Episode Transcript
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Speaker 1 (00:00):
Hi, I'm Susie Garden
and this is the Ageless and
Awesome podcast.
I'm an age-defying naturopathand clinical nutritionist and
I'm here to bust myths aroundwomen's health and aging so that
you can be ageless and awesomein your 40s, 50s and beyond.
The Ageless and Awesome podcastis dedicated to helping women
(00:24):
through perimenopause andmenopause with great health, a
positive mindset and outrageousconfidence.
Hit, subscribe or follow nowand let's get started.
Hello, gorgeous one, andwelcome to this week's episode
of the Ageless and Awesomepodcast.
This week, I'm actually going totalk about body pain.
(00:46):
Are you someone that hasexperienced additional body pain
since you have been inperimenopause or postmenopause?
I know a lot of women complainabout hip pain, and that's
something I've certainlyexperienced.
Also, shoulder pain, frozenshoulder, maybe muscle pain.
(01:09):
Often this kind of pain keepswomen awake, so it's pretty
significant because when itstarts impacting your sleep,
this is a problem.
And also, generally, pain inthe body is caused by
inflammation and inflammation,as I've spoken about many, many
times.
You're probably sick of hearingme say this, but inflammation
(01:31):
is the root cause of almostevery disease, whether it's
physical, whether it's a mentalhealth condition.
So inflammation and managingthat is really important.
But I wanted to particularlyfocus on a new review article
that was published just lastmonth and you may have seen me
post about it in my stories atthe time that it came out
(01:52):
because it was getting a lot ofdiscussion in the Instagram
world and it's a very coollittle review article.
So what a review article is iswhen the authors do a literature
review of all of the availablepublished studies in a
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particular area, particulartopic, and for this one, they
looked at what they're termingthe musculoskeletal syndrome of
menopause the musculoskeletalsyndrome of menopause.
So I guess their purpose withthis review article was to look
at what data is currentlyavailable and also to promote
the use of actually naming itthe musculoskeletal syndrome of
(02:36):
menopause, because currently,because there isn't like a just
very little research that's doneand focus that's done on women,
particularly women in menopause, the body pain aspect, I think,
has been really overlooked, andcertainly the authors feel the
same way, and when you look atsome of the stats, it's pretty
(03:00):
confronting.
So let's just look at theprevalence of musculoskeletal
pain in perimenopausal women.
So this is lookingperimenopausal, not
postmenopausal, but it says 71%of women in perimenopause will
experience some sort ofmusculoskeletal pain.
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That's 71%.
That's a lot.
25% of women will experiencesevere and disabling symptoms.
That's extraordinary One infour women, and 40% of women
with symptoms have no structuralfindings.
So if you go to your doctor andyou've got pain and they do an
(03:44):
ultrasound or they do x-rays orMRI or any other imaging,
they're not finding that there'sany sort of structural issue
going on.
So they're more than likelygoing to say to you oh no,
you're fine, see you later.
And I get so many women come tome with all sorts of symptoms,
whether it's fatigue, whetherit's insomnia, whether it's body
(04:05):
pain, saying that they've beento their doctor, they've had the
test done, whether it's bloodtests or the imaging that I just
mentioned and they're gettingtold everything's normal,
there's nothing wrong with you.
And it's pretty dishearteningwhen you've got body pain and
I've certainly experienced thehip pain aspect of this and it's
pretty disheartening if you'vegot pain that's keeping you
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awake at night, that's impactinga number of elements of your
life, and you're getting toldthere's nothing wrong with you.
It's really, reallydisheartening.
And so I'm loving thisparticular review article
because it really does drilldown that this is a big problem.
Because, when you look at thescale of this, currently 47
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million yes, 47 million womenglobally are entering
perimenopause every year.
I'm going to say that againbecause that stat just blew my
mind 47 million women globallyare entering perimenopause each
year, and when you think aboutmaybe 71% of those women are
(05:19):
going to have this pain andperhaps 25% will experience
severe and disabling symptoms,that's a lot of women.
