Patricia Yarberry Allen, M.D. is a Gynecologist, Director of the New York Menopause Center, Clinical Assistant Professor of Obstetrics and Gynecology at Weill Cornell Medical College, and Assistant Attending Obstetrician and Gynecologist at New York-Presbyterian Hospital. She is a board certified fellow of the American College of Obstetrics and Gynecology. Dr. Allen is also a member of the Faculty Advisory Board and the Women’s Health Director of The Weill Cornell Community Clinic (WCCC). Dr. Allen was the recipient of the 2014 American Medical Women’s Association Presidential Award.

Have a question about women’s health or menopause? Dr. Patricia Yarberry Allen may have the answer. Click here to send in your question to be posted on WVFC.


Question
: Is there a connection between menopause or peri-menopause and the onset of severe foot issues?

In the space of 24 months, I went from having healthy feet to having, among other things: hammer toe, bunions, Morton’s neuroma’s, ganglion tumors and more! It seems like there is a connection in the loss of natural hormones and my feet just falling apart. —Joanne C.

Dr. Pat: Joanne, thank you for your question. This is actually something I hear about quite often from women.

I solicited opinions from several experts, including Dr. Suzanne M. Levine, who wrote this response:

The wide fluctuation and inexorable decrease in estrogen and progesterone during perimenopause and menopause have effects throughout the body — not the least of which are the feet. Swelling is common, probably related to transient increased estrogen levels, which causes fluid retention. A woman’s favorite shoes no longer fit. Bunions, hammertoes, corns, Morton’s neuromas and other problems are exacerbated.

Rapid weight gain is common, and the foot adapts neither well nor rapidly. This causes ligamentous laxity, overpronation (rolling in on the arch and shifting weight towards the great toe.) Custom-made orthotics will help ameliorate this problem. Over-the-counter inserts will provide some, but much less, benefit. Foot-strengthening exercises will help the arch and the ankle to provide their essential functions of support and balance.

Osteoporosis is another problem in the peri and postmenopausal period. This predisposes one to fractures and stress fractures everywhere in the body — particularly in the spine, hips and feet. This can be lessened with a proper exercise regimen and proper diet, including vitamin D, magnesium, calcium and other essential nutrients.

Morton’s neuroma becomes more prevalent because the increasing weight puts extra stress on the ball of the foot (about three times the weight gained), particularly with high-heeled shoes. This typically results in pain on the ball of the foot between the third and fourth toes. 

Ganglion tumors develop along the tendons due to small ruptures in the tendon sheath, with fluid accumulating in saclike-out pouching. This occurs more commonly when the foot is not biomechanically sound and is exacerbated by weight gain.

Aging results in loss of fat below the bottom of the foot, even as unwanted fat is gained in most other parts of the body. This fat once provided cushioning, and we now find ourselves walking on the foot bones and skin. Orthotics can help. I have developed a technique called "pillows for the feet," in which I inject a filler material into the bottom of the feet to replace that which time has taken away. The results are often gratifying.

In addition, Dr. Matthew M. Roberts, a brilliant orthopaedic surgeon at The Hospital for Special Surgery in New York City, said that while his review of the literature does now show a direct correlation between foot deformity and menopause, there are definitely more forefoot deformities in women than men. He adds:

While we can place some blame on shoewear, hormones clearly have an effect. Whether it is estrogen or relaxin, the supportive soft tissues can become more flexible allowing deformity to occur. Genetics also play a role in the development of bunion deformities. 

In my own experience, it seems that symptomatic foot problems tend to occur more frequently in the 40-50 year age range. It seems to be mainly an aging process, but it may be an interesting area for further research.

* * * * *
Dr. Patricia Yarberry Allen,
director of the New York Menopause Center, is a gynecologist affiliated
with New York-Presbyterian Hospital and a board certified fellow of the
American College of Obstetrics and Gynecology
.

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  • Elaine July 29, 2012 at 10:01 pm

    I feel there is a total connection between mortons neuroma and menopause

    Reply
  • June Gibson June 3, 2008 at 12:38 pm

    Thanks so much for your article. I write this for your information.
    I am now 67. I have had the problem which you describe for over 20 years but it is really worsening now.
    Two types of fitted orthotics (expensive)bought a few years back have been largely useless. They only fit in certain huge and ugly shoes. The shop-bought foot aids don’t really help – they (and the use of my foot scalpel regularly) merely make visits to the chiropodist a less frequent necessity.
    However, I have recently taken to bandaging my feet in a certain way, over chiropodist felt, cut to shape by me. This is a lengthy daily process, and chiropody aids from the pharmacist are expensive. However the skeletal mid-sole of foot is bulked up by the felt as is my high arch, so that they take their share of the load as I walk. Normally, callouses form almost daily on the ball of each foot, now so pronounced, and lately on the feet outer rims (by the little toe)- but I note they are lessening almost immediately with the felt being properly placed, so it is worth the trouble. I think an answer might be hand-made shoes, if I had the money, but even then what would I do about shoe changes? I like wearing quite attractive shoes, although nowadays they are often ballet pumps or low heels. My days of “killer” heels are past!
    The walking problem probably first existed after a brain tumour was removed when I was 33. I was lucky to be here! However, the walking problem that the illness had caused was exacerbated at menopause by the disappearance of flesh you speak about.
    I was taking HRT at the time of menopause and beyond. I have recently started a daily oestrogen pill again to see if it helps with various other ailments but its so low-dose it is unlikely to give me back the fleshiness of youth.
    Your article was the first time I have seen the menopause linked with the loss of this fleshy pad from the sole of the foot. Your filler sounds just the thing for me but I expect it needs top-ups every few months – and I am in the UK!
    I should add that these problems result in my needing a wider shoe than the length required. If I take a larger size to get the width, the shoe length is too big, giving no arch support and leaving a gape in the inner side of the shoe with my arch entirely unsupported. Of course, there were no trainers available in my younger days; anyway, it was not OK to go to work in an office wearing inelegant shoes.
    Unless I do this fiddly felt-fitting procedure, my stability is poor, compounded by having lost my hearing in the same-side ear, after that same illness. The “no-balance” hearing, and the foot problems, take their toll on steps with no hand-rail or uneven surfaces. I am a thin person, only 5″3 so the feet haven’t much load to carry, plus I drive a car a lot.
    I’m once again counting myself lucky to be here at 67, but attending to my small ailments sure is taking up the day!
    I hope this feedback helps, i.e. that somewhat deformed walking gets infinitely worse because of the menopause flesh loss.

    Reply
  • Kristen May 12, 2008 at 2:37 pm

    This article focuses on hormonal change in pregnancy. Could hormonal changes during pregnancy also lead to severe foot problems? After 2 babies, I have bunions, neuromas, and plantar fascia problems.

    Reply
  • Joanne C April 8, 2008 at 9:01 am

    Thanks so much. The several MD’s I’ve seen about my feet said many of the same things but no one made any connection between my menopause and my tootsies.

    Reply
  • Elaine L April 7, 2008 at 7:58 pm

    Absolutely. And everyone should visit your site, Wendy.It’s terrific.

    Reply
  • [email protected] April 7, 2008 at 2:48 pm

    Thank you for posting this article. It’s good information and shows why, among other reasons, it’s important to maintain your optimal weight as we enter our middle years.

    Reply