Understanding Menopause – More Than Just Hot Flashes
With Natalia Sosnovsteva,
Pelvic Health Physiotherapist
Menopause is a natural part of life — but that doesn’t mean it’s easy. The symptoms can impact a woman’s personal, social, and work life. At Physio Pilates NP, we take a holistic, evidence-based approach to women’s health, with a goal of supporting clients through the menopause transition and promoting long-term health and wellbeing.
What Is Menopause?
Menopause marks the permanent end of menstruation, caused by the decline in ovarian function. It can happen naturally or due to surgery (such as ovary removal, cancer treatments).
It usually occurs between ages 45–55 and includes stages such as:
Perimenopause – from irregular cycles until 12 months after the final period
Menopause transition – the phase of cycle changes until the last period
Post-menopause – beginning 12 months after the final period
Surgical/Early menopause – menopause before age 45 due to medical interventions such as total hysterectomy and cancer treatment.
Menopause Is More Than Hot Flashes
There are over 35 recognised symptoms, which vary from person to person. They include:
Hot flashes, night sweats & fatigue
Sleep disturbance & brain fog
Anxiety, mood changes & low libido
Vaginal dryness, urinary urgency & recurrent UTIs
Joint stiffness, muscle weakness & bone density loss
These symptoms aren’t just “a part of ageing.” Many are linked to hormonal changes, especially declining oestrogen. Education about what’s happening in your body is the first step to managing them.
The Musculoskeletal Syndrome of Menopause (MSM)
As oestrogen levels drop, musculoskeletal issues often arise, such as:
Joint pain, stiffness & frozen shoulder
Sarcopenia (loss of lean muscle mass)
Osteopenia (bone density loss)
Reduced stamina, slower walking speed, poor posture
Tendon injuries and increased risk of fractures
More than 70% of women experience musculoskeletal symptoms during menopause — and 1 in 4 report severe issues.
Why Does This Happen?
As oestrogen declines, it contributes to inflammation, increased fat accumulation, reduced muscle recovery, and changes in bone, tendon, and ligament tissue. This makes muscles and joints more prone to injury, stiffness, and weakness — and slower to heal.
Stay tuned for Part 2, where we’ll explore how Physiotherapy can support you through these changes.
Sources:
Australian Physiotherapy Association. (2025, September 1). Five facts about physiotherapy and menopause. InMotion. https://australian.physio/inmotion/five-facts-about-physiotherapy-and-menopause
Davis, S. R., Taylor, S., Hemachandra, C., Magraith, K., Ebeling, P. R., Jane, F., & Islam, R. M. (2023). The 2023 Practitioner’s Toolkit for Managing Menopause. Climacteric, 26(6), 517–536. https://doi.org/10.1080/13697137.2023.2258783
Panay, N., Ang, S. B., Cheshire, R., Goldstein, S. R., Maki, P., & Nappi, R. E. (2024). Menopause and MHT in 2024: addressing the key controversies – an International Menopause Society White Paper. Climacteric, 27(5), 441–457. https://doi.org/10.1080/13697137.2024.2394950
Simon, J. A., Davis, S. R., Lindén Hirschberg, A., Kiesel, L., Pompei, L. de M., Reginster, J. Y., … Hillard, T. (2025). State of the art in menopause: current best practice approaches from the IMS World Congress 2024, Melbourne. Climacteric, 28(2), 98–103. https://doi.org/10.1080/13697137.2025.2457993
Wright, V. J., Schwartzman, J. D., Itinoche, R., & Wittstein, J. (2024). The musculoskeletal syndrome of menopause. Climacteric, 27(5), 466–472. https://doi.org/10.1080/13697137.2024.2380363