If you’re in your 40s or early 50s and have noticed new aches, increased stiffness, or a general sense that your body isn’t recovering the way it used to — perimenopause may be playing a bigger role than you’ve been led to believe.
Musculoskeletal symptoms are one of the most common and most underrecognised features of the perimenopausal transition. And they’re not just a normal part of ageing — they’re hormonally driven, well-documented, and very manageable with the right approach.
What the Research Shows
A meta-analysis of over 93,000 women confirmed that perimenopausal women have a significantly higher risk of muscle and joint pain compared to premenopausal women — a 35% increased risk, with back pain prevalence jumping from 42% to 57% during the transition. [1] An earlier systematic review found the overall prevalence of musculoskeletal pain in perimenopausal women to be as high as 71%. [2]
These aren’t small numbers — and yet for many women, these symptoms are dismissed or attributed simply to getting older.
Why It Happens
Oestrogen plays a far broader role in the body than most people realise. It helps regulate bone density, muscle mass, tendon and ligament integrity, and the body’s inflammatory response. As oestrogen levels begin to fluctuate and decline during perimenopause, all of these systems are affected.
What this can look like in practice:
• Joint stiffness, particularly in the morning or after periods of inactivity
• Muscle aches that feel disproportionate to activity levels
• Slower recovery after exercise or physical exertion
• New or worsening pain in the knees, shoulders, hands, neck, and lower back
• Increased sensitivity to pain that wasn’t there before
The fluctuating nature of hormone levels during perimenopause — rather than a steady decline — also means symptoms can feel unpredictable, varying significantly from week to week.
What Helps
Strength training is particularly valuable — it helps maintain muscle mass, supports joint stability, and counteracts some of the structural changes driven by declining oestrogen.
Regular bodywork can help manage the increased muscle tension, joint stiffness, and pain sensitivity that commonly emerge during this time — keeping the body mobile and comfortable enough to stay active.
Staying active generally matters more than ever. Movement helps regulate inflammation, supports bone density, and maintains the strength and mobility that protect joints under increased load.
The Takeaway
Perimenopause is a whole-body transition — and the musculoskeletal system is very much part of it. Understanding that these symptoms have a physiological cause, rather than being something to simply push through, is an important first step toward managing them effectively.
If your body has felt noticeably different over the past few years and you’re thinking of getting some remedial massage therapy to keep moving comfortably then get in touch or book a session here.
References
[2] PMC — Musculoskeletal Pain during the Menopausal Transition: A Systematic Review and Meta-Analysis
