scanning if you have risk factors (early menopause, prior fracture, family history, corticosteroid use). The NSW Menopause Clinician Toolkit outlines risks and management options relevant to Australian women.

7) Recovery basics

Prioritise sleep, manage stress, and space harder sessions 48–72 hours apart so tissues can adapt. Small, steady steps add up.

Bottom line: Build strength, balance and confidence now. Pair smart training with protein-rich meals, bone-friendly nutrients, and medical care when needed. A pelvic health physiotherapist can tailor loading to your joints, pelvic floor and goals.

 

References

1. Watson, S. L., Weeks, B. K., Weis, L. J., Harding, A. T., Horan, S. A., & Beck, B. R. (2018). High-intensity exercise for bone health in postmenopausal women with low bone mass: The LIFTMOR randomized controlled trial. Journal of Bone and Mineral Research, 33(2), 211–220. https://doi.org/10.1002/jbmr.3284
2. Healthy Bones Australia. (2023). Calcium, vitamin D and exercise: Clinical guidelines. Retrieved from https://healthybonesaustralia.org.au/
3. Nowson, C., O’Connell, S., & Daly, R. (2021). Protein intake and healthy ageing: Position statement. Nutrients, 13(10), 3580. https://doi.org/10.3390/nu13103580
4. Royal Australian College of General Practitioners (RACGP). (2022). Menopause: Information and guidance for GPs. Retrieved from https://www.racgp.org.au/
5. The North American Menopause Society. (2022). The 2022 hormone therapy position statement of The North American Menopause Society. Menopause, 29(7), 767–794. https://doi.org/10.1097/GME.0000000000002028
6. NSW Health. (2023). Menopause Care Clinician Toolkit: Bone and muscle health. Retrieved from https://www.health.nsw.gov.au/