Aching All Over? How to Deal with Menopause Muscle Pain

Muscle pain is a common symptom throughout peri- and postmenopause. Understanding how menopause affects your musculoskeletal system can help keep symptoms from negatively impacting your life. 

Read on as we discuss all things muscle pain and menopause, including what it is, why it happens, and how to manage it. 

Is muscle pain a symptom of menopause? 

If you’re reading this and have muscle aches and pains all over, know that it’s not “in your head." The menopause transition causes a whole host of full-body symptoms. Muscle pain, or myalgia, is one of them. 

Musculoskeletal symptoms 

Menopause muscle aches fall into the category of musculoskeletal symptoms, which can impact the health of your bones, joints, and muscles in profound ways. These symptoms can include:

• Decreased bone density and increased risk of bone fracture

• Loss of lean muscle mass and muscle weakness

• Increased risk of tendon and ligament injury

• Generalized joint pain, or arthralgia  

• Increased risk of osteoarthritis

• Other kinds of musculoskeletal pain

Menopause muscle aches are more common than you think

Though it receives less attention than hot flashes, musculoskeletal pain is one of the most common symptoms people experience during peri- and post menopause. Just how common are menopause muscle tension, painful joints, and body aches? Prepare to be surprised.

Over 70% of perimenopausal people experience musculoskeletal symptoms, and 25% experience symptoms so severe that they are disabled by them. With numbers like that, these symptoms warrant far more attention than they currently receive.

What causes muscle aches and pains from menopause?

Like many menopause symptoms, hormonal changes may be part of the problem, even if we don’t fully understand the specifics. 

A 2023 research review suggested that muscle pain may be directly linked to lower estrogen levels. This tracks with the high rates of musculoskeletal conditions among postmenopausal women, but researchers need more data to clarify the connection.

Whether estrogen deficiency directly causes muscle aches and pains is still up for debate. However, one study found that: 

• Perimenopausal women have a higher risk of musculoskeletal pain than their premenopausal counterparts.

• Postmenopausal women have a higher risk of moderate to severe musculoskeletal pain than peri- or premenopausal people. 

• The risk of moderate to severe musculoskeletal pain increases linearly with age.

A few other factors may contribute to menopause muscle pain: smoking, body mass index (BMI), and depression. The relationship between depression and pain is like the chicken and the egg. It’s unclear which comes first, but depression can make muscle pain worse and vice versa. 

How hormones affect the musculoskeletal system 

Hormonal changes in menopause can affect your musculoskeletal system in several key ways, often leading to persistent muscle aches. Let’s take a closer look. 

Muscle loss

Many postmenopausal people experience a loss of muscle mass and strength, also called sarcopenia. While this is certainly related to aging, studies show estrogen may also play a role. 

Having less muscle mass can make it easier to get injured and more difficult to recover. Lower estrogen levels don’t help here, as estrogen deficiency makes it harder to rebuild and repair muscle after an injury. 

Bone health and density

Low levels of estrogen are also associated with significant bone loss. You may already be familiar with the term for this: osteoporosis. Osteoporosis increases your risk of fractures, which can lead to chronic pain and disability. 

Osteoporosis and its precursor, osteopenia, are serious health problems. Despite being preventable and treatable, they often go undiagnosed. An estimated 200 million postmenopausal women worldwide suffer from osteoporosis, so we had better pay attention.  

Inflammation

Another “hat” that estrogen wears? Inflammation regulation. Specifically, estrogen can reduce the inflammatory proteins circulating in your system. Without it, inflammation can increase and lead to muscle aches, joint pain, and joint stiffness. 

Regulating pain 

Lastly, both estrogen and testosterone reduce pain by blocking pain pathways in the spinal cord. When they are present in high concentrations, they’re pretty good at suppressing pain: this comes in handy during painful experiences such as childbirth.

The opposite is also true. Studies on pain perception show that women typically experience more pain during periods of low estrogen—such as during ovulation—than they do when estrogen levels are high. 

Menopause is a bit like being stuck in the low estrogen stage of your menstrual cycle. As such, menopause may make you more sensitive to pain than you used to be.  