That's a lot of women, and thesymptoms that were looked at in
this review are things likejoint pain, decreased muscle
mass, decreased bone density,musculoskeletal pain, increased
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ligament and tendon injuries,cartilage fragility and
increased progression ofosteoarthritis.
So these are pretty significantconditions Because this can
have a profound negative impacton women's lives.
You know, particularly you know,mobility is a huge part of
(06:05):
enjoying life.
You know, getting out there anddoing activities you love.
You want to not be doing thatin pain, and if you do have pain
and therefore you have reducedmobility, then that impacts your
metabolic function.
Right, because your metabolicrate is going to go down if
you're not exercising or movingyour body.
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Your metabolic rate is going togo down if you're losing your
muscle mass it's one of thereasons that muscle mass is
really important, particularlyin weight management is because
you're burning more energy whenyou're resting, and we know that
if you're in perimenopause ormenopause, your metabolic kind
of health is really importantbecause you are already going to
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be impacted with a degree ofinsulin resistance.
It's just part of that processand that's some of the factors
that lead to weight gain.
And this weight gain I see inwomen particularly, because I
guess that's a lot of what I doin my work is that they're doing
the same things they've done,they're eating the same foods
but they're putting on weightand they don't know what to do.
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And a lot of it comes down tothis increase in insulin
resistance, which is going tohappen naturally.
But then you get the drop inyour muscle mass, so that's
going to reduce your basalmetabolic rate and lead
potentially to weight gain.
And if you've got pain in yourbody you're not going to want to
move.
Now we know with weightmanagement it's a bit of an
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80-20 rule, so 80% is whatyou're putting into your body
and 20% is movement.
And I work with a lot of peoplethat have lots of mobility
issues, particularly withautoimmune conditions like
rheumatoid arthritis, lupus orjust you know if having being
morbidly obese can really limitpeople's movement.
(07:56):
And so yeah, if you have alimitation in your mobility.
That can tremendously impactyour quality of life and also
lead to more and more healthissues.
And what was also interestingis when you think about some of
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these symptoms like the decreasein bone density.
And that's really importantbecause if you have a decrease
in bone density, that's going toincrease your risk of fractures
, again impacting your mobility.
So while the decreased bonedensity itself is not
symptomatic, the result, if youdon't do anything about it, can
be quite devastating.
(08:37):
So that decrease in bone density, sometimes a decrease in muscle
mass, sometimes you'll noticeit on your body, but sometimes
also it's an asymptomatic thing.
You're not necessarily going toget pain from that.
And if you're not someonethat's really kind of into
fitness, I guess or you're notkind of, you know, wanting to
build muscle specifically, it'snot something you're focusing on
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you can lose muscle mass andnot really notice it.
So cartilage fragility, that'sgoing to be asymptomatic.
So a lot of these things areasymptomatic.
So you're going to be losingyour bone density, losing your
muscle mass, and not know, notnotice, and until it's to a
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point where maybe you get afracture or maybe you have a
fall or you notice your balanceisn't so good anymore.
So if we get down to what's theunderlying cause of this, it
becomes and I have talked aboutthis before but it's largely
influenced by these fluctuationsin estrogen, because estrogen
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has quite an anti-inflammatoryeffect.
So when we lose thatanti-inflammatory effect, we get
increased inflammation, whichcan lead to pain.
But also the impact of estrogenon things like our bone density
and our muscle mass and thingslike that, through way more
complicated biochemicalprocesses than I'm going to go
(10:04):
through on this podcast.
But if you're interested inthat, you can certainly find
lots of information about thaton the internet.
But yeah, for me to describe itwithout using an image to show
you, because it is very complexthe impact of estrogen in all of
these different parts of ourbodies.
But yeah, certainly thatinformation is available.
(10:25):
So we know, okay, there's thismusculoskeletal syndrome of
menopause.
