Menopause is a natural stage of life, but that doesn't mean every symptom should be endured in silence or considered inevitable. The body changes, yes. But when pain begins to interfere with daily activities, movement, sleep, exercise, intimacy, or confidence in your body, it deserves attention.
For a long time, menopause has been discussed almost exclusively in relation to the same symptoms: hot flushes, mood changes, sleep disturbances, menstrual irregularities, and hormonal changes. All of these can be part of the experience for many women, but they don't tell the whole story.
Pain can also be part of this stage of life. And it shouldn't be normalised.
Pain During Menopause: What Can Happen?
During the menopausal transition and after menopause, some women experience joint pain, muscle pain, lower back pain, stiffness, a feeling of heaviness in the body, increased fatigue, pelvic discomfort, or reduced confidence in movement.
Research has increasingly focused on this relationship. A systematic review and meta-analysis published in 2020 examined musculoskeletal pain during the menopausal transition and found an association between this stage of life and increased vulnerability to musculoskeletal symptoms. More recently, the International Menopause Society selected chronic pain at midlife as the theme for World Menopause Day 2026, reinforcing the importance of better recognising this issue.
This doesn't mean that all pain experienced during this stage is caused by menopause. Pain is multifactorial. It may involve hormonal changes, age, sleep, stress, body composition, physical activity, previous injuries, rheumatic conditions, muscular changes, emotional factors, and life circumstances.
However, it does mean that pain should not be dismissed with statements such as "it's just your age" or "it's normal at this stage of life."
The Body Changes. The Approach to Care Should Change Too.
Declining oestrogen levels can influence several tissues and systems in the body. Many women notice changes in muscle mass, strength, body composition, bone health, pelvic function, sleep quality, and recovery after physical exertion.
For this reason, care during menopause should take a holistic approach. It isn't enough to focus on an isolated area of pain. It's important to understand how a woman moves, how she sleeps, how she breathes, her strength levels, which activities she avoids, what limitations she experiences, and which goals she wants to achieve.
NICE recommends explaining to people experiencing menopause the importance of maintaining muscle mass and strength through physical activity. This recommendation is particularly relevant because strength isn't just about exercise or appearance. It is essential for living better, with greater safety, independence, and confidence.
Lower Back Pain, Pelvic Pain and the Pelvic Floor
During menopause, some women may experience pelvic floor-related changes, such as urinary leakage, a feeling of heaviness, pelvic discomfort, pain during sexual intercourse, or increased difficulty managing certain symptoms. These complaints are common, but they shouldn't be viewed as something women simply have to accept.
Women's Health Physiotherapy and Pelvic Floor Physiotherapy can help assess pelvic floor function, breathing, posture, pelvic mobility, strength, pain, and the relationship between these factors.
Lower back pain and body stiffness should also be assessed individually. In some cases, the body needs to regain mobility. In others, it needs strength. Often, it needs both, through a progressive and guided approach.
Exercise Is Not a Punishment. It's a Form of Care.
Many women reach this stage of life with a difficult relationship with exercise. Some have never exercised regularly. Others no longer feel comfortable in their bodies. Some experience pain, fear making their symptoms worse, or have had negative experiences with exercise in the past.
But exercise doesn't have to be intense, rigid, or the same for everyone. It can begin with simple, adapted, and safe activities. Its purpose may be to reduce fear, improve function, rebuild strength, support bone health, improve balance, reduce stiffness, increase exercise tolerance, and restore confidence.
At Physioclem, care during this stage of life may include Women's Health Physiotherapy, Pelvic Floor Physiotherapy, Musculoskeletal Physiotherapy, Osteopathy, and Clinical Exercise, always based on an individual assessment and goals tailored to each woman.
It's Not About Turning Back Time. It's About Living Better Now.
Menopause shouldn't be treated as the loss of the body a woman once had. Instead, it should be understood as a stage of life that calls for a different perspective, greater understanding, and a different approach to care.
When pain interferes with daily life, when the body feels less capable, when movement brings uncertainty, or when pelvic, lower back, or musculoskeletal symptoms begin to limit everyday activities, seeking a professional assessment can make a difference.
During menopause, pain shouldn't be normalised. It should be understood, assessed, and appropriately managed.
Because caring for your body during this stage of life isn't about fighting against time. It's about helping your body live better as time goes by.
References
Lu CB, Liu PF, Zhou YS, Meng FC, Qiao TY, Yang XJ, et al. Musculoskeletal pain during the menopausal transition: a systematic review and meta-analysis. Neural Plast. 2020;2020:8842110. doi:10.1155/2020/8842110.
International Menopause Society. World Menopause Day 2026: chronic pain at midlife [Internet].
National Institute for Health and Care Excellence. Menopause: identification and management. NICE guideline NG23 [Internet]. London: NICE; 2015, updated.
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