Written by Kerry May, a podiatrist at Highet Podiatry

Menopause is a phase in a woman’s life, marking the end of her reproductive years. Menopause, is defined as the point at which it has been a year since your last menstrual period. Menopause typically occurs between the ages of 45 and 55, and is preceded by perimenopause, which can last for several years. Perimenopause and menopause bring about a myriad of physiological changes driven primarily by fluctuations in hormone levels, particularly estrogen. While hot flashes, psychological symptoms, and osteoporosis are commonly discussed, one aspect often overlooked is the impact of menopause on foot health.

Let’s start with considering how menopause may be experienced, acknowledging no two women will have the same perimenopause and menopause.

The main feature of menopause is the decline in estrogen production. Estrogen is a crucial hormone that regulates various bodily functions. Its decrease affects multiple systems, leading to a wide array of symptoms.

Common physical presentations of menopause & perimenopause

1. Vasomotor Symptoms

Hot flashes and night sweats are among the most common vasomotor symptoms experienced by women in perimenopause. These can significantly impact the quality of life, causing discomfort and sleep disturbances.

2. Psychological Symptoms

Mood swings, anxiety, and depression may occur for some women during menopause. The hormonal changes can influence neurotransmitter activity in the brain, contributing to these psychological symptoms.

3. Urogenital Symptoms

The decrease in estrogen levels can lead to urogenital atrophy, causing symptoms such as vaginal dryness, itching, and discomfort during intercourse.

4. Bone Health

Estrogen plays a vital role in maintaining bone density. Its decline during menopause can accelerate bone loss, increasing the risk of osteoporosis and fractures.

Impacts of Menopause on Foot Health

While the systemic effects of menopause are well-documented, its impact on foot health is often underestimated. However, changes in hormone levels can have several direct and indirect effects on your feet.

1. Reduced Bone Density and Increased Risk of Fractures

The decline in estrogen levels during menopause leads to decreased bone density, a condition known as osteoporosis. This affects the bones in the feet as well, making them more susceptible to fractures. The risk of stress fractures in the foot increases, particularly in the metatarsal bones, which bear a significant amount of weight during walking and standing.

2. Joint Pain and Stiffness

Perimenopause and menopause can exacerbate joint pain and stiffness for some women. The feet, with their numerous joints combined with the work we expect them to do every day, can be particularly affected. Women may experience pain and swelling in the toe joints, the ankle, and the midfoot. This discomfort can be debilitating, affecting daily activities and overall mobility.

3. Plantar Fasciitis

The plantar fascia is a thick band of tissue running along the bottom of the foot. During perimenopause and menopause, it may become inflamed due to changes in hormone levels and the impact this may have on reducing the elasticity of tissues. This condition, known as plantar fasciitis, causes severe heel pain and can be exacerbated by weight gain, another common experience for women in perimenopause and menopause.

4. Circulatory Problems

Hormonal changes can affect circulation, leading to poor blood flow to the extremities. This can cause symptoms such as cold feet, numbness, and tingling. Poor circulation can also delay the healing of cuts, blisters, or other foot injuries, increasing the risk of infections.

5. Changes in Foot Structure

The decrease in estrogen, along with the process of aging, can lead to a reduction in the fat padding on the soles of the feet, causing discomfort when walking or standing for long periods. Additionally, changes in muscle and ligament strength can alter foot structure, potentially leading to conditions such as flat feet or fallen arches.

6. Dry Skin and Nail Changes

Hormonal fluctuations during menopause can cause the skin on the feet to become dry and cracked. This can be particularly problematic for women with other medical conditions such as diabetes. Additionally, toenails may become brittle, thickened, or develop fungal infections more easily due to changes in the skin and immune response that may occur during perimenopause and beyond.

Managing Foot Health During Perimenopause & Menopause

Given the significant potential impact of perimenopause and menopause on foot health, it is crucial for women to take proactive steps to maintain their foot health. Good foot health helps you to stay active as you get older, with all the well-known benefits for your heart, muscular and psychological wellbeing.

1. Regular Exercise: Ensure that weight-bearing exercises are part of your weekly activity to assist with maintaining bone density and muscle strength. Low-impact activities like walking or swimming can help reduce joint pain and stiffness.
2. Proper Footwear: Our favourite thing at Highett Podiatry! Invest in well-fitting shoes with adequate arch support and cushioning to reduce foot pain and prevent injuries. We are always happy to provide advice and recommendations for you.
3. Moisturise your skin: Keep the skin on the feet hydrated helps to prevent dryness and cracking. The key is to do this daily to maintain the best possible skin on your feet. Sorbolene cream is a great choice, and if your skin is very dry or cracked, then using a cream with a Urea base can be helpful. We have some great choices available to our patients in the clinic at Highett Podiatry.
4. Routine Check-ups: Regular visits to your podiatrist allows us to help monitor your foot health and address any issues promptly. This is particularly important for women with pre-existing conditions like diabetes.
5. Healthy Diet: Maintain a balanced diet rich in calcium and vitamin D to support bone health. A healthy diet can assist with maintaining a healthy weight, which will reduce the stress on your feet and help prevent conditions such as plantar fasciitis.

Perimenopause and menopause are a natural phase of life that all women will experience. By understanding the potential impacts on your foot health and taking proactive measures to reduce the impact of perimenopause and menopause on your feet, women can maintain their mobility and quality of life during perimenopause and after menopause. Regular consultation with healthcare providers, including podiatrists, is essential to address any concerns promptly, ensure you are well informed about your wellbeing and together we can secure your optimal foot health during this transitional period and beyond.