The Link Between Menopause And Musculoskeletal Pain

In this article, we demystify some of the symptoms you may experience if you are going through menopause.

Menopause marks a significant change in the health and wellbeing of women. People often talk about hot flushes and night sweats, but did you know the menopause can also put you at higher risk of pain and injury?

In this article, we will demystify some of the symptoms you may experience if you are going through menopause — because the more prepared you are, the more you can mitigate the risk of chronic pain and injury in the years following. Healthy aging is key!

What Is Menopause?

Menopause occurs when the body stops producing eggs and the hormones associated with reproduction are dramatically reduced. If you haven’t menstruated in 12 months, then you have entered menopause. It can begin in women as early as their 40s, however the period of fluctuation in hormones can be anywhere between 4-6 years. For some, this has minimal effect except for an end to monthly menstruation. However, for 80% of women this change in hormone production levels (especially in estrogen) will cause symptoms throughout the whole body.

The Musculoskeletal Impacts Of Menopause


High levels of estrogen can trigger headaches and migraines in some women. The good news is that declining levels of estrogen post-menopause can reduce headache frequency overall. However be mindful that as your hormone levels fluctuate during menopause, your headaches may be triggered more often in the short-term.

Bone health and osteoporosis

Bone density in women is strongest during their 20-30s and estrogen levels are especially important in maintaining this. However, as estrogen levels drop, bone loss increases, with an average of 10% bone mass lost in the first five years post-menopause. This means the risk of osteoporosis is far higher in women after menopause, making bones frailer and more prone to fractures, especially in the spine, wrist, and hips from falls.


Estrogen provides a protective effect on muscles, which is why women typically suffer less muscle strains than men throughout their lives. Unfortunately the reduction of estrogen during menopause leads to a decline in both muscle mass and strength, which means you may experience more pain or sustain injuries more frequently even though your level of activity hasn’t changed. Not only that, but it can also cause weakness in your core and pelvic floor muscles and lead to instability, poor posture, and even incontinence.

Joint pain and inflammation

Estrogen has been shown to help reduce inflammation in the body. If you already have a pre-existing inflammatory condition such as arthritis or a tendinopathy, this can become exacerbated post-menopause and cause more pain and restriction in your daily activities.

How To Minimise The Effects Of Menopause

Maintaining a good level of physical activity has been shown to counteract many of the negative musculoskeletal effects of menopause. This can be walking, swimming, cycling, gym classes, Tai Chi, strength training, pilates — just remember that consistency is key to reap the benefits to your health. If you can do some form of exercise for 30 mins most days of the week, then you are on your way!

Bone density can be maintained by ensuring adequate calcium and vitamin D levels in the body for bone production. Regular weight-bearing resistance exercise (i.e. exercise on land involving weights) also stimulates bone strength as well as counteracts the muscle loss that occurs menopause and aging. If you are experiencing specific weakness of core and/or pelvic floor muscles, consider getting a specific assessment and exercise program prescribed by a physiotherapist.

For most people, exercising more and being aware of your body changes will go a long way to attenuating the worse symptoms associated with menopause. However, if your symptoms persist and impact your quality of life, menopausal hormonal therapy may be an option to help adjust to the sudden decline in estrogen levels. This is best discussed with your GP to ascertain whether this is the right option for you.

If you are suffering from muscle aches and pain, we can help get you moving pain-free and prescribe an exercise program to keep you there despite the hormonal fluctuations in menopause. The earlier you start, the easier it is to keep the gains as your body undergoes these significant changes!


Introduction to Women’s Health APA Lecture Series

Bondarev, D., Laakkonen, E., Finni, T., Kokko, K., Kujala, U., Aukee, P., Kovanen, V. and Sipilä, S., 2018. Physical performance in relation to menopause status and physical activity. Menopause, 25(12), pp.1432-1441.

Chidi-Ogbolu, N. and Baar, K., 2019. Effect of Estrogen on Musculoskeletal Performance and Injury Risk. Frontiers in Physiology, 9.

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