Hormonal changes during menopause can have physical effects on the body. Some examples include weight gain, dry skin, or a loss of breast fullness. A link has also been found between menopause and body aches.(1) Pain sensations may begin during perimenopause, which typically occurs between the ages of 45 and 55. Body aches are not limited to one area of the body. Some women may experience headaches or jaw pain, while others may find their heels or feet most affected.
This article will explain why pain symptoms of menopause occur and explore the different types of body aches women may experience.
Understanding Menopause and Its Impact on the Body
Migraines, vulvovaginal discomfort, or urogenital irritation are a few types of body pain women may experience during menopause.(1) However, musculoskeletal pain is among the most bothersome menopausal symptoms reported by women. Musculoskeletal pain refers to pain affecting the muscles, joints, tendons, and ligaments.(2)
Women are more prone to musculoskeletal pain during different stages of menopause, with both perimenopausal and postmenopausal women at greater risk compared to premenopausal women. A scientific review found that over 70% of women were affected by body aches during perimenopause, with the pain in postmenopausal women found to be worse when compared to perimenopausal or premenopausal women.(2)
Body aches during menopause may be influenced by several factors, including body mass index (BMI) or certain health conditions. However, hormonal fluctuations are also believed to play a part. As ovarian function decreases during the menopause transition, estrogen and progesterone levels drop. Estrogen receptors are located within the central nervous system (CNS), which communicates pain sensations to the brain. Therefore, fluctuations in both estrogen and progesterone levels have been associated with body aches and stiff joints.(1)
Common Types of Body Aches During Menopause
The following are common types of body aches women report during menopause and potential causes for why these areas may be affected.
Genitourinary Pain
Decreases in hormone production cause physiological changes within the reproductive system. This can also increase the risk of certain health issues. As a result, menopausal women may experience the following types of pain:
Pelvic Pain: As estrogen levels fall, the tissue lining the vaginal walls becomes more thin and dry. This can lead to symptoms of genitourinary syndrome of menopause (GSM), such as pelvic pain or irritation of the lower urinary tract. Decreases in estrogen can also increase the risk of pelvic floor disorders (PFD) and recurrent urinary tract infections (rUTIs), both of which may cause discomfort.(3)
Uterine Pain: Pain in the uterus during menopause may be related to uterine fibroids. Uterine fibroids are non-cancerous growths that are influenced by sex steroid hormones. Although they tend to decrease during menopause, this is not always the case. Women with uterine fibroids may experience abnormal uterine bleeding (AUB) or a feeling of fullness in the pelvis.(4)
Alternatively, declines in estrogen levels can cause the muscles that support the vagina and uterus to weaken, known as the pelvic floor muscles. In the event of pelvic organ prolapse (POP), in which the uterus or other pelvic organs descend into the vagina, women may experience sensations of increased pressure.(3)
Ovarian Pain: Ovarian cysts may be the cause of ovarian pain during menopause. These small sacs often contain fluid and can develop as a result of hormone fluctuations. Postmenopausal women are prone to ovarian cysts, which may present as lower abdominal pain.(5)(6)
Back, Shoulder, and Joint Pain
Declining hormone levels during menopause can affect muscle and bone health. As estrogen levels drop, cartilage, lean muscle mass, and bone mineral density also decrease. Low estrogen can also increase inflammation and decrease joint lubrication, leading to bone and joint pain.(7)
Back Pain: Women between the ages of 45 and 60 are particularly prone to lower back pain, or lumbar spine pain. Women may be at an increased risk of menopause back pain as they enter the perimenopause stage.(8)
Shoulder Pain (Frozen Shoulder): Affecting more women than men, frozen shoulder (adhesive capsulitis) is a condition characterized by pain, stiffness, and reduced mobility in the shoulder. Although the connection between menopause and frozen shoulder is not entirely clear, it appears to be more common during perimenopause.(9)(10)
Knee Pain: Menopausal knee pain may be associated with osteoarthritis, which occurs when the erosion of cartilage causes joint pain. The risk of osteoarthritis increases during menopause, and research suggests a link between low estrogen and increased rates of knee osteoarthritis.(7)
Elbow Pain: Postmenopausal women are more prone to rheumatoid arthritis (RA) than premenopausal women. The condition causes pain and inflammation within the small, symmetrical joints of the body, such as the elbows. Early menopause may also be a risk factor for developing RA.(11)(12)