How menopause muscle pain impacts your whole life

Anyone who’s ever had an injury, muscle cramps, or even a toothache knows: persistent pain is miserable. Menopause muscle pain can affect nearly every part of your body, impacting your overall quality of life. 

These symptoms can cost you time and money at medical appointments, and despite this, you might struggle to get treatment that helps. Menopausal women frequently visit the doctor because of muscle aches and pains. 

However, many musculoskeletal symptoms don’t show up on MRI scans and other tests. Many people with pain have no clear imaging results that explain their pain symptoms: there’s nothing obviously “wrong” with the tissues that hurt.

As a result, your provider may not be able to recommend a specific medical intervention that will quickly “fix” your muscle pain. This can be frustrating and leave you questioning your options. 

But remember: your pain is very real, and options to address it do exist. 

How to manage and reduce muscle pain

There’s no magic pill to relieve muscle pain completely. This means it’s even more important to consult with your healthcare provider about your symptoms. Talk with your doctor about how over-the-counter medications and prescriptions can help. 

Lifestyle measures like exercise, weight control, diet, and sleep are first-line interventions for certain musculoskeletal symptoms. Let’s look at some general guidelines, along with other potential options: 

• Resistance training: Combatting muscle loss with exercise can help keep you strong and healthy. Resistance training with heavier weights and lower repetitions is an effective way to build and keep muscle power.

• Vitamins and supplements: Before starting any supplement, talk with your doctor to see which option is best for you, if any. When taken correctly, creatine has shown positive effects on bone density and muscle power. 

• Diet: Eating enough protein can help keep you strong and active. The recommended daily allowance of protein is 0.36 grams of protein per pound of body weight. This amount is a good place to start, but consulting with a registered dietitian will help you know what diet is best for you. 

• Sleep and mental health: Fatigue, depression, anxiety, and stress can make muscle aches worse, which can make you more fatigued, anxious, and stressed. Do your best to keep this feedback loop from spiralling with proper sleep hygiene and caring for your mental health.    

• Over-the-counter (OTC) medications: Talk with your doctor to see if they recommend taking any OTC medications, such as Advil or Tylenol. While these aren’t long-term solutions, OTC options can help ease menopause muscle pain, providing short-term relief.     

• Menopausal hormonal therapy (MHT): Also called hormone replacement therapy, MHT is a possible, but complicated, option. In full transparency, we need more research on MHT as a treatment for muscle aches and joint pain. Data from studies with many participants show that, on average, MHT may reduce these symptoms. However, this may be a case where large numbers make a treatment seem more (or less) effective than it is. It's not clear if the effect is as strong for an individual perimenopausal person. All that said, MHD is FDA-approved for the prevention of osteoporosis in postmenopausal women. 

Stay ahead of your pain with tracking  

If you’re starting to notice a pattern of muscle pain and menopause symptoms, don’t ignore it. Tracking your symptoms over time can help you identify patterns and advocate for better care.

We covered that a ton of variables affect the muscular aches and pains you feel each day. Track your sleep, follow your stress and anxiety levels, and note how they impact your pain levels. This can help you pinpoint pain triggers and avoid them.

Tracking your muscle pain over time helps you notice if your symptoms are worsening or improving. This big picture view arms you with information when speaking with your healthcare provider. Details about your menopausal symptoms can help your provider more accurately assess the cause of your pain, getting you the help you deserve. 

Questions to ask your provider

Managing menopause symptoms requires honest communication with your doctor. Wondering how to bring up muscle pain at your next appointment? Consider asking these questions to start the conversation:

• I’ve been having a lot of muscle pain and soreness recently. Can you help me figure out what might be causing it? 

• My muscle aches and pains are seriously bothering me. Do you think they could be connected to perimenopause? 

• I’ve tracked my muscle tension and joint pain using my smartwatch over the last few months, and I’ve noticed some changes. Can I share those records with you to get your opinion?

DISCLAIMER

This article is intended for educational purposes only, using publicly available information. It is not medical advice, and it should not be used for the diagnosis, treatment, or prevention of disease. Please consult your licensed medical provider regarding health questions or concerns.