Why Am I Suddenly So Achy? Could It Be Perimenopause?

By Dr. Tara Campbell, ND
Higher Health Naturopathic Centre & IV Lounge, Toronto

You stand up after an hour at your desk and need a moment before you can walk comfortably. Your hips feel stiff. Your shoulders ache. A familiar workout leaves you sore for longer than it used to.

There hasn’t been an obvious injury, so you start running through the possibilities. Did I overdo it? Am I losing strength? Is this just how my body feels now?

Perimenopause could be part of the explanation. Joint and muscle aches can occur alongside changes in your periods, sleep and other menopause symptoms. [1]

But the timing alone doesn’t tell us what is causing your pain.

What matters is understanding what has changed for you, what deserves a closer look, and what might help you move through your day more comfortably.

Why joint pain can show up in perimenopause

During the transition towards menopause, hormone levels change. Estrogen influences joint and muscle tissues and the way your nervous system processes pain. At the same time, changes related to aging, existing injuries and the demands you place on your body can overlap. [2]

Aches deserve a place in the conversation about menopause. In fact, the International Menopause Society has made chronic pain at midlife the focus of World Menopause Day 2026. [3]

What I would want to understand about your aches

Before suggesting a treatment, I would want to hear what the discomfort is actually like.

Does it affect one shoulder or several joints? Did it start after you changed your workout? Are you stiff for a few minutes when you get up, or does it take much longer to loosen up? Is there swelling?

Those details help guide an assessment. Joint pain can have several explanations, including injury, overuse and different forms of arthritis. Persistent swelling and prolonged morning stiffness deserve attention. [4]

I would also ask what the pain is changing in your life. Are you avoiding the stairs? Waking when you roll over? Giving up the walks that used to clear your head?

That gives us something concrete to work towards.

Would a hormone test give you the answer?

If you’re 45 or older and otherwise healthy, typical perimenopause symptoms, such as newly started hot flashes alongside changes in your menstrual cycle, can usually be assessed without routine hormone testing. Your symptoms and history are central to that assessment. [5]

That is different from investigating joint pain. Depending on your history and examination, targeted tests or another assessment may still be useful.

A test should help answer a specific question about your care.

When to get medical help sooner

Arrange an assessment if pain is worsening, keeps returning, disrupts your sleep or daily activities, or if morning stiffness regularly lasts more than 30 minutes.

A hot, swollen joint, or joint pain with fever or feeling unwell, needs urgent medical assessment. Severe pain after an injury or being unable to bear weight needs emergency assessment. [4]

A useful place to start

You don’t have to overhaul your routine to begin paying attention to what helps. Start with your current ability and the activities that matter to you.

Keep movement manageable

If a particular activity aggravates your symptoms, adjust it. A shorter walk or a gentler version of a familiar activity may be a more comfortable starting point. Avoid completely stopping movement of the affected joint, and seek guidance if pain is limiting what you can do. [4]

Strength work can help maintain the muscles you rely on for everyday tasks. It can involve your body weight, resistance bands or weights, with the difficulty built up gradually over time. [6]

If you’re unsure where to begin, or an exercise hurts, a physiotherapist can help you work out an appropriate starting point. [3]

Bring sleep into the conversation

If you’re waking through the night and feeling more achy the next day, mention both.

Research shows that sleep loss can increase pain sensitivity. It doesn’t establish the cause of your particular pain, but it gives us a reason to take disrupted sleep seriously. [7]

If you can, notice whether you’re waking with discomfort, night sweats or no clear reason. You don’t need to work out the cause yourself; describing what happens is enough to start the conversation.

Would hormone therapy help?

It’s a reasonable question, especially if aches have arrived alongside other menopause symptoms.

Menopausal hormone therapy, also called HRT, can help with several menopause symptoms. Some women may find that their overall experience of pain improves too. However, the current IMS guidance says it does not reliably treat joint or muscle pain on its own. [3]

Whether it is appropriate for you depends on your symptoms and health history. A conversation about options should include the expected benefits, possible risks and other approaches that may help.

Save these notes for your next appointment

When you finally sit down with someone, it can be surprisingly difficult to remember when everything started or explain how your symptoms vary.

A few notes can help. You can keep them in your phone:

• Where it hurts: One joint, several joints, or mainly muscles?
• When it began: Gradually, suddenly, or after a change in activity?
• When you notice it most: Morning, after sitting, during activity or overnight? Roughly how long does morning stiffness last?
• What else has changed: Your periods, sleep, medications, exercise or other symptoms.
• What you’ve tried: What seemed to help, and what made it worse?
• What you want help doing: Name the everyday activity that matters most to you.

Bring these notes to your appointment, whether that’s with us, your family doctor or another clinician. You can start with whatever you remember; you don’t need to finish a diary before asking for help.

How I would approach this with you at Higher Health

At Higher Health, I would look at your aches alongside your health history, sleep, activity and nutrition. We would discuss what needs a closer look, whether an examination or targeted testing would help, and whether another clinician should be involved.

Then we would work out the next steps. That might mean support with movement, sleep or nutrition, a discussion of menopause care, or a referral. I want you to understand why each recommendation is being made and how we will check whether it is helping.

Would you like to talk about the next step?

If you’ve recognized your own experience here and would like to know how we could help, you’re welcome to book a free 15-minute introductory call with one of our naturopathic doctors.

You can tell us what has been bothering you, ask about our approach, and find out what an appointment at Higher Health would involve.

Book your free 15-minute introductory call

For Ontario residents. There is no obligation to book an appointment afterward. Assessment and treatment planning take place during a booked visit.

Dr. Tara Campbell, ND, is the founder of Higher Health Naturopathic Centre & IV Lounge at Yonge and Lawrence in North Toronto.

This article provides general health information and is not a substitute for an individual medical assessment, diagnosis or treatment. Speak with a qualified healthcare professional about new, persistent or worsening symptoms.

References

1. NHS. Symptoms of menopause and perimenopause. Reviewed May 19, 2026.
2. Mailis A, Ang SB, Di Renna T, et al. Chronic pain at midlife. Climacteric. International Menopause Society White Paper, 2026. doi:10.1080/13697137.2026.2722558.
3. International Menopause Society. Chronic Pain at Midlife: A World Menopause Day Factsheet. Prepared September 2026.
4. NHS. Joint pain. Reviewed February 26, 2026.
5. National Institute for Health and Care Excellence. Menopause: identification and management. NICE guideline NG23. Updated April 15, 2026. Section 1.3: Identifying perimenopause and menopause.
6. NHS. How to improve your strength and flexibility. Reviewed July 21, 2026.
7. Krause AJ, Prather AA, Wager TD, Lindquist MA, Walker MP. The Pain of Sleep Loss: A Brain Characterization in Humans. Journal of Neuroscience. 2019;39(12):2291–2300. doi:10.1523/JNEUROSCI.2408-18.2018.