Doctor's Library
Aches, Pains and Perimenopause: When to Ask for Help
Ask most people to name a symptom of menopause and they will say hot flushes. Very few will say sore knees, stiff hands in the morning or headaches that have changed. Yet these are things women in their forties and fifties often mention to me, usually with an apology, as if pain at this age were simply something to put up with.
Chronic pain at midlife was the theme of World Menopause Day 2026. It is worth saying plainly that pain during these years is common, that it is real, and that it deserves a proper conversation.
What is happening
Menopause is when periods stop completely. In Ireland the average age is 51, and it usually happens between 45 and 55. The years leading up to it are called perimenopause, and the HSE notes that symptoms can begin seven to ten years before periods stop. That means many women are in their early forties, still having periods, when things start to change.
The HSE lists joint aches and pains and headaches among the recognised symptoms, alongside the better-known ones: hot flushes, disturbed sleep, low mood, anxiety and difficulty concentrating. These rarely arrive one at a time. Poor sleep makes pain harder to bear. Pain makes sleep worse. Both wear down mood. It is easy to see why a woman might feel that everything is going wrong at once, and why she might not connect any of it with her hormones.
Not every ache is menopause
Here I want to be careful. Midlife is also when other conditions appear, arthritis and thyroid problems among them. Blaming everything on hormones is as unhelpful as dismissing hormones altogether.
A good consultation looks at the whole picture: the pattern of symptoms, the menstrual history, medical and family history, medication, sleep, work and what daily life looks like. For women over 45, a GP can usually recognise menopause from symptoms alone, without a blood test. Sometimes further investigation is needed, and part of a doctor's job is to recognise when.
What can help
There is no single answer, and anyone who offers one should be treated with caution. For some women, regular movement, strength exercise and better sleep make a real difference. For some, hormone replacement therapy (HRT) is appropriate. Since June 2025, HRT medicines have been free at participating pharmacies for women with a medical card or a Drugs Payment Scheme card, although the consultation itself is not covered (see Free HRT in Ireland). For others, HRT is not suitable or not wanted, and there are other approaches to discuss.
The right plan depends on the woman, her health and her preferences. My role is to explain what may be happening and what the options are. The decision is hers.
When to speak to a doctor
Speak to your GP if symptoms are affecting your daily life, if they begin before 45, or if your periods stop before 45. Do not wait until things are unbearable, and do not apologise for raising it.
If you are in your forties or fifties and something hurts that did not hurt before, mention it. You may be told it is nothing to worry about. You may find it is part of a bigger picture that can be helped. Either way, you will know.
If you would like time to talk it through, read what to expect at your first menopause consultation or see menopause care at VERA MD.
Sources and further reading
This article is intended for general information and does not replace individual medical advice.