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

SMR | Self-care with self myofascial release | Emma Simpson

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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What the Fascia?!

In terms of physical anatomy, we’re all likely very familiar with the skeletal system, circulatory system, immune system, digestive system as well as muscles, tendons, and ligaments.

But, what if I told you that an entire body system (that affects virtually every other system) – has been left off that list?!


The term fascia is from the Latin word meaning “band” or “bandage”, and it is the biological fabric or infrastructure that holds us together.

Essentially, it is our complex network of connective tissue and can be likened to a spider web of fibrous, glue-like proteins that binds all of the other systems together in their proper places.


“Each organ, each muscle, each artery, each vein, each nerve — there is not one single structure in the whole body that is not connected with fascia or not enveloped by fascia.”
– Andreas Haas, Manus Fascia Center, Austria


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Good Posture & Mental Health | Emma Simpson

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:

  • the digestive system
  • the immune system
  • the reproductive system
  • other major organs
  • even your posture and alignment
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Emma treating a client in a seated position during a structural integration session

How to Thaw Out Your Frozen Shoulder

What if one day you woke up and you weren’t able to lift your arm above your head? No matter how hard you tried, it just won’t move.

And to make matters worse, your shoulder is swollen and you’re in a lot of pain.

These are just a few of many symptoms of a condition commonly known as Frozen Shoulder. As the medical folk like to call it — Adhesive Capsulitis. (See, that’s why most people prefer to just say ‘frozen shoulder’!)

Frozen Shoulder is a condition in which the shoulder joint experiences an extremely limited range of motion. In some severe cases, an individual with the condition will have difficulty performing basic daily tasks like getting dressed or brushing their teeth.

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SI Joint Pain and a Wiggly Pelvis: Could This Be The Cause of Your Low Back Pain Too?

I recently had a new client in my clinic who was experiencing pain in her lower back. “Lisa” had just leaned down to pick up her toddler son, turned to grab something, and… BOOM. The searing pain stopped her in her tracks.

She immediately gave me a call so we could start treating the problem and she could get back to her busy life.

After a few evaluations, I was able to determine the cause of the problem: SI Joint Dysfunction caused by Pelvic Girdle Instability.

So, my pelvis is wiggly, and could be the cause of my SI joint pain?!

In simple terms, Lisa’s pelvis moves all over the place when she walks and therefore is unable to support her lower back and torso. And Lisa is not alone in this.

An unstable Pelvic Girdle (just think wiggly pelvis) is extremely common, especially among women who have given birth OR are currently pregnant — AND HERE’S WHY…

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Hips That Have Heart: The Powerful Connection Between Your Hips and Your Emotions

What if I told you that that tight feeling you have across your hips (better known as cranky hips!) had more to do with your feelings than your daily activities or an old injury?

Sure, our lifestyles these days are a contributing factor:

– We sit a lot.

– We drive in cars a lot.

– We spend time hunched over tech devices…A LOT.

And, yes these things can all cause tightness through the front of your body, including your hips.

But sometimes there’s more to the story… literally.

What if I told you that your hips are tight because of your emotions?

You might think I’m crazy, but read on! I promise you’ll learn that there’s actually a HUGE connection between our emotional wellbeing and those chronically tight spots in your (seemingly cranky) hips.

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