Stepping Through Menopause: How Hormonal Changes Impact Your Feet and Mobility

As women transition through menopause, they often experience a range of symptoms like hot flashes, mood swings, and weight gain. However, less frequently discussed is how menopause can profoundly affect foot health. From foot pain to biomechanical changes, the decline of estrogen plays a significant role in how our bodies, including our feet, respond to aging.

This article dives into the changes that occur during menopause, with a focus on feet and mobility. Understanding these changes is empowering, allowing women to seek better care and improve their quality of life during this important stage of aging.

 

Menopause and Hormonal Changes: A Whole-Body Impact

The end of reproductive function during menopause is driven by the depletion of ovarian hormones, particularly estrogen and progesterone. While these hormones are essential for reproduction, they also play significant roles in other systems of the body, including the brain, cardiovascular system, bones, and musculoskeletal structure. Dr. Felice Gersh, MD, and Alexis Perella’s Menopause: 50 Things You Need to Know emphasize that menopause affects nearly every aspect of the female body, contributing to decreased muscle function, changes in metabolism, and increased joint and ligament stiffness. The cumulative impact of these changes influences foot health and mobility (Gersh & Perella, 2020).

 

With estrogen levels declining, musculoskeletal systems, including muscles and tendons, become less flexible, which can lead to foot pain, including plantar fasciitis—a common condition experienced by postmenopausal women. Women are often unaware of the link between menopause and foot pain, but understanding this connection can lead to better care and management of these symptoms.

 

Changes in Foot Structure and Function

Postmenopausal women often experience structural changes in their feet, driven by both hormonal shifts and age-related degeneration. A study published in Clinical Biomechanics found that the decline of muscle-tendon unit (MTU) stiffness, combined with an increase in body mass, can contribute to the collapse of the medial longitudinal arch in postmenopausal women, leading to flat feet (Faria et al., 2010). This can further exacerbate foot pain and discomfort, particularly during walking, as the arch no longer functions effectively to absorb shock and distribute weight properly.

Both high and low-arched feet have been associated with increased risk of injury. High-arched feet are rigid and less capable of absorbing shock, which can lead to lateral ankle sprains and bony injuries. Conversely, low-arched feet are more flexible but place more stress on soft tissues like ligaments and tendons, increasing the risk of plantar fasciitis and overuse injuries (Faria et al., 2010). The study suggests that postmenopausal women are at greater risk of developing these foot problems due to hormonal changes, making foot care and intervention critical.

 

Pelvic Floor Dysfunction, Pes Planus, and Foot Pain

 

An emerging area of research has linked foot structure, particularly pes planus (flat feet), with pelvic floor dysfunction (PFD). A 2024 study by Seyda Toprak Celenay and colleagues found that while pelvic floor muscle strength (PFMS) did not differ significantly in women with and without pes planus, those with flat feet showed a higher prevalence and severity of pelvic floor dysfunction compared to women without pes planus. The pelvis, responsible for connecting the musculoskeletal system and transmitting forces between the upper and lower body, can be affected by changes in foot posture, such as calcaneal eversion (flattening of the heel), leading to internal rotation of the hips and pelvis (Celenay et al., 2024).

This alignment issue can exacerbate pelvic floor dysfunctions such as urinary incontinence and pelvic organ prolapse. Additionally, the hormonal changes in menopause can weaken musculature, contributing to both pelvic floor dysfunction and foot pain, particularly plantar fasciitis. The connection between foot posture and pelvic health emphasizes the need for comprehensive care and research into how menopause affects both foot and pelvic floor function.

 

The Role of Body Weight and Plantar Pressure

Elevated plantar pressure, often seen in postmenopausal women, obese individuals, and pregnant women, is another concern. Research by Bailey (2011) highlights that increased plantar pressure can heighten the risk of gait dysfunction and falls in older women. Gait disorders, caused by changes in foot structure and biomechanics, are exacerbated by foot pain, further increasing fall risk (Bailey, 2011). Appropriate footwear and the use of prefabricated orthotics are effective measures in dispersing plantar pressures, offering comfort and reducing the risk of injury.

Exercise is also a powerful tool for managing these symptoms. Bailey’s research supports the incorporation of exercise as a treatment to manage gait dysfunction in postmenopausal women. Regular, moderate-to-vigorous exercise can reduce plantar pressure and improve foot biomechanics, which in turn helps to alleviate foot-related discomfort (Bailey, 2011). This is particularly beneficial for postmenopausal women who may struggle with foot pain or mobility issues.

 

Foot Pain and Its Impact on Quality of Life

Foot health directly affects quality of life, and postmenopausal women are especially vulnerable. A case-control study found that women in menopause report significantly lower quality of life related to both general and foot health, compared to non-menopausal women (López et al., 2016). Common symptoms include foot pain, reduced functionality, and limitations in social capacity due to mobility issues. Many women endure foot pain as part of the natural aging process, but this need not be the case. Interventions such as orthotics and consultations with a podiatrist can significantly improve foot health and quality of life for menopausal women.

 

The Importance of More Research

Menopause has long been under-researched, especially when it comes to its impact on areas like foot health. As Baker and Benayoun (2023) note, menopause is more than just the loss of fertility—it affects every system in the female body, and foot health is no exception. Women deserve to be informed about how menopause impacts their overall health, including their feet.

The medical community is becoming increasingly aware of these connections, and there is more support available for women to address symptoms related to menopause. More research is needed to explore the links between hormone depletion, foot biomechanics, and musculoskeletal health, and to develop treatments that can effectively manage these conditions. Collaboration between women, doctors, and allied health practitioners like podiatrists is essential to navigate the changes of menopause effectively and ensure women receive the care they deserve.

 

Taking Control of Your Foot Health

Menopause is a significant life stage that brings about many changes, but it doesn't mean women have to accept foot pain or reduced mobility as inevitable. Prefabricated orthotics, designed to support the arches and disperse plantar pressures, offer a conservative yet effective solution to many foot-related issues that postmenopausal women experience. Regular exercise programs tailored to individual needs can also play a crucial role in managing foot pain, enhancing mobility, and preventing further injury.

If you’re experiencing foot pain or noticing changes in your feet during menopause, it’s important to consult a podiatrist who specializes in foot health. With the right care, support, and intervention, it is possible to maintain an active, healthy lifestyle throughout menopause and beyond.