Today, 18 October, is World Menopause Day—a global opportunity to improve understanding of menopause and the care women receive throughout midlife.
The theme chosen by the International Menopause Society for 2026 is Chronic Pain at Midlife. It recognises something many women already know from experience: pain can appear, change or become more difficult to manage during the menopause transition.
Joint stiffness, aching muscles, migraine, pelvic pain and widespread pain can affect sleep, work, exercise, relationships and everyday confidence. Yet women’s pain is still too frequently normalised, fragmented into separate complaints or dismissed as simply part of getting older.
This World Menopause Day, the message is clear: persistent pain deserves to be heard, investigated and treated.
The key idea
Menopause can influence how pain develops and is experienced, but not every new pain is caused by menopause.
The right response is neither to dismiss the hormonal connection nor to blame every symptom on hormones. It is to look at the whole person and consider menopause alongside other possible causes.
What is chronic pain?
Chronic pain is generally defined as pain that persists or repeatedly returns for longer than three months.
It may remain in one area or affect several parts of the body. Some women can identify a specific injury or medical condition. For others, the pain is widespread or continues after the original injury has healed.
The International Menopause Society’s 2026 White Paper explains that chronic pain is shaped by interacting biological, psychological and social factors. Hormonal changes, ageing, the nervous and immune systems, sleep, mood, previous experiences and everyday circumstances can all affect how pain is processed.
That does not mean pain is imagined or “all in your head”. Pain is a real experience, even when a scan or blood test cannot fully explain its severity.
How common is pain during menopause?
The International Menopause Society estimates that approximately half of midlife women experience chronic pain, sometimes with more than one overlapping pain condition.
A 2026 systematic review involving more than 93,000 women found that muscle or joint pain was reported by:
- 40% of premenopausal women
- 57% of perimenopausal women
- 59% of postmenopausal women
The studies included in the review varied considerably, so these figures cannot prove that menopause directly caused the pain. They do, however, show that muscle and joint symptoms are common and deserve greater clinical attention. Read the systematic review.
The HSE also recognises joint aches and pains among the physical symptoms that can occur during perimenopause and menopause.
What kinds of pain may occur at midlife?
Joint and muscle pain
Women may notice aching, stiffness or reduced mobility in the knees, hips, shoulders, hands or back. Morning stiffness and feeling unusually sore after ordinary activity are common descriptions.
Age-related changes, previous injuries, osteoarthritis, reduced muscle strength and the menopause transition can overlap. It is rarely as simple as identifying one cause.
Migraine and headache
Migraine can change during perimenopause as hormones fluctuate. Some women notice more frequent or unpredictable attacks, while others develop new headaches.
A new, sudden or unusually severe headache should not automatically be attributed to menopause and requires medical assessment.
Pelvic, vulval and bladder pain
Persistent pelvic pain may be associated with conditions such as endometriosis, pelvic-floor dysfunction or bladder pain syndrome.
Falling oestrogen can also affect the tissues of the vagina, vulva and urinary tract. This may cause dryness, burning, painful sex or urinary discomfort—symptoms sometimes grouped under genitourinary syndrome of menopause.
These concerns are common and treatable. They should not be accepted as an unavoidable consequence of ageing.
Widespread pain and fibromyalgia
Some women experience pain across multiple areas of the body, often alongside fatigue, unrefreshing sleep, headaches or heightened sensitivity to touch.
Fibromyalgia and other chronic overlapping pain conditions can become especially challenging when sleep disruption, mood changes and menopause symptoms occur at the same time.
Why might pain change during menopause?
The relationship between menopause and pain is complex.
Oestrogen interacts with bones, muscles, joints, nerves and immune processes. Fluctuating and declining hormone levels may influence inflammation, tissue health and the way pain signals are processed.
At the same time, several common menopause symptoms can amplify one another:
- Poor sleep can make pain harder to tolerate.
- Pain can repeatedly interrupt sleep.
- Fatigue can reduce activity and physical conditioning.
- Anxiety and low mood can increase the burden of persistent pain.
- Hot flushes and night sweats can interfere with recovery.
- Loss of muscle strength may make ordinary movement more demanding.
This helps explain why treating only one part of the problem is not always enough.
Pain should not automatically be blamed on menopause
Menopause may contribute to pain, but it should not become a catch-all diagnosis.
