World Menopause Day: Chronic Pain

October 18 is World Menopause Day, a day set aside each year to raise awareness of the menopause transition and the support available to people going through it. The International Menopause Society chooses a theme each year, and for 2026 the theme is chronic pain in midlife. It is a fitting choice. Hot flushes and night sweats tend to dominate the conversation about menopause, while aching joints, stiff muscles, worsening headaches, and flare-ups of long-standing pain conditions are often brushed aside as simply getting older.

This blog post looks at chronic pain during the menopause transition from a mental health perspective. It covers how pain and menopause influence each other, why pain takes such a heavy toll on mood, sleep, and identity, and how psychological therapies can help people live more fully, even when pain does not disappear completely.

If pain has been wearing down your mood, sleep, or sense of self through the menopause transition, we can help. Pacific Maple Psych Centre offers individual therapy in Vancouver and virtually across BC.

Why Pain Belongs in the Menopause Conversation

Perimenopause, the years leading up to the final menstrual period, often lasts four to eight years and sometimes longer. Estrogen does much more than regulate the menstrual cycle. It influences joints, cartilage, muscle, bone, inflammation, and the way the nervous system processes pain signals. As estrogen levels rise and fall unpredictably and then decline, many people notice new aches and stiffness, particularly in the hands, knees, hips, shoulders, and back. Researchers have recently proposed the term “musculoskeletal syndrome of menopause” to describe this cluster of joint pain, muscle loss, and related changes, in the hope that it will be recognized and treated rather than dismissed.

Menopause can also change the course of pain conditions that were already present. Migraine patterns often shift during perimenopause. People living with arthritis, fibromyalgia, back pain, or pelvic pain may find their symptoms harder to manage. The relationship runs in the other direction too. A large British cohort study found that women who reported chronic pain at age 44 were considerably more likely to experience a heavy burden of menopausal symptoms by age 50, including hot flushes, sleep problems, and psychological symptoms. Pain and menopause are not separate stories. They tend to amplify each other.

The Mental Health Side of Chronic Pain

Chronic pain is usually defined as pain that lasts or recurs for longer than three months. About one in five Canadians lives with it. Pain that does not go away affects far more than the body, and research has consistently found that chronic pain and depression occur together much more often than chance would predict. Each makes the other worse. Our article on depression and chronic illness explores this connection in more detail.

During menopause, several of these effects can stack on top of one another.

• Sleep breaks down. Pain makes it harder to fall and stay asleep, night sweats wake people repeatedly, and poor sleep in turn lowers pain tolerance the next day. Our article on how sleep and mental health affect each other describes this cycle.
• Mood drops. The risk of depressed mood already rises during perimenopause. Ongoing pain adds fatigue, frustration, and a sense that the body can no longer be trusted, which can tip low mood into depression.
• Anxiety grows. New pain can raise worrying questions about what is wrong, and fear of a flare-up can make people anxious about plans, travel, or work. Our article on anxiety in perimenopause describes the hormonal side of this.
• Life gets smaller. It makes sense to avoid activities that hurt, but over time avoidance can mean giving up exercise, hobbies, social plans, and work roles. This loss of meaningful activity is one of the strongest drivers of low mood in chronic pain.
• Identity is shaken. Many people in midlife have built their sense of self around being capable, active, and dependable. When pain limits what they can do, it can feel like grieving a version of themselves.

Stress plays a role as well. The nervous system does not process pain in isolation, and chronic stress can turn up the volume on pain signals. Our article on why stress makes chronic pain worse explains how this happens.

When Pain Is Not Taken Seriously

Many people in midlife describe a frustrating experience of having their pain minimized. They are told it is just their age, that everyone gets aches, or that it is probably stress. Research on chronic pain care has found that women’s pain is more likely than men’s to be attributed to emotional causes and less likely to be fully investigated. Being dismissed adds a second layer of suffering on top of the pain itself. It can leave people doubting their own experience, delaying care, or feeling alone with something they cannot explain.

How Therapy Can Help With Chronic Pain

Psychological therapies are a recognized part of chronic pain care. They do not promise to make pain vanish, but they can reduce how much pain controls daily life, ease the depression and anxiety that so often come with it, and improve sleep and functioning. Our article on the mind-body connection in chronic pain explains the science behind this.

Cognitive Behavioural Therapy

Cognitive behavioural therapy (CBT) for pain helps people notice the thoughts and habits that make pain harder to live with, such as expecting the worst, pushing through until a crash, or avoiding all activity. It teaches practical skills such as pacing, problem solving, and relaxation. CBT for insomnia is also one of the most effective treatments available for the sleep problems that so often accompany both pain and menopause.

Acceptance and Commitment Therapy

Acceptance and commitment therapy (ACT) takes a different angle. Rather than fighting pain at every turn, it helps people make room for discomfort while moving toward what matters most to them. Many people find that letting go of the constant struggle against pain reduces their distress, even when the pain itself remains.

Mindfulness-Based Approaches

Mindfulness practices help people relate to pain sensations with curiosity rather than alarm. This can break the cycle in which pain triggers fear, fear increases muscle tension, and tension increases pain.

