How does your body feel when you first step out of bed in the morning or get up from the sofa?
Have you noticed your previously intermittent back ache or joint pain is now bothering you a lot more? Are you getting more injuries than you used to like plantar fasciitis or a frozen shoulder?
A very common – and often debilitating – symptom of perimenopause and menopause is stiffness, aches and pains in the joints and muscles. This can be all over or in specific spots. There are times when you know it’s going to happen (like moving when you’ve been in a fixed position for a long time), and other times it can just suddenly happen out of the blue.
For those of you who already live with a long term pain related condition, your peri/menopause may be making your existing symptoms worse.
Why do these aches and pains happen and is there anything you can do about it?
Musculoskeletal symptoms and related conditions
This kind of pain is known as musculoskeletal (MSK) pain and it includes sudden or longer-lasting pain affecting the bones, muscles, ligaments, tendons, and nerves.
In perimenopause and menopause, common MSK related symptoms are:
- muscle and joint aches and pains
- joint stiffness
- joint swelling
- reduced muscle strength
- low stamina
- pins and needles
- fatigue
Aside from our hormones, MSK pain can also be due to overuse, for example at work or while playing sports, poor posture, or prolonged periods of inactivity or bed rest, such as during an illness or after surgery.
A common pain related condition that particularly affects women in their 40s and 50s is fibromyalgia. If you have this condition, you may have an increased sensitivity to pain, muscle stiffness (especially in the mornings), sleeping difficulties, fatigue, brain fog, headaches, and an irritable bowel. Many women who already know they have fibromyalgia notice a flare up of their symptoms when they reach perimenopause.
Did you know that pain affects women differently to men? Women have more recurrent pain, more severe and longer lasting pain, and are more troubled by painful conditions like fibromyalgia, IBS and arthritis than men.
After menopause, there is an increased risk of the following health conditions that affect the musculoskeletal system:
- osteoporosis (a progressive disease of bone tissue loss that causes bones to become weak and more likely to fracture)
- osteoarthritis (a condition relating to wear and tear, causing the joints to become painful and stiff, and problems moving the joint)
- sarcopenia (the gradual loss of muscle mass and strength that can happen with age)
- rheumatoid arthritis (a long-term inflammatory condition causing pain, swelling and stiffness in the joints, especially the hands, feet and wrists)
- lupus (an autoimmune condition causing joint pain, skin rashes and tiredness).
Why does MSK pain occur at peri/menopause?
Although the exact science isn’t fully understood yet, hormone levels and changes to these levels appear to affect how sensitive we are to pain, how our body responds to pain, as well as contributing to issues that can cause pain, like inflammation. Hormone changes also affect how well we sleep and our mood, which indirectly affects how well we cope with any pain too.
Estrogen, progesterone and testosterone all work as anti-inflammatory agents in your muscles and help lubricate the joints. When hormone levels are low, the joints may be more inflamed and feel stiffer to move, especially in the mornings.
How can I reduce aches, pain and stiffness?
As with many symptoms of perimenopause and menopause, to see the most improvement, it’s best to use a combination of approaches.
- Keep a healthy lifestyle to manage MSK pain. Staying active and giving your joints, bones, muscles and ligaments plenty of work to do is vital to keep them strong and functioning well. Aim for a combination of exercise including activity that impacts through your joints like brisk walking/jogging, dancing, racquet sports or aerobic workout sessions, and activity that stretches the muscles more and challenges your flexibility like Pilates, yoga or tai chi. You can read more about staying active in our guides, Keep Moving and Keeping Bones Strong.
Weight is another important factor when it comes to pain – people who are overweight are 4x more likely to report pain. Staying a healthy weight helps keep extra strain off your joints, muscles and bones. Our resource, Staying a Healthy Weight provides more information.
Along with staying a healthy weight and doing the right type of activity regularly, eating a well-balanced diet, getting enough sleep, caring for your emotional wellbeing, reducing stress and limiting alcohol are all other important aspects of maximising a healthy lifestyle in order to reduce symptoms of aches and pains.
Vitamin D deficiency is an important cause of musculoskeletal pain. In the UK, it is important to take Vitamin D as a supplement as our bodies don’t absorb it well from food sources, and the amount we generate from exposure to sunshine is unlikely to meet our needs, especially during the months of October to March.
- Plan, pace and prioritise. If you live with a long term condition or have chronic pain, you’ll already know how much you can realistically do in a day or week, you’ll understand your triggers and know how much time you need to recover.
If you’ve begun to suffer from MSK pain and it’s impacting your ability to live a normal life, it’s time to start planning your activities and spread them out strategically across your day and week.
Pace yourself when being active and stop when you are tired or the pain is just starting, rather than carrying on until you’re exhausted or in agony. You’ll recover faster if you’re kinder to your body. And finally prioritise the activities that aren’t essential – perhaps learn to let go of some activities if it’s simply too much. Avoid the temptation to take a boom and bust approach, where you’re knocked out for a few days afterwards because of overexerting yourself.
- Consider taking HRT. If your hormones are in a state of flux or at a consistently low level, top up your estrogen supply (usually via a skin patch, gel or spray) and if you still have your womb, you will need to take the progesterone hormone (or synthetic progestogen) too. In addition to this, testosterone (delivered in a cream or gel via the skin) can be particularly beneficial for MSK symptoms like muscle aches and pains, and it may give you more stamina and motivation to keep active.
Most women experience significant relief of their menopause related aches and pains when they are on the right dose and type of HRT. HRT has been extensively proven to significantly reduce the risk of developing osteoporosis and it also helps to reduce the occurrence and impact of other painful conditions such as arthritis.
- For other types of pain: you may have pain due to other causes that is exacerbated by your peri/menopause. Taking pain relief medication may be recommended, such as non-steroidal anti-inflammatories, if these medications are suitable for you (ibuprofen or naproxen, for example). And you may wish to try alternative options such as massage, physiotherapy, acupuncture, heat and/or ice packs, reiki, or herbal remedies such as turmeric.
Seeking help for pain
If you have ongoing concerns about pain, always see your doctor so it can be properly investigated. It will help if you know exactly where the pain is coming from (if it’s in a certain area) and how to describe the stiffness, aches and pain e.g. is it sharp, dull, stabbing, burning, aching, tingling? This can help identify the cause of your symptoms.
You could keep a pain diary leading up to your appointment to see if there are any patterns and/or triggers and rating your pain out of 10 can help monitor pain levels and progress.
Research on pain unfortunately points towards an unhelpful gender bias when it comes to women’s pain being taken seriously – known as the gender pain gap. Despite women being more prone to pain related conditions and more sensitive to pain, studies show it takes longer for clinicians to diagnose and treat women’s pain effectively compared to men. So if you feel you’re not being listened to, are getting dismissed, or your pain is not being investigated as you think it should, ask to see another doctor and be persistent.
Last updated: June 2026
