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Menopause:
How Physiotherapy Can Help You Keep Doing What You Love
For many women, Menopause can feel like a sudden shift in how their body moves, feels, and recovers. Menopause Physiotherapy can help women manage these changes and continue doing the activities they enjoy. One day you’re managing your usual activities with ease, and the next you’re noticing unexplained aches, stiffness, reduced strength, disrupted sleep, or injuries that seem to take longer to settle.
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While hot flushes and mood changes are commonly discussed, the impact of menopause on the musculoskeletal system often receives far less attention. At PEAK Sports & Spine Centre, we regularly work with women navigating this transition and help them continue participating in the activities that matter most to them.
Understanding Menopause
Menopause is a natural stage of life that marks the end of a woman’s reproductive years. In Australia, the average age of menopause is around 51 years, although symptoms can begin several years earlier.
There are several ways menopause can occur:
Natural menopause occurs when the ovaries gradually reduce hormone production as part of the ageing process.
Surgical/medical menopause occurs when both ovaries are removed causing a sudden drop in hormone levels and often a more rapid onset of menopause symptoms, or following treatments such as chemotherapy, radiation therapy, or certain medications that affect ovarian function.
The menopause transition is typically divided into three stages:
Perimenopause – the years leading up to menopause when hormone levels fluctuate and symptoms may begin. Menstrual periods often become irregular during this stage.
Menopause – officially reached when a woman has gone 12 consecutive months without a menstrual period.
Postmenopause – the years following menopause, when hormone levels remain lower and some symptoms may continue while others improve.
During this transition, levels of oestrogen and progesterone decline. These hormones influence far more than just reproductive health, playing important roles in bone density, muscle function, tendon health, cardiovascular health, cognition, sleep, skin integrity and bladder function. As hormone levels change, many women notice differences in how their body responds to exercise, movement and recovery.
Common symptoms women report include:
- Joint aches and stiffness
- Muscle soreness or reduced strength
- Increased injury frequency
- Reduced exercise tolerance and slower recovery
- Fatigue and sleep disturbances
- Weight changes
- Reduced balance and coordination
- Mental health challenges
- Bladder and bowel changes
- Changes in libido
Many women assume these changes are simply something they have to accept. However, there are effective strategies to help manage symptoms and maintain an active lifestyle.
Bone Health Concerns
Approximately 90% of our bone mass is built by age 18. After age 30, we experience a gradual decrease each year in both bone density and muscle mass. Oestrogen plays a critical role in maintaining bone density, which is why there is often a faster reduction during perimenopause and menopause as reproductive hormone levels decline. As a result, the risk of osteopenia and osteoporosis increases during this stage of life. In fact, approximately one in two women over the age of 50 will experience an osteoporosis-related fracture in their lifetime according to recent statistics. Menopause Physiotherapy can help women maintain strength, mobility, and bone health as hormonal changes occur.
The biggest opportunity to optimize our bone mass and muscle strength is between the ages of 12 and 25. However, this doesn’t mean the opportunity is lost later in life. Strength training remains one of the most effective ways to preserve bone density, maintain muscle mass, and support long-term independence. It is never too late to start, but the sooner the better. Our team can help you find a safe and achievable starting point and build from there.
Tendon Pain and Tendinopathy
Research suggests that declining oestrogen levels may influence how muscles, tendons, ligaments and bones function and adapt to load. This can contribute to conditions such as:
- Achilles tendinopathy
- Gluteal tendinopathy (outer hip pain)
- Rotator cuff-related shoulder pain
- Frozen shoulder
- Tennis elbow
Many women notice these conditions developing despite no obvious change in activity levels. Physiotherapy can help manage these conditions through education, load management, and graduated strengthening programs designed to improve tendon capacity over time.
Joint Pain and Osteoarthritis
Many women experience widespread joint aches during perimenopause and menopause. Reduced oestrogen may influence joint cartilage health, inflammation, and pain sensitivity, potentially contributing to increased stiffness and discomfort.
Menopause Physiotherapy can help women manage these symptoms and maintain joint mobility.
While menopause does not directly cause osteoarthritis, hormonal changes may contribute to symptoms becoming more noticeable during this stage of life. Regular exercise, strength training, and maintaining joint mobility can play an important role in managing symptoms and supporting long-term joint health.
Reduced Muscle Mass and Strength
From midlife onwards, both men and women naturally begin to lose muscle mass if they are not actively strength training to maintain it. However, this process may be accelerated in women during menopause due to hormonal changes. Maintaining muscle mass is critical for preserving strength, reducing injury risk, supporting bone health, improving balance, and maintaining independence as we age, which is a key focus of Menopause Physiotherapy. Strength training remains one of the most powerful tools available to counteract these changes, and our Exercise-Led Prevention Classes classes are a fantastic way to engage in strength training. They are small-group focused with individualised programs that provide accountability, lots of laughter and real results for strength goals.
Pelvic Floor Changes
Hormonal changes can also affect the pelvic floor and surrounding tissues. Women may experience:
- Urinary leakage
- Urgency or frequency
- Pelvic organ prolapse symptoms
- Pelvic pain
- Exercise-related pelvic floor symptoms
Our Women’s Health team at PEAK can help identify factors contributing to these symptoms, provide guidance around pelvic floor exercises, and discuss whether referral to a Pelvic Health Physiotherapist for an internal assessment may be beneficial. These symptoms are common, but they should never be considered “normal” or something you simply need to put up with.
How Physiotherapy Can Help
At PEAK, we believe that understanding your goals is just as important as understanding your symptoms. Whether your aim is to keep up with the kids, return to the gym, continue playing sport, or simply move with greater confidence, we’ll work with you to create an individualised plan.
Your symptoms and concerns
Exercise and activity history
Sleep and recovery patterns
Previous injuries
Current health conditions
Menopause-related changes you may have noticed
This is followed by a physical assessment that may include strength, mobility, balance, movement patterns, and activities relevant to your goals, allowing Menopause Physiotherapy treatment to be tailored to your individual needs.
Treatment is tailored to your needs and may include:
- Strength and resistance training
- Bone health exercise prescription
- Tendon rehabilitation programs
- Mobility and flexibility strategies
- Pelvic floor guidance and referral where appropriate
- Education around recovery, pacing, and symptom management
- Return-to-exercise planning
Our goal is not simply to reduce pain, but to help you confidently continue doing the things you love.
You Don't Have to Stop Doing What You Love
Menopause is a significant life transition, but it doesn’t have to mean giving up exercise, sport, travel, or the activities that bring you joy. With the right support and Menopause Physiotherapy, many women can improve strength, reduce pain, build confidence, and continue living active, fulfilling lives.
If menopause-related symptoms are affecting your movement, exercise, or quality of life, the team at PEAK Sports & Spine Centre can help. We’re passionate about helping women understand their bodies, stay active, and continue achieving experiences they may not have thought were possible.
Stay Active Through Menopause