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Holistic and nutritional approaches to reducing bone and joint pain during perimenopause

Magdalena Marvell investigates how you can stregthen your bones and joints during perimenopause.

Perimenopause, the transitional phase before menopause, brings various changes to a woman’s body, including hormonal fluctuations that can lead to bone and joint pain. With declining oestrogen levels, bones may lose density, becoming more susceptible to osteoporosis, while joint pain can be exacerbated by inflammation.

The good news is that there are holistic and nutritional approaches that can help alleviate discomfort and support joint and bone health during this stage of life.

Here’s how you can strengthen your bones and joints during perimenopause with natural remedies, nutritional strategies, and the right types of exercise for maintaining strong, healthy bones.

Key nutrients for bone and joint health
Calcium:
As oestrogen levels drop during perimenopause, bone density declines, making calcium one of the most crucial nutrients for preventing osteoporosis and reducing bone pain. Women over 50 should aim for around 1,200 mg of calcium daily from dietary sources or supplements. The best sources of calcium include:
• Dairy products (milk, yogurt, cheese)
• Leafy greens like kale and collard greens
• Almonds and sesame seeds
• Calcium-fortified plant milks and juices

Vitamin D: Vitamin D enhances calcium absorption and is vital for maintaining bone strength. It also plays a role in reducing inflammation, which can help alleviate joint pain. Sunlight is the most natural source of vitamin D, but food sources such as fatty fish (salmon, mackerel), egg yolks, and fortified foods can help meet daily requirements. For women with low sun exposure, a supplement of around 800-1,000 IU per day may be beneficial¹.

Magnesium: Magnesium supports bone structure and promotes the production of collagen, which is essential for maintaining joint health. It also aids in calcium absorption. Foods rich in magnesium include:
• Nuts and seeds (pumpkin seeds, almonds, sunflower seeds)
• Whole grains (quinoa, brown rice, oats)
• Dark leafy greens (spinach, chard)
• Legumes (black beans, chickpeas)²

Omega-3 Fatty Acids: Omega-3 fatty acids have potent anti-inflammatory properties that can reduce joint pain and stiffness. Fatty fish such as salmon, sardines, and mackerel are excellent sources. For a plant-based option, flaxseeds, chia seeds, walnuts, and algae oil are great alternatives. A high-quality omega-3 supplement, especially one with EPA and DHA, may also be considered to further reduce inflammation.³

Vitamin K2: Vitamin K2 helps direct calcium into the bones and away from soft tissues, preventing calcium buildup in the arteries. It works synergistically with calcium and vitamin D to maintain strong bones. Fermented foods like natto (fermented soya bean), sauerkraut, and some cheeses are good sources of K2, as well as supplements.⁴

Collagen: Collagen is essential for healthy cartilage, which cushions the joints and reduces friction. As we age, natural collagen production declines, contributing to joint pain. Including collagen-rich foods, such as bone broth or a high-quality collagen supplement, can support joint health and reduce pain.⁵

Anti-Inflammatory Diet and Natural Estrogen-Boosting Foods
Inflammation can worsen joint pain during perimenopause, making an anti-inflammatory diet essential for pain relief. Foods rich in antioxidants, healthy fats, and phytonutrients can help reduce inflammation and support joint mobility.

Additionally, certain foods can naturally boost oestrogen, helping to counteract the hormonal decline during perimenopause that leads to bone thinning and joint discomfort. These foods can enhance oestrogen production and maintain hormonal balance.

Estrogen-Boosting Foods:
• Flaxseeds: Rich in phytoestrogens, particularly lignans (polyphenols), which can mimic oestrogen and support bone health.
• Soy products: Foods like tofu, tempeh, and soy milk contain isoflavones, which can boost oestrogen levels and improve bone density.
• Sesame seeds: Another excellent source of polyphenols, these seeds help enhance oestrogen activity in the body.
• Fennel and chickpeas: These are also known to support oestrogen production naturally.⁶

Key Anti-Inflammatory Foods:
• Fruits and vegetables: Aim for a rainbow of colours, particularly berries, leafy greens, sweet potatoes, and cruciferous vegetables (broccoli, cauliflower).
• Herbs and spices: Ginger and turmeric have been shown to reduce joint inflammation and pain. Turmeric, especially when paired with black pepper, can be particularly effective due to its active compound curcumin.⁶
• Nuts and seeds: Walnuts, flaxseeds, and chia seeds are high in omega-3s, which help reduce inflammation.
• Healthy fats: Olive oil, avocado, and coconut oil contain anti-inflammatory properties that benefit joints and overall health.

