Understanding the Link between Perimenopause & Menopause & Pain

Understanding the Link between Perimenopause, Menopause, and Musculoskeletal Pain

Reaching a certain age has heightened my awareness, and I truly understand it now! Through my clinical experience, I’ve consistently observed that women often encounter pain during a particular phase of their lives. The challenge lies in the variability of these experiences, making identification and diagnosis more complex. However, a common thread emerges—sudden occurrences of frozen shoulder, knee pain, and general joint discomfort are recurrent themes.

Perimenopause and menopause are natural stages in a woman’s life that signify the end of reproductive capabilities. While these transitions bring hormonal changes that impact various aspects of health, one significant issue is musculoskeletal pain. This blog post aims to shed light on the relationship between perimenopause, menopause, and musculoskeletal pain by exploring recent peer-reviewed papers.

1. Hormonal Changes and Musculoskeletal Pain:

During perimenopause and menopause, hormonal fluctuations occur as estrogen levels decline. These changes have been associated with an increased risk of musculoskeletal pain. A study by Roman-Blas et al. (2009) found that decreased estrogen levels were linked to an increased prevalence of joint pain and osteoarthritis in menopausal women.

2. Osteoporosis and Bone Health:

Estrogen plays a crucial role in maintaining bone health, and its decline during menopause can lead to osteoporosis—a condition characterised by loss of bone density and increased fracture risk (Better Health Channel, n.d.). According to a review article by Sozen et al. (2017), osteoporotic fractures often manifest as musculoskeletal pain, particularly in the spine, hips, wrists, and shoulders.

3. Fibromyalgia:

Fibromyalgia is a chronic disorder characterised by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive issues. Several studies have suggested a potential link between menopause and fibromyalgia symptoms (Dias et al., 2019).

4. Psychological Factors:

The hormonal imbalances during perimenopause and menopause can also contribute to psychological distress, such as anxiety and depression. These psychological factors have been associated with an increased perception of pain intensity and decreased tolerance for musculoskeletal pain. A study by Lu et al. (2020) reported that women experiencing menopausal symptoms were more likely to report severe musculoskeletal pain.


Perimenopause and menopause are significant life stages for women, accompanied by hormonal changes that can impact their musculoskeletal health. Understanding the link between these transitions and musculoskeletal pain is crucial for healthcare professionals in providing appropriate care and support. As evidenced by recent peer-reviewed papers, the decline in estrogen levels, osteoporosis, fibromyalgia, and psychological factors, all contribute to the prevalence of musculoskeletal pain during perimenopause and menopause.

Remember, it’s important to consult a healthcare professional if you’re experiencing persistent or severe musculoskeletal pain during these stages of life. They can provide appropriate guidance and treatment options tailored to your specific needs.


Dias, R. C. A., Kulak Junior, J., Ferreira da Costa, E. H., & Nisihara, R. M. (2019). Fibromyalgia, sleep disturbance and menopause: Is there a relationship? A literature review. International Journal of Rheumatic Diseases22(11), 1961–1971. https://doi.org/10.1111/1756-185x.13713

Lu, C., Liu, P., Zhou, Y., Meng, F., Qiao, T., Yang, X., Li, X., Xue, Q., Xu, H., Liu, Y., Han, Y., & Zhang, Y. (2020). Musculoskeletal Pain during the Menopausal Transition: A Systematic Review and Meta-Analysis. Neural Plasticity2020, 1–10. https://doi.org/10.1155/2020/8842110

Roman-Blas, J. A., Castañeda, S., Largo, R., & Herrero-Beaumont, G. (2009). Osteoarthritis associated with estrogen deficiency. Arthritis Research & Therapy11(5), 241. https://doi.org/10.1186/ar2791

Sozen, T., Ozisik, L., & Calik Basaran, N. (2017). An overview and management of osteoporosis. European Journal of Rheumatology4(1), 46–56. https://doi.org/10.5152/eurjrheum.2016.048

Breaking the Silence on Perimenopause and Menopause

Emma Simpson communicating with a client during a treatmentPerimenopause and menopause have gained significant attention recently, which is highly encouraging. The symptoms associated with these stages of life are extensive and diverse, often leaving many unaware that they are related to hormonal changes. As a healthcare provider, I regularly discuss these topics at my clinic. I find it intriguing that despite readily available information, there are still prevalent misconceptions. Additionally, some people express hesitancy in disclosing their use of Menopausal Hormone Therapy (MHT) due to concerns about judgment and the pressure to pursue more “natural” approaches.


This blog post will provide recommendations and credible sources for further information. It is important to note that we do not have to endure the distressing symptoms of perimenopause and menopause alone. There are numerous safe and easily accessible options available. However, consulting a knowledgeable healthcare professional who remains up-to-date with the latest research and guidelines is crucial.


