Hot flushes have an excellent publicist. Joint pain tends to sneak in quietly. One morning, a shoulder objects to getting dressed. Then the knees start having opinions about stairs. Before long, getting out of bed involves a few more sound effects than it used to.

It is tempting to file all of this under getting older. Women are often encouraged to do exactly that. But chronic pain at midlife is the theme of World Menopause Day 2026, and these aches and pains deserve more than a shrug (1).

A 2026 review brought together 37 studies involving more than 93,000 women. Muscle or joint pain was reported by about four in ten women before menopause, compared with more than half of women in perimenopause and after menopause (2). The numbers do not mean menopause caused every ache, but they do show how many women are dealing with the same issue during this stage of life.

Researchers have described what they call the musculoskeletal syndrome of menopause: changes that may affect joints, muscle, bone, tendons and ligaments as oestrogen levels decline (3). The reality is seldom as tidy as a label. A stiff hand could have several explanations, while poor sleep, stress or an existing condition may make pain harder to manage (4).

Whatever its cause, pain can quietly make a woman’s world smaller. A sore shoulder makes carrying shopping awkward. A painful knee puts off the evening walk. Eventually, activities that once felt ordinary become things to plan around. Advice to “stay active” is all very well, but it helps to know why movement hurts and how to make it manageable.

There is a wider health story here too. Menopause can bring changes in muscle and metabolic health, while inflammation may also change during the hormonal rollercoaster (3, 5). In one long-running study, some groups of women had rising levels of inflammatory markers around their final menstrual period, while others followed different patterns (5). Inflammation is not an explanation for every painful joint, but these findings are another reason to look at the whole person.

Food, movement and sleep all belong in that picture too. Eating enough nourishing food, including adequate protein, helps support muscle. Finding ways to keep moving matters too, although a painful knee is unlikely to be persuaded by a lecture about exercise. Depending on the cause, a healthcare provider might discuss physiotherapy, an adapted strength programme, treatment for another condition or menopause treatment (4).

Women should be able to say what hurts, how long it has been happening and what they have stopped doing because of it, without feeling that they are making a fuss. Those details can help a healthcare provider investigate the pain and discuss what might help.

This World Menopause Day, the message is simple: common does not mean unimportant, and “normal for your age” is not a treatment plan.

References

1. International Menopause Society. World Menopause Day 2026: Chronic Pain at Midlife.
2. Kruse C, et al. Musculoskeletal manifestations of perimenopause: A systematic review and meta-analysis of 93,021 women. JBJS Open Access. 2026;11(1).00254.
3. Wright VJ, et al. The musculoskeletal syndrome of menopause. Climacteric. 2024;27(5):466–472.
4. Strand NH, et al. Pain during menopause. Maturitas. 2025;191:108135.
5. El Khoudary SR, et al. The relation between systemic inflammation and the menopause transition: The Study of Women’s Health Across the Nation. The Journal of Clinical Endocrinology & Metabolism. 2025;110(11)–e3576.