Foods to Avoid
• Processed and refined foods: Sugary snacks, processed meats, and refined grains can promote inflammation.
• Excessive alcohol and caffeine: These can increase the risk of bone loss by interfering with calcium absorption and increasing dehydration, affecting joint lubrication.⁶

Herbal and Natural Supplements
Ashwagandha:
Ashwagandha is an adaptogenic herb that helps balance hormones, particularly during perimenopause. It supports the adrenal glands, reduces cortisol levels, and may contribute to better hormonal balance, which can positively affect bone and joint health. Its anti-inflammatory properties also make it a useful supplement for reducing joint pain.⁷

Rhodiola Rosea: Rhodiola rosea is another adaptogenic herb known for its ability to help the body cope with stress. It has been shown to balance hormones, support adrenal function, and reduce fatigue. By helping regulate hormonal imbalances, Rhodiola may assist in improving bone health and reducing joint discomfort associated with hormonal shifts.⁸

Boswellia (Frankincense): Boswellia is a potent anti-inflammatory herb traditionally used to treat arthritis and joint pain. It inhibits inflammatory pathways, helping to reduce discomfort and improve mobility.⁷


Turmeric (Curcumin): Curcumin, the active ingredient in turmeric, has strong anti-inflammatory and antioxidant effects. Taking turmeric supplements, ideally with black pepper for enhanced absorption, can help relieve joint pain.⁶

Evening Primrose Oil: Rich in gamma-linolenic acid (GLA), evening primrose oil can help reduce the inflammation associated with joint pain during perimenopause. It’s particularly helpful for those with hormonal fluctuations.7

White Willow Bark: Known as a natural pain reliever, white willow bark contains salicin, which works similarly to aspirin. It’s effective in reducing joint pain and inflammation without the side effects of non-steroidal anti-inflammatory drugs (NSAIDs)⁸.

Exercise for Bone and Joint Health
During perimenopause, maintaining an active lifestyle is essential to preserving bone density and joint mobility. However, exercise must be gentle and supportive to avoid stressing already weakened bones.

Weight-Bearing Exercises
These exercises help stimulate bone formation and maintain bone density. Activities like walking, dancing, and low-impact aerobics are great for perimenopausal women. Weight-bearing exercises apply pressure to bones, encouraging them to stay strong and resist thinning.¹

Resistance Training
Using resistance bands or light weights helps to strengthen muscles around the joints, providing better support and reducing joint pain. Focus on exercises that target key areas such as the hips, knees, and spine, which are often most affected by bone loss.¹

Yoga and Pilates
These low-impact exercises focus on improving flexibility, balance, and core strength, which can protect bones and joints. Yoga and Pilates are also excellent for stress relief, an important factor in reducing inflammation and pain.⁸

Swimming and Water Aerobics
Water-based activities are ideal for those with joint pain, as the buoyancy of water reduces the impact on joints while still providing resistance to help strengthen muscles and bones.¹

References:

  1. ods.od.nih.gov/factsheets/Calcium-HealthProfessional
  2. Dean C. The Magnesium Miracle.Ballantine Books; 2017.
  3. tandfonline.com/doi/abs/10.1080/07315724.2002.10719248
  4. nature.com/articles/pr200772
  5. tandfonline.com/doi/abs/10.1185/030079906X148373
  6. health.harvard.edu/staying-healthy/the-anti-inflammatory-diet-a-way-to-ease-pain
  7. acpjournals.org/doi/10.7326/0003-4819-145-1-200607040-00005
  8. researchgate.net/publication/26663098_Anti-inflammatory_properties_of_curcumin_a_major_constituent_of_Curcuma_longa_A_preclinical_and_clinical_research
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