If you’re in your 40s or early 50s and beginning to notice more stiffness, muscle soreness, joint discomfort or general body aches, you’re not alone. These kinds of perimenopause aches and pains are commonly reported by women entering the hormonal transition towards menopause. Yet, they’re often under-recognised, misunderstood or dismissed as “just ageing.” In this post, we’ll explore why these symptoms occur, how to manage them, and when it’s important to seek medical guidance.

Why do perimenopause aches and pains occur?

During perimenopause, your ovaries gradually produce less oestrogen and progesterone, and hormonal fluctuations become more erratic. Because hormone receptors are present in muscle, bone, joints and connective tissue, these shifting levels can influence pain sensitivity, inflammation and tissue health.

Here are some of the mechanisms believed to underlie perimenopause-related aches and pains:

• Loss of the protective effects of oestrogen. Oestrogen is thought to help maintain joint cartilage, modulate inflammation, and support muscle repair. As oestrogen falls, joints may feel stiffer and muscles more prone to soreness.
• Reduced muscle mass or strength. With age and hormonal change, many women lose lean muscle, which puts more strain on joints and connective tissues.
• Increased pain sensitivity. Fluctuating hormones may alter how your brain perceives signals from muscles and nerves, making previously tolerable aches feel sharper.
• Other contributing factors. Poor posture (for instance from sitting at a desk), stress, disrupted sleep, weight gain, and reduced physical activity can all worsen aches and pains.

Symptoms often manifest as:

• Joint stiffness (especially in the morning)
• Muscle aches or soreness (in the back, hips, thighs, shoulders)
• Occasional shooting pains, cramps or spasms
• Generalised “all over” aches as if you had mild flu, though without fever

While many women will first notice these signs in perimenopause, they can continue into menopause and beyond.

What you can do (self-care strategies)

A compassionate, integrative approach often brings the most relief. Below are evidence-based strategies to ease perimenopause aches and pains.

1. Stay gently active and build strength

Moving your body, even in short bursts helps keep joints mobile, supports circulation, and maintains muscle. Focus on:

• Low-impact cardio: walking, swimming, cycling
• Resistance training: bodyweight exercises, light weights, resistance bands
• Flexibility work: yoga, Pilates, gentle stretching

Start small if needed, but consistency is key. Over-doing it on a “good day” may lead to flare-ups, so pacing (see below) matters.

At Owning Your Menopause, our experts can help you, whether you’re easing back into movement or want to build strength safely, our specialist trainers will guide you with realistic, compassionate support, all through the Owning Your Menopause app. Join today and start moving in ways that help your body feel strong, supple and supported.

2. Use the “3 Ps”: Pace, Plan, Prioritise

Experts often recommend the 3 Ps for managing pain and energy levels:

• Pace: break tasks into smaller chunks, schedule rest breaks
• Plan: organise your day/week so high-effort tasks are balanced with recovery
• Prioritise: decide what must get done, and what can wait or be delegated

3. Apply heat or cold

Heat can help loosen tight muscles and ease stiffness; cold can reduce inflammation in more acute flare-ups. Try alternating depending on what feels best.

4. Over-the-counter pain relief (short term)

Nonsteroidal anti-inflammatories (e.g. ibuprofen) or paracetamol may help for periods of discomfort but these should not be a long-term solution without guidance. Always check for contraindications or interactions, especially if you have other health issues.

5. Improve sleep, manage stress and support mood

Pain is often worse when sleep is poor, or stress is high. Consider:

• Sleep hygiene: regular bed/wake times, screen-free wind-down, cool/dark room
• Relaxation techniques: mindfulness, breathing exercises, gentle stretching
• Address psychological stressors or anxiety (e.g. via counselling or CBT)

If you find it hard to relax or unwind, you’re not alone — many women in perimenopause struggle with restlessness and racing thoughts. Inside the Owning Your Menopause app, you’ll find guided mindfulness and breathing sessions designed specifically for midlife women, plus expert-led yoga and stretching classes to help you release tension and restore calm.
Join OYM and access tools and expert advice to help you sleep better, feel grounded, and manage your stress more effectively.

6. Healthy diet and maintaining ideal weight

A nutrient-rich diet helps reduce inflammation, supports bone and muscle health, and avoids excess weight that strains joints. A Mediterranean-style diet, including omega-3 fats, lean proteins, fruits, vegetables and whole grains, is often recommended.

If you’re unsure where to start, Owning Your Menopause offers practical nutrition plans and guidance. You’ll get realistic, supportive advice, not restrictive rules and tailored meal ideas that fit your lifestyle and hormonal needs.
Join the OYM community to discover how small, sustainable changes in your diet can make a big difference to how you feel every day.

Role of hormone replacement therapy (HRT) and medical options

Because many perimenopause aches and pains are linked to low or fluctuating hormone levels, HRT may offer relief for some women. Studies suggest it can reduce joint stiffness and musculoskeletal pain.

However:

• The effect of HRT on muscle pain is less clear, and individual responses vary.
• Potential risks and benefits should be discussed thoroughly with a menopause-aware clinician.
• The formulation (e.g. transdermal vs oral), dose, and progestogen choice matter.

If HRT is not appropriate, other medical or adjunctive therapies may include:

• Physiotherapy or osteopathy to mobilise stiff joints
• Targeted pain management (e.g. local injections, analgesic prescriptions)
• Referral to rheumatology if there is suspicion of a separate joint disease
• Supplements may be considered (e.g. vitamin D, calcium) but only with medical supervision

When to seek medical help

You should consult your GP or a menopause specialist if:

• Pain is severe, worsening, or interfering with daily living
• You experience joint swelling, redness, warmth or signs of inflammation
• You notice sudden weakness, numbness, or changes in sensation
• You have unexplained weight loss, fever or systemic symptoms
• You suspect coexisting conditions (e.g. arthritis, fibromyalgia)

A clinician can assess, run investigations (blood tests, imaging), and help differentiate perimenopausal pain from other causes.

Final thoughts

Living with perimenopause aches and pains isn’t something you must just accept or “put up with.” Though it can feel frustrating, many strategies, especially when combined can bring relief, restore function and improve quality of life.

Here’s what I’d encourage you to remember:

• You’re not imagining it: many women experience these symptoms
• Pain is multifactorial: hormones, musculoskeletal health, lifestyle and mood all play a role
• Small, sustainable adjustments often outperform extreme fixes
• You deserve support and validation

In the Owning Your Menopause app we aim to support women in midlife through every aspect of perimenopause and menopause; including issues like these. Join us for just £16.99 a month and benefit from the support of a whole team of qualified wellbeing experts and start to really thrive in midlife.