Menopause and aches/pains/injuries – is there a link?


Have you ever noticed that since going through menopause not only have you had increased hot flushes, night sweats and mood changes but also noticed an increase in pain or onset of different aches and pains? You are not imagining it! Did you know that there is a link between changes in oestrogen and increase in pain levels. 

Perimenopause typically begins during early to mid 40’s. Menopause consists of a rapid oestrogen decrease in the first 6 months, that continues for about 3 years.

Oestrogen has many important functions for our musculoskeletal system, including: 

  • Stimulating bone production and maintaining bone density 
  • Improving muscle mass 
  • Decreasing tendon and ligament stiffness 
  • Stimulating collagen synthesis in tendons 
  • Increasing tensile strength of tendons 
  • Reducing inflammation

Hence a drop in oestrogen during menopause correlates with 

  • Reduction in bone density 
  • Reduction in bone mass 
  • Reduction in tensile strength of tendons 
  • Decrease in collagen synthesis, fibre diameter, density and increase degradation in tendon tissue 
  • Elevation in proinflammatory markers + increase in inflammation 
  • Increased tissue sensitivity and an increase in pain. 

These changes can lead to reduced tissue tolerance and reduced tolerance to load. This means the activities you participated in prior to menopause may have not led to injury or pain, but after menopause these same activities may contributed to tissues being overloaded and hence to the onset of certain injuries. 

Other changes during menopause can have an impact on pain levels as well, including:

  • Sleep disturbances and sleep deprivation (leading to increased tissues sensitivity) 
  • Weight gain 
  • Mood disturbances 

Tips for easing and minimising pain during menopause:

  • Keep active. Focus on muscle strengthening, aerobic exercise and weight bearing exercise to help: 
    • Maintain muscle mass 
    • Improve tendon strength and function 
    • Maintain aerobic capacity 
    • Maintain bone density 
  • Strength training is extremely important – heavy, slow resistance training simulates tendon growth
  • Listen to your body – Take notice of your body and how well you recover after training sessions. You may need longer rest periods than before menopause 
  • Reduce stress levels (cortisol – our stress hormone is inflammatory – keeping this to a minimum is key) 
  • Maintain a healthy and balance diet 
  • Maintain a health weight 
  • Talk to your doctor about Hormone Replacement Therapy. Not a lot of research has been done on this yet, but it does seem that HRT may help improve your tendon health

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