Perimenopause is one of the most significant hormonal transitions a woman will experience in her lifetime — and while it’s completely natural, it can create unexpected challenges for physical and musculoskeletal health. As a Women’s Health Osteopath working with women across all life stages, I see firsthand how perimenopause affects the body, daily function, and overall wellbeing.
While hot flushes, irregular cycles, and mood changes are commonly discussed, the physical symptoms — particularly muscle pain, joint stiffness, and reduced recovery — often go unnoticed or unvalidated. Yet for many women, these are some of the most impactful changes.
Let’s break down why this happens, and how an Osteopath can support you through this stage with personalised, holistic care.
1. Hormonal Changes Affect Muscles, Joints & Fascia
During perimenopause, levels of oestrogen fluctuate significantly before gradually declining. Our cells in our body have receptors for Oestrogen, and this hormone plays a vital role in maintaining:
- Muscle mass and tone
- Collagen production (affecting ligaments, fascia and skin)
- Joint lubrication
- Bone density
- Inflammation regulation
As these hormones shift, many women begin to experience:
- Widespread muscle aches
- Joint stiffness, especially in the morning
- Increased tendon irritation (common in the Achilles, rotator cuff, hips, Frozen Shoulder)
- Reduced flexibility
- Greater sensitivity to pain
This isn’t “in your head” — your body is responding to real physiological changes.
2. Increased Systemic Inflammation
Oestrogen has an anti-inflammatory effect. When it declines, the body can become more prone to inflammation, leading to:
- Soreness after light workouts
- Feeling “old” or stiff when getting out of bed
- Slower recovery after physical activity
- Heightened muscle tension
As an osteopath, I often see women in perimenopause who suddenly feel like their usual exercise routine is becoming harder or more painful. The culprit is usually this shift in inflammatory response.
3. Sleep Disruption Worsens Pain & Healing
Sleep quality often changes during perimenopause due to night sweats, temperature changes,and hormonal fluctuations. Poor sleep is directly linked to:
- Increased muscle soreness
- Slower tissue healing
- Heightened pain perception
- Reduced energy for activity or rehab
Addressing sleep — whether through lifestyle strategies or coordinated care with other health professionals — is a key part of effective osteopathic support.
4. Stress, Mood & the Nervous System
Perimenopause can amplify stress responses through changes in cortisol and neurotransmitter regulation. This affects the musculoskeletal system by:
- Increasing muscle tension (particularly neck, shoulders, jaw)
- Heightening pain sensitivity
- Reducing your ability to “switch off” or relax
- Causing postural changes from bracing or tension
As osteopaths, we consider nervous system balance just as much as structural function, because they are deeply connected.
5. Why Osteopathic Treatment Helps During Perimenopause
A Women’s Health Osteopath focuses on the full picture: hormones, nervous system, lifestyle, movement patterns, stress, and musculoskeletal health.
Osteopathic care during perimenopause may include:
Gentle hands-on treatment
To reduce muscle tension, improve joint mobility, and support circulation.
Individualised exercise programs
Targeting strength, flexibility, bone health and load management.
Education on pacing, recovery & exercise adaptation
Because your body may need a different approach now — but you can still move and train with confidence.
Support for stress & nervous system regulation
Breathing techniques, mobility drills and lifestyle strategies to help reduce tension.
Collaborative care with women’s health professionals
Including GPs, pelvic health physios, dietitians and mental health practitioners.
The goal is not just symptom relief, but helping you feel strong, supported and informed throughout this transition.
6. When You Should See an Osteopath
Seek help from an Osteopath or a Women’s Health Osteopath if you notice:
- New or unexplained muscle or joint pain
- Stiffness that doesn’t improve with movement
- Tendon pain that keeps returning
- Fatigue or slower recovery from exercise
- Heightened stress or tension through the neck, back or pelvis
- A sense that your body is “different” or not functioning the way it used to
Early support can make a huge difference — not just for pain, but for long-term mobility, bone health and confidence in your body.
Final Thoughts
Perimenopause is a chapter of transition — not decline — and with the right support, you can continue to feel strong, capable and empowered in your body. Osteopathic care provides a holistic, personalised approach that honours the full complexity of what women experience during this time.
If you’re navigating perimenopause and want guidance, gentle treatment, and a clear plan forward, our team of Osteopaths at Alpha Sports Medicine in Newport can help you move well, feel well and stay active through
