Women in their mid-50s faces a cascade of menopausal symptoms. Among them, arthralgia —muscular and joint pain — proved to be the most debilitating, causing a decade-long struggle that impacted her spine, nerves, and daily functioning. It led to severe deterioration, hindering her ability to perform basic tasks and leaving her grappling with excruciating discomfort.

"Menopausal arthralgia or joint pain is a condition that even clinicians globally are not well aware of," highlighted Professor Yong Eu Leong, Emeritus Consultant at the National University Hospital's Department of Obstetrics and Gynaecology. "Filling these gaps will help understand the burden of arthralgia and its associated factors among a healthy population of midlife women and may shed understanding on improving its management."

Patients with enduring a decade-long battle with joint and nerve pains have significantly increased over the years especially due to the ageing population and greater awareness. Researchers from the Integrated Women’s Health Programme (IWHP) at the National University Hospital (NUH) and the Yong Loo Lin School of Medicine, National University of Singapore (NUS Medicine), conducted two comprehensive studies in 2023 funded by the Singapore National Medical Research Council.

The earlier study published in October 2023 revealed that 62.6% of 1,054 Singaporean women reported at least one moderate to extremely severe symptom during their menopause. According to the study, Arthralgia was ranked as the top menopausal symptom, significantly affecting a third (32.9%) of the cohort. This groundbreaking research, unique to Southeast Asia and focused on Chinese, Malay, and Indian ethnicities, highlighted arthralgia's prominence over other symptoms such as sleep problems (27.5%), vaginal dryness (20.3%), physical and mental exhaustion (19.6%), and hot flushes (18.6%).

A second study published in December 2023 affirms the significance of arthralgia as a condition that affects midlife women. The study found that a huge proportion (74.9%) in the cohort of 1,120 midlife women suffered from some form of arthralgia, ranging from mild to very severe. 

The majority of the women studied experienced arthralgia in the postmenopausal period, and it is associated with other menopausal symptoms of vaginal dryness, physical and mental exhaustion as well as poor muscle strength.

Prof Yong added: “Our studies have revealed that arthralgia often correlates with other challenging symptoms during the postmenopausal phase, indicating a complex interplay within menopausal experiences. Arthralgia can be debilitating and may lead to a decline in the quality of life among healthy midlife women. Despite being one of the most frequent complaints, there is a paucity of studies examining the risk factors associated with this condition.”

Diverging from western studies, the findings underscore the necessity of understanding and managing menopausal symptoms, particularly arthralgia, in midlife Singaporean women. 

In response to these critical findings, the IWHP is gearing up for a follow-up study. Furthur, collaborating with physiotherapists from NUH, the team aims to develop targeted interventions, including exercise regimes to enhance muscle strength, along with exploring menopausal hormone therapy's potential in alleviating joint pains and improving overall well-being for premenopausal, perimenopausal, and postmenopausal women. This forthcoming research endeavours to fill crucial gaps in managing menopausal symptoms among Singaporean women, ultimately enhancing their quality of life.

Image Caption:

NUH Principal Physiotherapist Ms Cammy Tsai (right) providing a demonstration to Singaporean postmenopausal women on muscle strengthening exercises to help alleviate muscle and joint pains.