Menopause Matters hosts forum on chronic pain for World Menopause Day

Chronic pain impacts more than half of women in midlife

Chronic pain affects more than half of women in midlife. Research shows that women experiencing menopausal symptoms are significantly more likely to live with chronic pain, highlighting the connection between hormonal health and physical wellbeing.

The International Menopause Society reports that nearly 3 in 4 women experience muscle or joint pain during perimenopause. Women face up to a 70 percent higher likelihood of experiencing chronic pain compared to others.

A UK survey found 1 in 3 women said pain was the menopausal symptom they least expected. Falling estrogen changes how the body processes pain and weakens protection around joints, muscles, and vaginal tissues.

Clinicians call this cluster the musculoskeletal syndrome of menopause. More than 70 percent of women in perimenopause report musculoskeletal pain.

Leigh Williams leads conversation on menopause support

Leigh Williams said, "I know what it feels like when pain starts to shrink your world". She added that some women attending support groups are "really desperate for an outlet" because they have been unable to discuss these topics or receive the support they desired.

Bismeen Jadoon, a consultant obstetrician, gynecologist, and menopause specialist, runs complex menopause clinics. Jadoon is British Menopause Society-accredited and regularly sees women who are surprised to learn that their pain may be linked to hormonal changes.

Hormonal changes influence pain perception and sensitivity

Hormonal shifts during menopause play a significant role in chronic pain. Estrogen affects how nerves transmit pain signals and how the brain processes them. During perimenopause, estrogen levels fluctuate and eventually decline, which alters pain sensitivity.

New symptoms like muscle aches, joint pains, or migraines can emerge during this transition. Existing chronic pain conditions can also worsen.

Joint and muscle symptoms are common, with many women reporting generalized stiffness in the hands, feet, knees, or hips, particularly in the morning.

Migraines, which are neurological conditions involving severe head pain, nausea, and light or sound sensitivity, can also shift. Estrogen fluctuations influence the severity of these headaches. Some women experience migraines around their periods, and symptoms often worsen during perimenopause. While migraines improve for some after menopause when hormones stabilize, this is not the case for everyone. Stress, anxiety, and sleep quality also influence migraine symptoms.

Lifestyle medicine and management strategies for pain

The International Menopause Society 2025 White Paper, which reviewed 25 years of research from 2000 to 2024, recommends six pillars of lifestyle medicine as the foundation of menopause care. This includes a Mediterranean diet rich in vegetables, fruit, whole grains, pulses, oily fish, nuts, and olive oil, which may help ease joint pain through anti-inflammatory properties. The society also advises a daily intake of 700 to 1,200 mg of calcium and 400 to 1,000 IU of vitamin D after menopause.

Physical activity, particularly strength training, is a primary treatment for joint pain. While movement is helpful, women may require longer warm-ups and recover more slowly from exercise. They should continue moving and consider physiotherapy for appropriate exercises.

Stress management, including cognitive behavioral therapy, helps reduce the impact of pain on daily life. Restorative sleep lowers pain sensitivity, while avoiding smoking and excess alcohol intake reduces inflammation. Loneliness is also a factor, with a UK study of more than 500,000 people linking it to nearly double the rate of chronic pain.

Not every ache stems from menopause, as aging, injuries, and conditions like osteoarthritis require consideration. Mild stiffness that improves with movement may be menopause-related. However, severe pain, localized swelling, heat, redness, or persistent morning stiffness should prompt a visit to a doctor. Factors like anxiety, low mood, and poor sleep can further complicate the experience of chronic pain.

Medical treatments and HRT options for menopause symptoms

For most women under 60, or within 10 years of their last period, the benefits of hormone replacement therapy (HRT) outweigh the risks. HRT remains the most effective treatment for hot flushes and night sweats, protects against osteoporosis and fractures, and can ease joint and muscle aches, poor sleep, and low mood.

Body-identical HRT, with oestrogen delivered through the skin as a patch, gel, or spray, does not raise the risk of blood clots the way tablets can. Micronized progesterone protects the womb with a lower breast risk than older progestogens. Because any change in breast cancer risk is small and depends on the type and length of treatment, doctors should tailor and review prescriptions each year.

Testosterone can help some women with low libido, and low-dose vaginal oestrogen effectively treats painful sex and bladder symptoms. For women who cannot or prefer not to take hormones, NK3 receptor antagonists for hot flushes, certain antidepressants, gabapentin, and cognitive behavioral therapy (CBT) are real alternatives. A new NK3 receptor antagonist is also available for women unable to take HRT.

Patients should avoid long-term reliance on strong painkillers. Aromatase inhibitors commonly cause joint pain, and doctors usually avoid systemic HRT in women with a history of breast cancer or those planning risk-reducing surgery. In these cases, clinicians use non-hormonal treatment, exercise, and physiotherapy first. Removing the ovaries brings an immediate menopause, so planning before surgery makes a real difference.

Workplace initiatives encourage dialogue on menopause

The International Menopause Society (IMS) is shining a spotlight on chronic pain in midlife for World Menopause Day, which falls on Saturday, October 18, 2026. Cromwell Hospital notes that symptoms such as headaches, muscle aches, and joint pain can have a significant impact on women.

Deborah Garlick and Sally Leech of Henpicked: Menopause in the Workplace hosted a Lunch and Learn series to provide advice and tips on chronic pain. During the session, they were joined by Dr. Clare Spencer to explore the link between menopause and chronic pain. Clare Spencer to explore the link between menopause and chronic pain. Current research does not show a clear benefit for pain, and established evidence for testosterone treatment in menopause is linked to sexual desire rather than chronic pain.

Deise, a Menopause Champion, hosts awareness events and leads the United Kingdom Talking Menopause Slack channel. The Salesforce Women’s Network and Genforce hold joint events to encourage open dialogue about menopause.