So what can we do about it?
My God, it sounds really scary,right?
Luckily, there is a lot we cando about it and a lot of that is
very much within your control,with diet and with movement, and
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it's not necessarily going tocost you a lot of money to do
that.
Now, obviously, if you listenedto my two podcasts last week
about osteopenia, if you havethe knowledge about your own
body.
It will help direct theinterventions that you take.
So if you are in perimenopauseor postmenopause and you've not
(11:08):
had a bone mineral density scan,I highly recommend that you
have one so you can see.
Is this something I really needto be taking dramatic action on
right now, because you may besurprised at the results that
you get, as I was, and we knowthat during perimenopause, women
have an average reduction of10% in their bone mineral
(11:31):
density.
So that's just duringperimenopause.
Perimenopause is that period oftime that can be up to 10 years
before you reach menopause.
So we're looking at an averagereduction of 10% in bone mineral
density, but that might be more.
That's just the average.
Some people might be 15%, somepeople might be less, of course.
And furthermore, we have areduction this is women
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specifically a reduction ofabout 0.6% in muscle mass year
after year.
0.6% in muscle mass year afteryear, so per year.
0.6% in muscle mass reductionevery year after menopause, so
menopause being 12 months afteryour last menstrual period, and
so this is specifically due tothe decline in estrogen.
(12:14):
So we know this is a problem.
So the things that we can doabout it are increasing the
protein in your diet.
So, generally speaking, whenwe're as a nutritionist, when
I'm looking at calculating aprotein intake for somebody,
generally, we go on a very basickind of calculation of one gram
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of protein per kilo of bodyweight and that's a really
simple way and it's prettyeffective for most people.
If you're premenopausal and youdon't have any special needs
and you're not an athlete andall of those sorts of things,
that's probably a really goodguide.
But as a perimenopausal orpostmenopausal woman, you really
need to be increasing that.
(12:58):
Now we don't have the researchto say what that number should
be, but I would consider you'dprobably be looking at
increasing it by 10 to 20% Ifyou don't have kidney issues, if
you don't have dietaryrestrictions on protein remember
this is not personalized advice.
This is very, very generalinformation that I'm providing.
So please, if you do have, ifyou've been told by your doctor
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to restrict protein for a reason, please do not increase your
protein unless you've had a chatto them about it, because that
can be problematic in the bodyif you have certain medical
conditions.
So, having a good, decentamount of protein in your diet,
so protein at every meal.
If you're having snacks, haveit with every snack as well,
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because that's going to reallygive you a nice stream of
protein throughout the day andmake sure you're getting enough
of it.
In terms of supplementation,creatine is coming up again.
This is something that's stillundergoing research, but
creatine supplementationspecifically for peri and
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post-menopausal women is gettinga bit of a moment right now and
it's been shown actually toincrease bone mineral density
super important plus musclepower in conjunction with this
is really important.
It's in conjunction withresistance training, so lifting
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heavy things.
So creatine supplementationaround five grams a day.
That's generally.
If you're looking at buyingcreatine, it's very easy to get
hold of.
It's creatine monohydrate andit's five grams a day and
generally the scoop.
If you get a scoop in yourpacket, it will be a five gram
scoop, but have a look at that.
If you're looking at creatine,I've mentioned a lot last week
vitamin D plus K2, make sure youget them together, vitamin D
(14:52):
plus K2, and get your vitamin Dlevels tested.
If you can, you can definitelydo it through private pathology.
If your GP is unable to do itfor you, you will pay for it,
but it's not very expensive andyou're looking at a basic dosage
of vitamin D is a thousandinternational units a day, or 10
(15:14):
micrograms, depending on thetype of vitamin D that you're
having.
And it is really important thatyou don't just go crazy on
vitamin D.
You can get toxic from it ifyou have too much.
It's very unusual, it's quiterare, but I have seen it in one
client when I was in the studentclinic.
