perimenopause

Waking up with a stiff neck or a tension headache is a pain...literally. For some women, it seems like a never ending cycle of searching for a new pillow. They walk out of the store confident they've found the perfect pillow only to wake up with a stiff neck or tension headache days later–rinse and repeat. If this sounds familiar and you're over the age of 35, your pillow may not be to blame at all.

As women of a certain age wonder what's going on with their necks while they sleep, researchers say the problem is likely hormonal. Menopause is no secret. While the word was once whispered to close confidants or replaced with the phrase "the change" (as if women were becoming vampires), conversations happen openly now. Because of this shift, women feel more prepared for the process to occur...when they're over 50...but many people are finding out "the change" starts happening years before menopause.

Struggling with hot flashes, woman tries to keep cool.Photo credit: Canva

This process is called perimenopause, which is essentially pre-menopause, and the process can start as early as 35 and last up to a decade. Of course, genetics, health, and other biological factors determine how early the perimenopause stage starts for a woman, but it always starts the same–declining hormones. According to researchers, hormones control a lot of what's going on in someone's body, so any influx or reduction of these chemicals can have negative effects (including musculoskeletal performance).

"Both estrogen and testosterone are present in males and females. Both hormones contribute to the wellbeing of skeletal muscle and bone in men and women, and there is evidence that the loss of sex hormones is associated with the age-related decline in bone and skeletal muscle mass," Marybeth Brown writes in the article "Skeletal muscle and bone: effect of sex steroids and aging" for the journal Advances in Physiology Education.

Woman experiences back pain at home.Photo credit: Canva

It's those decreases in sex hormones that researchers say may be a contributing factor to perimenopausal women's musculoskeletal issues—which would include a stiff neck. While currently researchers aren't specifically looking at the link between declining hormones and stiff neck isolated from the rest of the musculoskeletal system, declining hormones explains why these aches, pains, and injuries happen.

The Menopause Society, a nonprofit that empowers healthcare professionals with evidenced-based resources says, “Hormonal fluctuations during perimenopause and menopause can cause muscle tension. This tension can manifest in various body parts, with the neck being a common area.”

Recently, a woman sought answers to her stiff neck in a menopause group, saying, "I've seen a lot of blanket talk, but not much about pillows. I get night sweats and also lately I've had some neck pain that is unrelated to perimenopause (I think). I want a better pillow than I have, but it needs to be able to get washed from all the sweating. What works for you? And how do you wash it? Memory foam? Shredded...latex? or is it just plain shredded foam? Wool? Buckwheat husks? Something else?"

Waking up with a sore neck.Photo credit: Canva

Much to the woman's surprise, she was flooded with comments from other women sharing they are also experiencing a stiff neck no matter what type of pillow they use. While several women shared their favorite type of pillow (memory foam seems to be the winner), others commiserated or were happy they weren't alone in the struggle.

One woman responded, "Just saw this post. Glad I did. My neck has been killing me over the last 3 months. I've bought so many pillows. Right now the shredded memory foam seems to be ok right now. Then I decided to do a quick search about neck pain and perimenopause....I'm pretty sure I have every symptom under the moon.... Currently on STD because of perimenopause is absolutely debilitating for me. Neck pain is a common symptom during perimenopause and menopause, often linked to declining estrogen levels and their impact on joint health and muscle function. This can manifest as aches, stiffness, and even frozen shoulder."

Office worker stretching to relieve back pain.Photo credit: Canva

Researchers Nkechinyere Chidi-Ogbolu and Keith Baar explain in their article "Effect of Estrogen on Musculoskeletal Performance and Injury Risk" in the journal Frontiers in Physiology, "Consistent with a role for estrogen in regulating musculoskeletal function, menstruating women suffer more ACL ruptures than men and menopause is characterized by increased risk of musculoskeletal injury, accelerated bone and muscle wasting, and decreased sensitivity to anabolic stimuli. To counteract many of the negative aspects of menopause, hormone replacement therapy (HRT) has been used to reduce muscle and bone loss, and restore muscle protein balance."

So if you've been struggling with neck pain and are over the age of 35, have ruled out injury or another cause by your doctor, it just might be hormones. There's no stopping a decline in your natural hormone levels as you age, but there may be things that can help when working with your physician. In the meantime, here's to restful nights and a good memory foam pillow.