Debunking the Old Study: 


Menopause Hormone Therapy (HRT) IS Safe and Effective


For decades, menopause has been a topic of interest and concern for many women. The transition into perimenopause and menopause brings about various hormonal changes that can lead to uncomfortable symptoms. In the past, hormone replacement therapy (HRT) was widely prescribed as a treatment option. However, due to an old study that raised concerns about its safety, HRT fell out of favour. Recent research has now debunked these claims, proving that Menopause Hormone Therapy is safe, effective, and even preventative (Cagnacci & Venier, 2019).


The Flawed Study:


In 2002, the Women’s Health Initiative (WHI), a large-scale study by the National Institutes of Health (NIH), released findings that shocked medical professionals and women alike. The study suggested that HRT use increased the risks of heart disease, stroke, blood clots, and breast cancer in postmenopausal women. This revelation led to widespread fear and confusion surrounding HRT usage (Cagnacci & Venier, 2019).


Reevaluating the Data:


Over time, researchers began reanalysing the data from the WHI study and discovered significant flaws in its methodology. It became evident that the results were not representative of all women experiencing perimenopause or menopause but were specific to a particular age group with preexisting health conditions (Cagnacci & Venier, 2019).


Alleviation of Symptoms:


MHT, whether in the form of systemic and local estrogen or systemic estrogen combined with progestin, can provide relief from bothersome symptoms like hot flashes, night sweats, vaginal dryness, and painful intercourse. These benefits persist for as long as MHT is continued (Mehta et al., 2021).


Enhanced Bone Health:


The use of systemic estrogen or estrogen plus progestin in MHT is associated with a decreased risk of hip and vertebral fractures. This positive effect on bone health is observed for the duration that MHT is maintained (Mehta et al., 2021).


Reduced Risk of Breast Cancer:


Contrary to common concerns, systemic estrogen is linked to a lower risk of breast cancer. This finding underscores the importance of understanding the nuanced impact of MHT on different aspects of women’s health (Mehta et al., 2021).


Lower Risk of Breast Cancer Mortality:


Additionally, there is evidence suggesting a lower risk of death from breast cancer associated with the use of systemic estrogen. This nuanced perspective sheds light on potential positive outcomes related to breast health in MHT (Mehta et al., 2021).




It is crucial to acknowledge that not every woman experiences symptoms during perimenopause and menopause, let alone severe ones. Therefore, blanket recommendations for MHT are unnecessary and potentially misleading. However, when discussing treatment options, including information about MHT clearly and straightforwardly can empower people to make informed decisions regarding their health.


By avoiding unnecessary fear tactics when presenting the range of options available, healthcare professionals can ensure that people receive unbiased information about MHT. This approach promotes transparency and empowers people to take control of their journey through menopause.


In conclusion, creating a culture of acceptance around menopause is vital. People should feel empowered to seek assistance without judgment or shame. While MHT may not be necessary for everyone, providing comprehensive and unbiased information will enable people to make informed choices regarding their health during this crucial phase of life.




Please form your opinion, remembering that knowledge is a source of empowerment. Seek advice from a healthcare provider, engage in conversations with your friends and family, and feel free to reach out to me for a chat anytime.


Dr Louise Newsom 

Dr Mary Claire Haver, author of The New Menopause 

Estrogen Matters 

Jean Hailes 

Australasian Menopause Society 

Davina McCall – this documentary was originally on SBS





Cagnacci, A., & Venier, M. (2019). The Controversial History of Hormone Replacement Therapy.  Medicina55(9). https://doi.org/10.3390/medicina55090602


Mehta, J., Kling, J. M., & Manson, J. E. (2021). Risks, Benefits, and Treatment Modalities of Menopausal Hormone Therapy: Current Concepts.  Frontiers in Endocrinology12(564781). https://doi.org/10.3389/fendo.2021.564781

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Self-myofascial Release (SMR): What it is and Why You Need it in Your Life

Wouldn’t it be great if you could get a massage every single day? Imagine how great it would feel to get rid of all your tight knots and sore muscles on a regular basis.

Practically heaven right?

For most of us, it’s fairly unlikely that we could fit this into our busy lives. However, there is a way to get that “ohh, I just got a massage feeling” every single day! And the best part is it doesn’t take a ton of time, it’s inexpensive, and it’s really quite simple.

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The Physical Effects of Low Mood and Depression

{This was originally published one year ago…}

Depression is a very prevalent mental disorder affecting 340 million people globally and is projected to become the leading cause of disability and the second leading contributor to the global burden of disease by the year 2020.

(And here we are amidst a global pandemic #Covid19… wow, just WOW!!!)

While we think of depression as more a mental health issue, it also affects your physical health and well-being – in more ways than you can probably imagine!

Having experienced depression myself in the past, I can attest to the fact that it’s a full-body experience. Interestingly, living with chronic anxiety and depression is what actually got me into remedial massage, yoga, and holistic & functional movement as a profession, as I personally experienced the healing powers of these “touch therapies” myself.  

