Menopause and Chronic Pain with Dr Eloise Elphinstone

Menopause and chronic pain often go hand in hand. As oestrogen fluctuates and then drops during perimenopause and menopause, it can affect how pain is felt in the body. Dr Eloise says that, “oestrogen has a really complex effect on pain modulation.”

Pain in menopause isn’t just about sore joints. It can show up as:

- joint stiffness and aches

- frozen shoulder

- tendon or ligament pain

- migraines

- pelvic pain

- vulval or vaginal pain

- bladder and urinary pain

- worsening of conditions like endometriosis, adenomyosis or fibromyalgia

Another key point is that pain can present in so many different ways, which is one reason it often gets missed. Hot flushes usually get the attention, but pain can be just as disruptive.

Why it happens

Oestrogen is found throughout the body, including in joints, ligaments and tendons. When hormone levels change, pain sensitivity can change too. That means old injuries may flare, recovery can feel slower, and new aches can appear.

Sleep often makes things worse too. If pain is disturbing sleep, or if night-time waking means more trips to the loo, symptoms can quickly snowball.

What can help

There isn’t one answer for everyone, but a few things may help:

- HRT, if hormones are contributing

- physiotherapy and gentle movement

- exercise, if and when it feels manageable

- CBT for coping with long-term pain

- acupuncture or reflexology

- diet tweaks, anti-inflammatory foods, vitamin D, omega 3, magnesium or glucosamine in some cases

Dr Eloise says, for some people, “once the underlying cause is found and treated, exercise becomes more manageable.”

If endometriosis is part of the picture, HRT may still be possible, but it often needs to be tailored carefully, usually with progesterone as well as oestrogen.

When to push for more help

Pain that continues after periods stop is still worth investigating. It doesn’t have to be “just menopause,” and conditions like inflammatory arthritis or rheumatoid arthritis may need ruling out.

If you feel dismissed, you’re not alone. Many women say they’ve been made to feel like they should just put up with it. “Chronic pain often leaves women feeling dismissed.”

Keeping a symptom diary and asking for a GP or menopause specialist with an interest in women’s health can really help.

The bottom line

Menopause can affect pain in lots of ways, and chronic pain doesn’t have to be something women simply live with. There are options, support and treatment paths worth exploring.

“Pain should not be a normal state of being.”