Menopause Joint Pain? Why It Deserves Real Answers

Chronic pain at midlife: why joint aches, migraines and pelvic pain belong in the menopause conversation

October 18 is World Menopause Day. The International Menopause Society (IMS) founded it in 2009 and sets a theme each year. The 2026 theme is Chronic Pain At Midlife (IMS). If you have menopause joint pain, migraines that have changed, or pelvic pain that hasn't gone away, this year's message is simple: it's real, it's common, and it belongs in your care plan. This post explains what the IMS says, and what it doesn't.

What the IMS 2026 theme is about

IMS says chronic pain "affects a significant proportion of women during and after the menopause transition, yet it remains underestimated in both research and care" (IMS). The campaign centers on a White Paper for clinicians, published in the journal Climacteric, and a plain-language factsheet for everyone else. Both are free:

• IMS 2026 White Paper, "Chronic pain at midlife" (PDF) (Mailis, Ang, Di Renna, et al., Climacteric, 2026)
• World Menopause Day 2026 factsheet (PDF)

IMS President Prof. Rossella Nappi put it this way: "Chronic pain at midlife should be recognized as a key component of menopause care, requiring gender-sensitive, individualized, and multidisciplinary approaches, alongside further research to address gaps in knowledge and care" (IMS).

How common is pain at midlife?

According to the White Paper, roughly half of midlife women have chronic pain, often with more than one pain condition at the same time. It also finds that women, compared to men, are approximately 50–70% more likely to experience chronic pain (IMS White Paper). The IMS factsheet adds that almost 3 in 4 women experience joint or muscle pain during perimenopause, citing the White Paper (IMS factsheet). "Chronic" here means pain that lasts, or keeps coming back, for more than three months (same source).

The pain conditions the White Paper highlights

Joint and muscle pain. The factsheet calls this the most common type of pain at midlife. It can affect the hands, knees, hips, neck or back, often with morning stiffness (IMS factsheet). The White Paper discusses a recently proposed "musculoskeletal syndrome of menopause." The term covers changes possibly related to falling estrogen, including joint pain, muscle pain and reduced muscle mass (IMS White Paper).

Migraine. For many women, migraine becomes more frequent or more severe in the lead-up to menopause, often linked to changing hormone levels. For some, it improves after menopause (IMS factsheet).

Pelvic pain. This can include period-type pain that continues after periods stop, pain during sex, or bladder discomfort. The factsheet says it is common and treatable (IMS factsheet).

Widespread pain and fatigue. Some women have pain in several places at once, along with tiredness, poor sleep and trouble concentrating. This pattern is sometimes called fibromyalgia (same source).

These conditions often overlap. The factsheet notes that having more than one "does not mean anything has been missed" (same source).

Why menopause joint pain and other midlife pain get underestimated

The White Paper describes chronic pain in midlife women as "often under-recognized, underdiagnosed and inadequately treated." It points to "prolonged diagnostic delays, systemic medical dismissals and a significant lack of sex-specific biological research," and notes that gender stereotypes and inequalities in healthcare may keep women's pain from being properly recognized (IMS White Paper). The overlap with other menopause symptoms adds to the problem. The White Paper notes that hot flushes, poor sleep, mood changes and fatigue can all shape how pain is experienced (same source).

What it doesn't mean: "it's hormonal" isn't the whole explanation, and it isn't a reason to stop looking. The factsheet is clear that this pain has physical causes, even when scans or blood tests look normal. It also says new pain, or pain that changes in a way that worries you, should be checked (IMS factsheet).

What individualized, multidisciplinary care looks like

The IMS says there is no single fix. Chronic pain at midlife usually needs more than one type of care (IMS factsheet). Based on the White Paper and factsheet, a plan might draw on:

• Movement and strength training. Systematic reviews support exercise therapy for osteoarthritis, chronic low back pain, fibromyalgia and general musculoskeletal pain. The White Paper notes the benefits are generally modest to moderate and depend on sticking with it (IMS White Paper).
• Physiotherapy, which the factsheet says can help with joint, muscle and pelvic pain (IMS factsheet). For pelvic pain, the White Paper highlights specialized pelvic floor physical therapy (IMS White Paper).
• Psychological approaches. The White Paper says CBT, mindfulness-based interventions, relaxation training and paced breathing show moderate evidence for improving insomnia, anxiety, coping and pain-related distress (IMS White Paper). That doesn't mean the pain isn't real.
• Sleep and stress. Poor sleep can make pain worse, and pain can make sleep harder (IMS factsheet).
• Medication, when appropriate, alongside these approaches (same source).
• Team-based care. The White Paper describes interdisciplinary pelvic pain programs that bring together gynecology, pain medicine, physiotherapy, psychology, psychiatry, nursing, occupational therapy and social work. Those programs have improved function, quality of life and pain interference (IMS White Paper).

Where hormone therapy fits, and where it doesn't. The factsheet says hormone therapy can ease many menopause symptoms, and for some women it also improves how pain feels overall. However, "the evidence does not show that it reliably treats joint or muscle pain on its own" (IMS factsheet). The White Paper cites a meta-analysis of 57 studies that found no significant overall effect of hormone therapy on generalized musculoskeletal pain (IMS White Paper). If you have a history of migraine or endometriosis, the decision needs extra individual attention (IMS factsheet). Hormone therapy also has risks, and the American College of Obstetricians and Gynecologists (ACOG) recommends deciding on it together with a clinician, weighing your own risks of cardiovascular disease, breast cancer and blood clots (ACOG). For more on ACOG's new guidance, see ACOG issues its most comprehensive menopause guidance yet. If hormones aren't right for you, our guide to non-hormonal alternatives covers other options for menopause symptoms.

Be wary of "miracle" fixes. The IMS factsheet warns that many supplements and detox products for menopause pain are not well supported by evidence and can be expensive for little or no benefit (IMS factsheet). ACOG likewise says evidence doesn't support phytoestrogens or herbal supplements for menopausal symptoms (ACOG). See our menopause supplements guide for details.

If you start any medication and notice side effects, you can report them to FDA through MedWatch.

Questions to bring to a clinician

Some of these come from the IMS factsheet's own list (IMS factsheet):

1. Could my pain be connected to menopause?
2. Is it possible I have more than one condition causing my pain?
3. What non-hormonal options are there, alongside or instead of hormone therapy?
4. Could I be referred to a physiotherapist (including pelvic floor), or a pain specialist?
5. What can I do myself, and what treatments might help?
6. My migraines have changed. How does that affect which treatments are safe for me?
7. How will we track whether the plan is working?

The factsheet also suggests going back to your clinician if your pain is new or has changed in a worrying way, if it is stopping you from doing things that matter, or if you feel it isn't being taken seriously (same source).

The bottom line

World Menopause Day 2026 is a reminder that joint aches, migraine and pelvic pain aren't just "part of getting older" to put up with. Pain may not go away completely, but the IMS says many women find a mix of treatments helps over time and that pain can get easier to manage. Being heard and taken seriously is often the first step (IMS factsheet).

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Medical disclaimer: This article is for educational purposes only and is not a substitute for individual medical advice, diagnosis or treatment. Kindr Health is a telehealth platform connecting patients with licensed providers. Not an emergency service. If you are experiencing a medical emergency, call 911. Prescription medications require clinical evaluation. Individual results vary.

Medically reviewed by Kindr Health Clinical Team
Kindr Health Inc. — Editorial & Clinical Team, led by Kevin Wolfe, CMO
NPI 1609792902 · Last reviewed: October 18, 2026