Clinical Hypnosis

Clinical hypnosis has research support for several chronic pain conditions, and it is recognized as an evidence-based non-hormonal option for reducing hot flushes. For people dealing with both, it can be a useful part of a broader care plan.

Support for Self-Compassion

Many people with chronic pain are harder on themselves than they would ever be on a friend. They criticize themselves for cancelling plans, resting, or needing help. Therapy can help replace that inner critic with a kinder and more sustainable voice. Our article on chronic self-criticism explores this further.

Support at Pacific Maple Psych Centre

Several members of our team work with people living with chronic pain and health challenges. Dr. Irene Matijczak, a Registered Clinical Counsellor, supports clients facing chronic pain, diabetes, and recovery from surgery, drawing on CBT, ACT, mindfulness-based cognitive therapy, and lifestyle medicine. Sydney Harrison, a clinical psychology doctoral student, focuses on chronic illness, anxiety, depression, and life transitions using CBT, ACT, and person-centred approaches, and is currently offering lower-cost therapy. Our full team page lists other clinicians who work with anxiety, depression, sleep, and midlife transitions.

The Role of Relationships and Support

Chronic pain is often invisible, which can make it lonely. Partners, family members, friends, and colleagues may not understand why someone who looked fine yesterday cannot manage today. Research on pain within couples has found that the responses of people close to us matter. Dismissive or critical responses tend to increase distress, while warm, encouraging support is linked with better mood and functioning.

Interestingly, the most helpful support is not always doing everything for the person in pain. Well-meant over-helping can sometimes reinforce avoidance and shrink a person’s world further. What tends to help most is believing the pain, asking what would help, and encouraging the person to keep doing what matters to them at a pace that works. For people without a partner, friendships, community, and peer support groups can offer the same kind of understanding. Our blog post on creating emotional safety describes the kind of environment that makes these conversations easier, and couples therapy can help when pain has become a source of tension at home.

Practical Steps You Can Take Now

• Track patterns. A simple log of pain, sleep, mood, and where you are in your cycle can reveal connections and give your physician useful information.
• Ask about menopause directly. If you are in your forties or fifties and have new aches or worsening pain, ask whether perimenopause may be contributing and what treatment options might suit you.
• Pace rather than push. Break activities into smaller pieces and rest before you need to, rather than alternating between overdoing it and crashing.
• Keep moving gently. Movement that suits your body often helps joint pain, mood, and sleep, even when it feels counterintuitive.
• Protect sleep. Treat sleep problems as a priority rather than an afterthought, since they affect both pain and mood.
• Stay connected. Let at least one trusted person know what you are going through.

When to Seek Support

Consider reaching out for psychological support if pain has been affecting your mood for several weeks, if you have stopped doing things you used to enjoy, if sleep has become a constant struggle, if you feel hopeless about the future, or if pain is putting strain on your work or relationships. Depression during perimenopause and depression alongside chronic pain are both common and treatable. If you ever have thoughts of suicide, call or text 9-8-8 at any time.

A Final Thought

Chronic pain in midlife has been overlooked for too long, and this year’s World Menopause Day theme is a welcome step toward changing that. Pain during the menopause transition is real, it is common, and it deserves to be taken seriously by physicians, by the people around you, and by you. Caring for the mental health side of pain is not a sign that the pain is less real. It is a way of making sure that pain does not take more from your life than it has to.

Common Questions About Menopause, Chronic Pain, and Mental Health

Can menopause cause joint and muscle pain?

Yes. Joint aches, stiffness, and muscle pain are common during perimenopause and menopause, and falling estrogen levels appear to play a role. Menopause can also change how existing pain conditions such as migraine, arthritis, or fibromyalgia behave. New or worsening pain is worth discussing with a physician.

Is chronic pain linked to depression and anxiety?

Yes. Chronic pain and depression often occur together, and each can make the other worse. Pain disrupts sleep, limits activity, and wears down mood, while low mood and anxiety can increase how intense and distressing pain feels.

If therapy helps with pain, does that mean the pain is in my head?

No. Pain is processed by the nervous system, which is shaped by sleep, stress, mood, and attention. Therapy works on those factors and on the distress pain causes. It is used alongside medical care, not as a replacement for it, and it does not mean the pain is imagined.

What kinds of therapy help with chronic pain?

Cognitive behavioural therapy, acceptance and commitment therapy, mindfulness-based approaches, and clinical hypnosis all have research support for chronic pain. They can reduce distress and disability, improve sleep and mood, and help people return to valued activities.

Can hypnosis help with menopause and chronic pain?

Clinical hypnosis is recognized as an evidence-based non-hormonal option for reducing hot flushes, and research also supports hypnotic approaches for some chronic pain conditions. It works best as part of a broader care plan.

How can family and partners support someone with chronic pain during menopause?

Believe their pain, ask what would help rather than assuming, avoid doing everything for them, encourage them to keep doing what matters to them at a manageable pace, and support them in seeking medical and psychological care.

Sources

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