Joint and muscle symptoms can also be caused by injury, osteoarthritis, inflammatory conditions, nerve compression, thyroid disorders, vitamin or mineral deficiencies and other health problems. Pelvic pain, migraine and abdominal discomfort each have their own possible causes.
Speak with a doctor if pain:
- Persists or repeatedly returns
- Is becoming more severe
- Causes swelling, redness or loss of movement
- Wakes you regularly at night
- Is associated with numbness or weakness
- Prevents you from working, exercising or managing daily life
- Is accompanied by fever, unexplained weight loss or marked fatigue
- Begins suddenly or feels significantly different from pain you have experienced before
Chest pain, sudden severe headache, breathing difficulty or new neurological symptoms require urgent medical attention.
Any bleeding after menopause should also be assessed, even if it happens only once.
What can help?
Begin with a proper assessment
A useful consultation looks beyond a single painful joint. Your clinician may ask:
- When did the pain begin?
- Is it constant or intermittent?
- Did it start around other menopause changes?
- Are there signs of inflammation or injury?
- How are you sleeping?
- Are fatigue, migraine, pelvic symptoms or low mood also present?
- How is pain affecting movement and everyday life?
- Are tests, imaging or referral appropriate?
Keeping a short pain and symptom diary can make these patterns easier to recognise.
Keep moving—but build gradually
Avoiding all activity can lead to further loss of strength and confidence. Regular movement and appropriately progressed resistance exercise can support muscles, bones, balance and long-term function.
The right starting point is individual. Walking, swimming, mobility work and supervised strength training may all be useful, depending on the cause of the pain.
Exercise should be adapted when symptoms flare. The goal is not to push through severe pain but to find a sustainable level of movement and increase it gradually.
Adequate nutrition supports this process. Our guide to protein during menopause explains how protein and resistance exercise work together to support muscle health.
Pay attention to sleep and recovery
Pain and poor sleep reinforce one another. Addressing night sweats, insomnia, restless legs or possible sleep apnoea may form an important part of pain management.
Pacing can help too. Alternating demanding tasks with recovery is often more sustainable than doing too much on a good day and being unable to function the next.
Consider the wider menopause picture
If pain has appeared alongside hot flushes, night sweats, irregular periods, sleep disruption or other recognised menopause symptoms, it is reasonable to discuss whether the menopause transition is contributing.
Hormone replacement therapy can be effective for many menopause symptoms, but it is not a universal treatment for chronic pain. A recent systematic review found that the evidence does not currently demonstrate a significant overall effect of HRT on musculoskeletal pain. Read the review.
Some women may notice an indirect improvement when HRT reduces sleep disruption, hot flushes or other symptoms. The decision to use HRT should still be based on your full symptom pattern, medical history, preferences and individual balance of benefits and risks.
Our HRT guide for women in Ireland explains the available options in more detail.
Use a multidisciplinary approach when needed
Chronic pain rarely responds to a single intervention. Depending on the cause, care may involve a GP, menopause clinician, physiotherapist, pelvic-health specialist, neurologist, rheumatologist, psychologist or pain-management service.
Treatment may include physical rehabilitation, menopause care, appropriate pain medication, support for sleep and mood, or condition-specific treatment.
The important point is that care should fit the woman—not force every woman into the same plan.
You do not have to prove that your pain is real
One of the most important messages of World Menopause Day 2026 is that women’s pain must be taken seriously.
A symptom does not become insignificant because it is difficult to measure. It does not become normal because it is common. And a woman should not have to wait until pain has taken over her work, sleep and relationships before asking for help.
A practical next step
Before an appointment, write down:
- Where you feel pain
- When it began
- What makes it better or worse
- Whether it follows a cycle or pattern
- Any swelling, stiffness, weakness or numbness
- Changes in sleep, mood, periods or menopause symptoms
- How it affects everyday activities
This gives your clinician a clearer picture and helps ensure the consultation focuses on what matters most to you.
This World Menopause Day, let’s listen
Chronic pain at midlife is common, but suffering in silence should not be.
At Munster Menopause Clinic, we take time to understand the complete picture—your symptoms, medical history, daily life and treatment preferences. We consider menopause as part of your health, without assuming it explains everything.
No GP referral is required for an in-person consultation at our clinic in Tallow, Co. Waterford.
This article provides general information and is not a substitute for individual medical advice. Sources checked on 18 October 2026.