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She had a past history ofvitamin D toxicity.
So you can have too muchvitamin D.
So you do have to be careful.
If you have low vitamin D likeI'm talking close to 50, then
you may wish to take that dosageup a little.
When I have clients workingwith me, I work specifically on
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what the right dosage is forthem, so that's not something
I'm going to talk about on ageneral forum like this.
But yeah, you can take more,but you need to know what your
number is so that you don't taketoo much of it.
But please take the vitamin Dand K2 together.
You can see lots of supplementswith those two together these
days, so it's really easy to get.
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Another thing the research isshowing that about 500
milligrams of magnesium a day isvery helpful for increasing
your vitamin D, and 500milligrams of magnesium is a
reasonable dose.
Some people might get diarrheaat that dose.
But if you try that dose andyou do get diarrhea but if you
(16:46):
try that dose and you do getdiarrhea, generally just back it
off a little or stop taking ituntil that diarrhea stops and
then maybe try a lower dose andwork your way up.
Generally when we see thediarrhea in people with high
dose magnesium, it's oftenbecause they are a little
deficient and we know that abouta third to one half of the
population is deficient inmagnesium.
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So it's really importantmineral.
We use magnesium for hundredsof chemical reactions in the
body and most people takingvitamin D will see an
improvement in sleep.
They will see an improvement intheir muscle health.
They often if you suffer fromconstipation, it can be very
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helpful for that I would alwaysrecommend.
There's two types of magnesium Ireally quite like.
There's magnesium glycinate andmagnesium L3 and eight.
So they're both really goodmagnesiums.
They're the ones that I wouldrecommend for women in
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perimenopause and menopausespecifically.
So if you're a younger person,if you're an athlete, anything
like that, it might be adifferent form of magnesium that
I would recommend.
So just keep that in mind.
This is general information and, again, 500 milligrams of
magnesium is a fair bit.
So if you have a cardiaccondition, a heart condition,
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that may not be suitable for you.
If you have chronic diarrhea,that may not be suitable for you
.
So, again, just take intoaccount, if you have medical
conditions in your body or thesesorts of symptoms, you probably
need to speak to a healthcareprofessional before
self-administering supplements.
The other two things I willmention, if we're looking at
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trying to improve, are ourmusculoskeletal syndrome of
menopause I'm still trying toget my mouth around it deletal
syndrome of menopause I'm stilltrying to get my mouth around it
.
I already mentioned resistancetraining.
So weight training liftingheavy things is really important
to help keep your musclesworking well.
If you're spending a lot of timesitting, which many of us are,
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many of us are I have a sitstand desk.
I'm very lucky, and when I'vegot a few specific tasks that I
must do standing up, it's littlerules that I've made for myself
.
So when I'm recording thepodcast, for example, I'm always
standing when I'm doing that,and when I'm having certain
(19:19):
consultations with clients whereI don't have to do a lot of
writing, then I will also stand,because I find if I'm needing
to write, I've just not beenable to get myself in the right
position ergonomically.
I do have a dodgy shoulder andneck injury from my nursing day,
so I do have to be very carefulwith the ergonomic setup of my
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desk and I just haven't beenable to get it right for long
periods of writing or typing.
But if I'm reading off my screen, if I'm doing some training,
for example, then I do all ofthat standing up and it's really
amazed me, just by standing up,how much I'm using my body
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compared to when I'm sitting,and maybe it's because I'm a bit
of a yogi.
I'm constantly stretching, I'mmoving from one foot to the
other.
I'm very careful not to standwith all my weight on one hip,
for example.
I'm constantly moving and I'mnot even really having to think
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about it, and that's something Ithink is fantastic for mobility
, for keeping, you know, someweight bearing on my legs during
the day, because as a clinicianI do spend long periods of time
sitting and I know that that isnot good for me.
So that's part of it, that bitof weight-bearing exercises,
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which is why resistance trainingis so good.
