Menopause and Chronic Pain: Why Does Everything Ache?

Chronic pain is pain that affects one or more parts of your body, lasts for more than 3 months, or keeps coming back. It’s 70% more common in women than men.

During perimenopause (the years leading up to menopause, which is marked by your last ever period) and postmenopause (the years after your last period), chronic pain can become more challenging. It can have a serious impact on your wellbeing and cause physical and emotional distress.

Yet, despite how many women are affected by it, chronic pain is still underdiagnosed, undertreated, and often dismissed. Part of the problem is that there are still so many harmful menopause myths that need to be unlearned and debunked. Then there’s the problem that this kind of pain often can’t be identified with routine blood tests or scans. 

But this doesn’t mean the pain isn’t real. That’s why at Welbeck, we offer a cutting-edge Menopause Diagnostics package to confirm if you’re going through perimenopause and help to identify any menopause-related conditions to be aware of. 

It’s also why the International Menopause Society has published a first-of-its-kind white paper deep-diving into women’s chronic pain during midlife, what causes it, and how it should be treated. 

Here’s what their 2026 review has highlighted.

What’s the link between chronic pain and menopause? 

Chronic pain becomes more likely in the run-up to menopause as your hormone levels shift. Specifically, your oestrogen levels dip. This has knock-on effects on your joints, muscles, nerves, and how your brain processes pain signals. 

The fall in oestrogen is also what’s usually behind the other uncomfortable and sometimes distressing symptoms associated with perimenopause, such as sleep disturbances, mood changes, hot flashes, and night sweats. 

These physical and psychological changes can not only bring new pain, but also compound existing pain.

However, everyone’s experience is unique. It’s not guaranteed that chronic pain will hit or get worse as you transition to menopause. While it’s certainly true for a lot of women, others find that their existing pain actually improves.

‘Changes in oestrogen can affect muscle and joint health, sleep, mood and the way the nervous system processes pain. However, we should never assume that every new symptom is simply due to menopause. Pain that is persistent, severe or changing deserves a proper clinical assessment so that other important causes are not overlooked.’

— Dr Iranthi Meththananda, Consultant Gynaecologist at Welbeck

How can chronic pain manifest around menopause? 

For those who do experience chronic pain in perimenopause and after menopause, it often shows up in more than one place, with symptoms existing alongside each other.

These are some of the most common types of pain during that time:

Joint and muscle pain

Around 3 in 4 women experience aches in the muscles and joints in the hands, knees, hips, neck, and back during perimenopause. This makes joint and muscle pain the most common type of pain for women in midlife. 

Pelvic pain

From pain during sex and bladder issues that cause discomfort, to period-type pain that can hang around even after menopause when periods have stopped, these all fall under what’s known as pelvic pain. It can affect up to 3 in 10 women.

‘Pelvic pain in midlife is not a single diagnosis. Vaginal and vulval changes, pelvic floor dysfunction, adenomyosis, endometriosis, and bladder or bowel conditions can overlap, but each may require a different treatment approach. Normal blood tests or scans do not make the pain any less real; they may simply mean that we need to look more carefully at the complete clinical picture.’

— Dr Iranthi Meththananda, Consultant Gynaecologist at Welbeck

Migraine

It’s common to have more severe and frequent migraine attacks in the lead-up to menopause. For around 3 in 10 of those women, these migraines begin with visual, sensory, or speech disturbances known as aura.

For some, the migraines improve after menopause. However, migraine is still one of the leading causes of disability in women aged between 15 and 49.

Fibromyalgia

Fibromyalgia is a condition that’s roughly 3 times more common in women than in men. It describes a pattern of pain that’s experienced in a number of places at once (widespread pain), and that typically comes with fatigue, poor sleep, and concentration issues. 

What can help?

Chronic pain in the lead-up to, and after, menopause is not something you just have to learn to live with. While there isn’t a silver bullet or a one-size-fits-all fix, there’s a range of medical and non-medical approaches that can ease your pain and make it feel more manageable. 

What a doctor or specialist can do

If you have new pain, if your pain has changed and concerns you, or if it’s getting in the way of your ability to enjoy any aspect of your life such as work, exercise, sleep, or your relationships, seeing a doctor or specialist can help. Depending on your symptoms and medical history, they may recommend:

• hormone therapy (HRT): This can involve a combination of oestrogen, progesterone, and testosterone. It can ease some pain alongside other menopause-related symptoms; however, on its own, it’s not the most effective way to treat joint or muscle pain

• non-hormonal medication: Several medications that don’t contain hormones can be prescribed instead of or alongside HRT to help ease pain and other symptoms. These include antidepressants for regulating mood and hot flushes, and medications for pain and migraines

• physiotherapy: A physiotherapist can give you a personalised plan to help with joint, muscle, and pelvic pain

• psychotherapy: Talking therapies, such as cognitive behavioural therapy (CBT), can help you learn how to live well with your pain. It’s not about denying that your pain is real — instead, it can help you find new ways to cope

‘HRT may improve pain for some women, particularly when it also improves hot flushes, sleep, and mood, but it should not be presented as a universal or stand-alone pain treatment. The most effective approach is usually personalised and multidisciplinary, combining appropriate hormonal or non-hormonal treatment with physiotherapy, progressive strength exercise, sleep support, and treatment directed at the underlying pain condition.’

— Dr Iranthi Meththananda, Consultant Gynaecologist at Welbeck

What you can do

If you’d like to tackle your pain yourself, or want to support any medical treatment you’re receiving with lifestyle tweaks and home remedies, there are a few things that may help.

• movement: Strength-based exercise, even when it feels like the absolute last thing you want to do, can be one of the most helpful ways to ease joint and muscle pain over time

• sleep and stress management: Pain can feel worse when you’re sleep-deprived or stressed. That’s because stress, fatigue, and pain are all interconnected. So, if you can find a manageable and realistic way to improve your sleep or manage your stress, your pain could ease as a result

• take your time: It may require a trial-and-error approach to find the exact mix of treatments and lifestyle changes that work for you. It may be a frustrating and upsetting process, but it may help to know that it’s expected for any change to be gradual. Most women do find their pain eases when they unlock their unique combination of treatments and lifestyle tweaks

And finally, remember that you’re the expert on your own body and only you know what’s normal for you. If something doesn’t feel right or your quality of life is taking a hit, ask for support. Whether you reach out to a GP, menopause specialist, physiotherapist, or psychotherapist, your pain should be acknowledged and taken seriously.

Menopause care at Welbeck

Welbeck’s Women’s Health centre is home to some of the UK’s leading gynaecologists with specialist interest and expertise in menopause diagnosis, treatment, and management. 

Get in touch today to make an appointment with one of our consultants.