Hand Pain: Increased cases of hand and finger osteoarthritis have been observed in women over 50, with declining estrogen levels believed to play a role.(7)(13)
Foot and Heel Pain
Estrogen helps maintain bone strength. However, as hormone levels change during midlife, women become more vulnerable to osteoporosis, or weak bones. Decreases in sex steroid hormones can also affect the connective tissue around the bones and throughout the body. Together, this can cause physical discomfort in the heels and feet.(14)(15)
Foot Pain: In an observational study measuring women’s foot health, researchers found that menopausal women experienced increased foot pain and decreased quality of life compared to non-menopausal women.(16) Balance and proprioception can also decline as women age, beginning in perimenopause. A study showed that perimenopausal women with low foot arches demonstrated improvements in balance with the support of insoles.(17)
Heel Pain: Changes in hormone levels can impact the elasticity of the body’s muscular fascia, or connective tissue. For this reason, menopausal women may be more susceptible to plantar fasciitis, a primary symptom of which is heel pain. Research demonstrates that the plantar fascia — a band of tissue connecting the heel to the toes — increases elasticity during ovulation when estrogen levels rise. As the body loses estrogen during menopause, connective tissue may become stiffer.(15)(18)
Tooth and Jaw Pain
Women’s dental health can also be affected during and after menopause. In fact, up to 43% of postmenopausal women are estimated to be affected by oral pain, including burning sensations in the mouth or decreased pain tolerance.(19)
Decreases in estrogen cause structural changes to the mucosal lining of the mouth, leading to reduced salivation and an increased risk of injury or infection. Women may experience the following types of oral pain during menopause or postmenopause:(19)(20)
Tooth Pain: Hormone fluctuations can make women more susceptible to cavities, gum disease, inflammatory lesions, and tooth loss, all of which can cause tooth pain.
Jaw Pain: Postmenopausal women are at greater risk for temporomandibular disorders (TMDs). People with TMDs often experience jaw tenderness, clicking, popping, headaches, or facial pain.
Managing Body Aches During Menopause
Body aches related to estrogen deprivation can be managed throughout menopause. However, treatment options may vary depending on the type of pain a woman experiences. For musculoskeletal pain, supplementing the body with estrogen and progesterone through systemic hormone replacement therapy (HRT) may help reduce symptoms.(7)
Other natural approaches that may help relieve body aches associated with menopause include the following:(7)(21)
Practicing Strength Training Exercises: Resistance training strengthens the muscles and supports balance, which can help reduce physical pain and lower the risk of falling as women age.
Eating Nutritious Foods: Vitamin D, vitamin K2, and protein are all essential for maintaining strong muscles and bones. Eating a healthy diet that includes these nutrients may help relieve musculoskeletal pain.
Lowering Stress Levels: Stress can heighten physical pain sensations. Using relaxation strategies like mindfulness meditation can help reduce stress that may be exacerbating body aches.
Using a Hot and Cold Compress: Switching between a hot and cold compress on the affected area can help relieve inflammation and discomfort in the muscles and joints. Adding in some light stretching between applications may further reduce pain.
Taking Over-the-Counter Pain-Relief Medications: Certain nonsteroidal anti-inflammatory drugs (NSAIDs) can serve as a short-term treatment method for mild bone, joint, or muscle pain. They can also help relieve toothaches or headaches. Individuals should speak with their doctor before taking any medications or supplements.
Consulting a Doctor for Pain in Menopause
While body aches are not uncommon during menopause, women should consult with a doctor to rule out any potential underlying causes. This is particularly important if the pain is persistent or accompanied by other symptoms.
Body aches can sometimes be a sign of a physical injury or chronic health condition that requires treatment. Depending on the cause, prescription medication, surgical intervention, or physical therapy may be recommended for chronic pain management. Professional mental health treatment may alternatively be recommended to reduce stress, while professional dental or periodontal treatment may be required for tooth or jaw pain. In some cases, certain types of body pain, such as pelvic pain or oral pain, may be indicative of cancer. A doctor can assess a patient’s symptoms and prescribe treatment for any underlying causes of body aches.
Menopausal women shouldn’t have to endure pain during this phase of life. If body aches are affecting daily functioning, it’s crucial to talk to a doctor to determine if HRT may be a suitable treatment option.