But walking you cannotunderestimate the benefits of
walking, because walking is aweight-bearing exercise and if
you do some brisk walking, sowhere you can only just hold a
conversation, that gets you intoyour fat burning zone with your
(21:08):
heart rate, and that isextremely good for women in
perimenopause and menopause.
Walking is fantastic for usingglucose so that you can help
reduce your insulin resistance.
I think I've spoken about thebenefits of doing around a 10
minute walk after eating andI've brought that in at my lunch
(21:30):
times and it is awesome.
It has the benefit of helpingwith glucose management in your
blood, but at the same time, I'malso finding it's making me way
more alert and motivated in theafternoon, so I just think it's
really refreshing for the mindto be out in the fresh air out.
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I'm lucky in that I have a lotof trees around me, so I'm
looking at nature.
I'm generally taking one of mydogs for a walk, so that's fun
for me and it's fun for them andthat makes me feel good and
it's fun for them and that makesme feel good.
And so, yeah, I really cannotstress enough the benefits of
just walking.
And even if you're not, if yourmobility is limited, even if you
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can't do a 10 minute walk, evenif you can't do one, that's
quite brisk enough to get in thefat burning zone any walk, even
if you're just walking down toyour letterbox and back.
You do that for a few days andyou start to build up your body
conditioning so that you canmanage longer periods of time
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where you're on your feet.
Now, obviously, again, that'sgoing to be limited for some
people with certain medicalconditions.
But if it's more just, yourbody is not used to moving and
it's not so much because of apain situation or a medical
condition, it's more just yourlifestyle.
Just start Just.
You know, get up and go down tothe letterbox or go down to the
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end of your street.
It doesn't have to be, you know,getting into active wear and
getting into the gym.
Particularly if you don't enjoythat, you just won't go.
I know, because I don't reallyenjoy the gym.
I'm trying to get myself backin there at the moment and it is
getting my mindset in the rightplace, even though I'm
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theoretically, I'm motivated,but I'm just, I just need to get
myself in there.
But I'm just, I just need toget myself in there.
And so I do understand whatit's like when you're not
someone that loves exercise.
I mean, I love Reformafantastic, and I think having a
class is also helpful, like ifyou have an accountability buddy
.
If you've got a friend that youcan meet to do a short walk
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with, or a neighbor or someonelike that, you're way more
likely to do it with me with mydogs If I just mention the W
word, then I can't take it back,so that's a really good thing.
And one of my dogs inparticular she's gotten quite
used to my lunchtime walks now,so she starts bailing me up
straight after lunch.
(24:00):
It's like, right, where are wegoing?
So, yeah, anything like thatwill really help.
So the musculoskeletal syndromeof menopause.
If you would like access tothis article actually I might
put it in the show notes andthis might be something.
If you've been struggling withbody pain and you're having
trouble talking to your GP aboutit, it might be worth taking
(24:20):
this paper.
It is brand new, so they maynot have seen it, particularly
if they're not a menopausespecialist kind of GP.
So take this paper and say,look, this is what I've been
reading and this is somethingthat perhaps is going on with me
.
How can I get some support andrelief for my symptoms?
(24:43):
As I said, I've given you someoptions here.
That may or may not be rightfor you, but I really encourage,
if you are experiencing thisbody pain, that there is some
things that can be done to help.
So I hope this podcast has beenhelpful.
Please do let me know.
You can message me throughInstagram at SusieGardenWellness
.
You can send me an email, helloat SusieGardencom.
(25:03):
And I think on some of thepodcast providers I think maybe
Spotify you can even send me atext, which is pretty cool.
Anywho, I hope you're having agreat day, a great week so far,
and I'll be back on Thursdaywith Q and A.
Thanks so much for joining metoday on the Ageless and Awesome
podcast.
If you liked today's episode,please make sure you click the
(25:26):
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Or, if you'd like to continuethe discussion, head over to
(25:46):
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I'd love to connect with you.