Let’s learn more about some of the most common symptoms of depression, including how it can affect your entire body, especially if left untreated.

Please remember that if you’re experiencing symptoms of depression — you are not alone, there is nothing “wrong” with you, and there IS support for you!

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“Don’t be so touchy-feely”… heard from not too many people ever!

That’s because we, as humans, all crave touch – to touch more often and to be touched more often. I don’t mean this in a sexual manner either – it’s meant as being an essential element in your “love language”.

And we all need to be loved in different ways. Don’t we?


“To touch is to give life” ~ Michelangelo

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What Does Posture Have to Do With My Mental Health?

Here’s what Social Psychologist, Amy Cuddy had to say about this in her 2012 TedTalk “Your Body Language May Shape Who You Are”

“Body language affects how others see us, but it may also change how we see ourselves. Power posing — that is, standing in a posture of confidence, even when we don’t feel confident — can boost feelings of confidence, and might have an impact on our chances for success.”

That is so… POWERFUL!

Interestingly, Amy’s research on body language reveals that we can change other people’s perceptions – and perhaps even our own body chemistry, simply by changing body positions.

Doesn’t it make you feel more confident when you just stand a little taller, and not slumped forward with your eyes looking toward the ground?

I sure do! I feel like freakin’ Wonder Woman, in fact!

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The Stress Response: How to Curb the Destruction of Health!

This is Part 2 of a two-part series on STRESS and how it impacts your health, body, AND your mind…

Being chronically stressed (as in being in a state of nonstop, unrelenting stress!), as so many of us are these days – you might think that it only affects your nervous system.

After all, that’s where you perceive it to be in abundance – because it’s quite literally is unnerving!

But, the truth of the matter is that stress can also compromise most of your major body systems, including:

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  • the reproductive system
  • other major organs
  • even your posture and alignment
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Stress Impacts Health: It’s a full body (and mind) response!

This is Part 1 of a two-part series on STRESS and how it impacts your health, body & mind…

According to the Australian Psychological Association (APA),

“Seventy-two percent of Australians admit that stress affects their physical health, and 64% of us claim it’s not doing us any good in the mental health department, either.

The three main causes of stress in Australia are financial concerns, health issues, and family issues.”


Considering that being chronically stressed has become so mainstream these days, and it is such a regular (daily) occurrence, you might think that stress only affects your nervous system?

After all, that’s where you perceive it to be in abundance – because it is quite literally unnerving!

In actuality, stress, whether the source of it is physical, mental, real, or imagined – also compromises your digestive system, immune system, reproductive system, most major organs, and even your posture and alignment.

It really is a FULL BODY response!

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Low-tox Living: Top 3 Ways To Reduce Chemicals In Your Life

Hi, I’m Sarah! Your featured guest blogger!

As a busy mum living in Sydney, Australia, I remember when I began investigating alternative natural ways to support my two young girls.

It was the times when they had a cough, when they needed to relax for bedtime, or when they needed a confidence boost when they were worried.

You know – natural, holistic kind of Mum stuff!

This investigation led me to using essential oils to support my family naturally – and it just made so much sense to me.

I made my own household cleaning products and body products (like bath salts, body scrubs, face creams, room sprays) – all out of natural, chemical-free products. I wondered where these amazing oils had been my whole life!

This led me down the path of becoming a qualified Aromatherapist so that I could guide other health seekers, and promote safe, ethical essential oil usage.

I was thirsty to learn everything about essential oils; from the plant extracts to chemistry (including anatomy, physiology, pathology) to the effective and safe use of them. As you may know, some are not safe for use in all situations – like ingesting them!

Today, I thought I would share how reducing toxic chemicals from within your home and your personal environment can be beneficial to not only YOUR health & wellness – but that of your family.

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Is ‘Functional Movement’ Just Another Trendy Term? (or should you be doing it?!)

We’ve only got one body — so why not treat it well in everything we do, including moving it?

When we walk, run, play sports, lift weights, or just sit in front of the computer (umm, all day, every day), we should be tuning in to how we use our muscles — for optimal functioning in healthy, efficient and pain-free movement.

CONSIDER THIS: if any part of your body is experiencing pain, it’s pretty likely that some element of your body’s functional movement system (which I refer to as myofascial slings) has been compromised.

This may manifest as:

  • weakness/decreased strength
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  • poor functioning joint
  • decreased flexibility

And it doesn’t matter whether one or more of these show up in your ankles, hips, pelvis, knees, back, shoulders, neck or the classic “pain in the butt”…the whole body has been cleverly designed like a complex chain link system that works for you to move with biomechanical efficiency.

(At least that’s the idea!)

That’s why the term ‘functional movement’ – which I prefer to expand that to holistic and functional movement isn’t just a trendy exercise term du jour.

It’s a body movement concept that everyone needs in their everyday repertoire!

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