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Muscle aches and stiffness are common around menopause, and muscle mass starts to decline. Learn the causes, what to rule out and how strength training helps.
Muscle aches, stiffness and tension are common around menopause, and the NHS lists them among menopause symptoms. At the same time, muscle mass starts to decline, which can affect strength, balance and energy. Poor sleep and stress add to aches. Vitamin D deficiency, thyroid problems and some medicines are worth ruling out. Strength training helps most.
Aches often overlap with joint pain and fatigue.
Muscle supports balance, mobility, metabolism and bone strength. SWAN found greater muscle loss during the transition was linked with lower bone density and higher fracture risk afterward.
The 2024 international guideline on premature ovarian insufficiency notes that low estrogen may reduce muscle mass, strength and performance, raising the risk of sarcopenia, the age-related loss of muscle. See weight and metabolism after menopause and bone health.
| Possible cause | Clues |
|---|---|
| Vitamin D deficiency | Aches, muscle weakness, bone pain; more likely with little sun exposure |
| Underactive thyroid | Aches plus tiredness, weight gain, feeling cold |
| Cholesterol medicines (statins) | Aches or weakness after starting or increasing a dose |
| Fibromyalgia | Widespread pain, tiredness, sleep problems and poor concentration lasting months |
| Polymyalgia rheumatica | New stiffness and pain in the shoulders and hips, usually over 50, often worst in the morning |
| Low mood or depression | Aches often come with low mood and poor sleep |
| Viral illness | Aches with fever or other infection symptoms |
| Overuse or injury | Pain linked to specific activity |
See perimenopause or something else.
A clinician may ask where and when the aches occur, whether you have weakness as well as pain, and about your sleep, mood, activity and medicines. They may examine your muscles and joints and suggest blood tests, such as vitamin D, thyroid function, markers of inflammation or a muscle enzyme test.
Resistance exercise is the most effective way to maintain and build muscle at any age. NICE advises explaining to people going through menopause the importance of maintaining muscle mass and strength through physical activity. Aim for:
Walking, cycling, swimming and other regular activity reduce stiffness and improve mood and sleep.
Older NICE guidance noted limited evidence that HRT may improve muscle mass and strength. The 2024 POI guideline suggests hormone therapy prescribed for other reasons may benefit muscle health in people with early menopause. Hormone therapy isn’t prescribed for muscle aches alone, but may help if they come with other menopause symptoms. See early menopause.
Vitamin D deficiency, thyroid problems, fibromyalgia or medicine side effects each have specific treatments.
Try one or two sets of 8 to 12 repetitions, two or three times a week:
Increase the challenge gradually. If you have osteoporosis, joint problems or a heart condition, ask a physiotherapist to tailor the routine.
Muscle needs protein, particularly when combined with strength training. Include a source at each meal, such as eggs, dairy, fish, poultry, legumes, tofu or lean meat. Needs vary with age, activity and kidney health, so ask a dietitian if you’re unsure.
Book an appointment if aches persist, limit your activities, or come with other symptoms.
See a clinician promptly if you have:
- Muscle weakness, for example difficulty climbing stairs or getting up from a chair
- Severe muscle pain with dark or reduced urine, especially after starting a new medicine or intense exercise
- New shoulder and hip stiffness, particularly over 50
- Muscle pain with fever, rash, weight loss or feeling generally unwell
- Headache with jaw pain when chewing, scalp tenderness or vision changes. Seek same-day care.
See your first menopause appointment.
Joint pain · Fatigue · Sleep problems · Low mood
For long-term muscle and bone health, see healthy aging after menopause.
Yes. The NHS lists muscle aches and joint pains among menopause symptoms. Poor sleep, stress and muscle loss can add to them.
Research from SWAN found women begin to lose lean muscle around the start of the menopause transition. Strength training helps maintain it.
If you’re deficient, vitamin D can help. Ask for a blood test, and follow recommended doses, since too much can be harmful.
Usually yes, and gentle activity often helps. Stop if you have sharp pain, and see a clinician if you have weakness or severe pain.
Leg cramps are common in midlife and have many causes, including dehydration, some medicines and prolonged sitting. They’re not clearly linked to menopause itself. Gentle stretching before bed may help. Frequent cramps, or cramps with swelling or weakness, should be checked.
Editorial status: evidence-based educational article; not individually medically reviewed. Last evidence check: September 10, 2026.
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