MENOPAUSAL PAIN

As women enter the peri-menopausal period, the chances of developing other pain syndromes such as fibromyalgia, back pain or migraine tend to increase. This is known as Menopausal Pain Syndrome. Beyond physical pain, menopause can also bring emotional changes such as low mood and cognitive difficulties such as forgetfulness and reduced memory.

Menopausal pain is thought to be caused by hormonal changes. Estrogen and other female hormones interact closely with the body’s pain sensitivity. As hormone levels shift, this can lead to chronic pain or the sudden onset of symptoms that were not present before. Nerves become more sensitive, so pain can be felt even without an injury or underlying disease. This nerve sensitisation can also cause surrounding muscles to tighten and spasm, leading to muscle pain (myalgia), body aches, tendinitis and ligament instability. As oestrogen levels decline, this affects joint lubrication and muscle function, contributing to what is increasingly referred to as the musculoskeletal syndrome of menopause [1].

Menopausal pain is common among women in Singapore. A 2025 study by KK Women’s and Children’s Hospital (KKH), which followed over 1,400 local women aged 45 to 65, found that 7 in 10 experienced moderate to severe menopausal symptoms, and joint and muscle aches were among the top five most reported [2]. A separate 2023 Singapore study also found that new-onset muscle and joint aches were the most commonly cited perimenopause symptom among local women, ranking ahead of hot flushes [2].

Pain during menopause falls into a few categories: non-specific generalised body pain (such as headache, neck pain or back pain), musculoskeletal pain (such as muscle spasm and stiffness), and pelvic or abdominal discomfort.

Weight gain, hot flushes, increased sweating, low energy and mood disturbances are also commonly linked to the hormonal changes of menopause.

At Singapore Paincare, our team of primary care and specialist pain doctors carries out a thorough diagnosis. This includes a physical examination, a review of your symptoms, and an evaluation of your medical history. A CT or MRI scan may also be used to help confirm the cause of pain and match the findings to what you are experiencing.

In many cases, non-surgical treatment can provide good outcomes. At Singapore Paincare, we aim to treat pain using the least invasive option possible once the cause has been accurately identified. Our approach focuses on addressing pain generators through specialised injections and minimally invasive procedures, alongside pharmacological treatment and rehabilitative therapy, to help patients regain function and reduce the chances of pain returning.

Painkillers and non-steroidal anti-inflammatory drugs, including paracetamol and ibuprofen, can help reduce pain caused by menopause. Newer NSAIDs such as Celebrex and Arcoxia are gentler on the stomach. These medications may provide temporary relief while an accurate diagnosis is established.

Coreflex injections, such as cortisone, are a mild steroid used to treat muscle inflammation, tension and spasm. This anti-inflammatory treatment can relieve pain quickly, with minimal risk. Repeated injections (more than twice) may call for further evaluation with MRI before additional injections are given. Widespread muscle spasm and myalgia linked to Menopausal Pain Syndrome tend to respond well to this treatment, and when administered correctly, relief can be long-lasting.

Menopausal pain may be managed with hormone therapy to help restore the body’s hormonal balance, including treatment that replenishes estrogen levels. Hormone Replacement Therapy (HRT) can help address the underlying cause of Menopausal Pain Syndrome. HRT is not a decision to take lightly, and its risks, including its association with breast, endometrial and ovarian cancer, should be discussed with a gynaecologist.

Beyond NSAIDs, our physicians and specialists may prescribe medications such as antidepressants and anti-convulsants to help manage menopausal pain. These work by reducing pain sensitivity and calming the transmission of pain signals in the nervous system.

PRP is used to support muscle recovery and treat musculoskeletal issues, including in patients with fibromyalgia. In painful muscle conditions, PRP can support healing by encouraging tissue repair and strengthening of the affected muscles.

There is currently no surgical treatment for menopausal pain.

Most women will experience some form of menopausal pain, but the following habits may help ease symptoms:

• Eat a balanced diet and reduce spicy food and caffeine intake
• Exercise regularly. A certain threshold of activity is needed before benefits are felt
• Quit smoking
• Avoid known triggers of hot flushes
• Consider joining a support group of women going through menopause

References

1. Sugianto, S. (2025). Navigating Perimenopause and Menopause. SMA News, Singapore Medical Association. Available at: sma.org.sg/news/2025/May/Navigating-Perimenopause-and-Menopause
2. Puvanendran, R. (2026). Perimenopause: When Does It Start, Early Signs and How to Manage. HealthXchange.sg, SingHealth, citing a 2025 KK Women’s and Children’s Hospital (KKH) study of 1,461 women aged 45 to 65, and a 2023 Singapore perimenopause symptom study. Available at: healthxchange.sg/how-to-manage/menopause/perimenopause-how-to-manage-symptoms

Updated July 2026