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As podiatrists, many patients we see in our Congleton podiatry clinic are women over the age of 45. There’s no clear start or end point of the menopause, but it generally starts between the ages of 45 and 55 when there is an initial rapid drop in oestrogen and then continual steady decline over several years.
Fluctuations in oestrogen levels affect many of the body systems linked to foot and lower limb health including the cardiovascular system, musculoskeletal system, endocrine system, and skin.
Musculoskeletal health
Menopause and the drop in oestrogen has been linked with osteoarthritis, osteoporosis, and sarcopenia (reduced muscle mass & function).
Oestrogen prevents bone breakdown so when oestrogen levels fall, bone breakdown occurs faster than it is formed. Women lose roughly 1% of bone mass per year over 10 years starting during the perimenopause.
Changes in cartilage, loss of suppleness in ligaments and loss of muscle mass and strength can result in pain in the feet and foot disorders such as bunions and clawed or hammer toes.
Improving musculoskeletal health
Calcium, vitamin D and adequate protein intake are important for musculoskeletal health. It is best to get these from food and sensible sun exposure but if this is not possible, speak with your GP about suitable supplements.
Physical activity is extremely important for musculoskeletal health. One of the best things you can do is incorporate activity into your daily life. This will help to maintain a healthy weight and keep your muscles strong to help with balance, reduce discomfort and prevent falls.
Exercises that will specifically improve bone strength are impact exercises such as jogging or anything involving hopping or jumping. Resistance exercises 2 to 3 times a week are recommended to help improve muscle mass and strength.
Exercises to strengthen the foot and ankle combined with appropriate, well-fitting footwear and sometimes orthotics, can help to delay the development of bunions and other toe deformities. You can find examples and a video of foot strengthening exercises in our previous blog 'Exercise for treating plantar fasciitis'.
Cardiovascular system
Oestrogen helps control cholesterol levels which reduces the risk of fatty plaques building up in artery walls. During menopause, the drop in oestrogen may increase a woman’s risk of narrowed arteries due to plaque build-up. Narrowed arteries occur anywhere in the body and reduced blood flow in the legs can affect the feet. Poor circulation to the feet can cause dry, cracked skin, brittle nails, slow healing wounds, pain and cramping.
Help your heart
There is now significant evidence that HRT started in the early years of menopause can help protect your heart health. Some women feel apprehensive to take HRT due to the reported risk of blood clots. This risk is reported to be small and usually outweighed by the benefits. Research has found the risk is linked to HRT in tablet form and there is no increased risk when taking HRT via the skin with a patch or gel.
Lifestyle factors can make a positive difference to heart and cardiovascular health. Healthy eating, increasing physical activity, managing weight and stress levels and not smoking, all contribute to reducing the risk of heart and cardiovascular disease. Podiatrists are able to assess the circulation to your feet to screen for any abnormality.
Skin health
Oestrogen plays a role in collagen production, skin elasticity, thickness and moisture levels.
Menopause can bring noticeable changes to your skin and nails. Reduced hormone levels can cause reduced oil production, thin and dry skin. Dry, cracked skin allows moisture to escape and bacteria or fungus to enter more easily, increasing the risk of fungal infection to the skin and toenails.
Protecting your skin.
Use a broad-spectrum SPF 30 sunscreen to areas of skin exposed to the sun.
Wash skin with a mild cleanser instead of soap, which can be too drying.
Apply a moisturiser after bathing and throughout the day if skin feels dry.
Apply a foot cream 1 to 2 times per day to help the skin to maintain its protective barrier. Creams containing humectant such as Urea or glycerin, draw moisture into the skin.
Hydrate nails using a conditioning nail oil or simply massage olive or coconut oil into the nails and cuticles.
In summary
There are lots of things you can do to help prevent foot problems during menopause. A healthy lifestyle and regular exercise reduce the risk of complications to cardiovascular and musculoskeletal health. Incorporating resistance exercises to help strengthen the feet, legs and core will improve balance and help prevent falls. Wearing comfortable, well-fitting shoes and strengthening the smaller muscles in the feet helps to slow progression of toe deformities. Applying a urea-based foot cream daily will improve the condition of the skin, helping to prevent infection. Above all, seek advice from your GP or practice nurse for help with managing menopausal symptoms, and see a podiatrist for help with your foot health!
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