Aches, joints, headaches and the symptoms nobody expects
Original guidance written for MenoHealth by its editorial team. · 9 min read · Oct 2026
Medically reviewed by Karla F. Loken, DO, FACOOG on October 13, 2026
Sore joints, migraines, dizziness, itchy skin and bladder trouble rarely get blamed on menopause, which is why they get missed. What they may be, what a supporter does, and the few signs that are emergencies.
In brief
- What this helps with. Aches, headaches and odd symptoms, and which need a clinician.
- One thing to do. Believe the next ache she mentions, out loud.
- One thing to ask. "Which bothers you most?"
She gets out of bed like someone twenty years older, stands still for a moment with a hand on the wall, and then walks it off. Her doctor said it was probably age. She has stopped mentioning it. This article covers the symptoms nobody warned either of you about, and why some of them may belong to menopause too.
Aches and stiff joints
Joint and muscle pain is one of the most common complaints of the transition and one of the least expected. In the Study of Women's Health Across the Nation, women in perimenopause and after menopause were more likely to report aches and stiffness in their joints than women who had not yet begun the transition. Estrogen acts on joints, connective tissue and muscle, and as it falls, women who have never had a sore knee find their hands stiff in the morning, their shoulders aching, and their hips complaining on the stairs. Morning is usually the worst time of day. That is also why many doctors think it's just " Osteoarthritis" or "old joints".. It eases with movement and returns with rest, which is why she looks fine by lunchtime and moves like an older woman at seven.
From the outside it can look like reluctance. She does not want to hike, she is slow off the sofa, she has stopped running. Ask before you assume, because what looks like losing interest is often pain she has decided not to mention.
Headaches and migraines
For a woman who already has migraines, perimenopause can be the worst stretch of her life for them. In a large American study, women with migraine were more likely to have high-frequency headache, meaning ten or more headache days a month, during perimenopause and after menopause than women who had not started the transition. The swings in estrogen that drive hot flashes drive headaches too. A migraine is not a bad headache. It is hours or days of pain, nausea and sensitivity to light and sound, and a woman who cancels plans because of one is not being difficult. Practical help is a dark room, quiet, cold water, and taking the evening obligations off her hands without asking whether she is sure.
The odd ones
Some symptoms are so unexpected that women do not connect them to menopause, and not all of them belong to it.
- Dizziness. Light-headedness and feeling faint sit on the standard climacteric questionnaire alongside hot flashes.
- Bloating. A stomach that swells through the day and settles overnight.
- Itchy or crawling skin. Dry, itchy skin, sometimes with a crawling sensation, as estrogen's effect on the skin fades.
- Dry eyes. Gritty, tired eyes, often worse with screens.
- Palpitations. A pounding or fluttering heart, often travelling with flashes, poor sleep and anxiety, and sometimes a sign of something else. The article on anxiety, panic and palpitations covers what to do.
- Bladder urgency and infections. Falling estrogen thins the tissue of the lower urinary tract as well as the vagina, causing urgency, frequency and repeated infections. This is part of genitourinary syndrome of menopause, it is chronic and progressive without treatment, and low-dose vaginal estrogen is an effective option for most women.
Why these get missed
Three reasons. She is in her late forties, so everything gets blamed on age. She is busy and stretched, so everything else gets blamed on stress. And most clinicians were not taught this. In a survey of American residents in internal medicine, family medicine and obstetrics and gynecology, about one in five reported any formal menopause curriculum and under 7 percent felt adequately prepared to manage it. A woman who reports sore joints, migraines, dizziness and a bladder that has stopped cooperating, one at a time, to a doctor who does not know they can connect, may be told four times that it is nothing.
Some of these symptoms may be connected to the transition, and some may have a cause of their own. A clinician who knows menopause can sort out which is which, and the words she uses help. "I've been getting dizzy" gets one response. "I've been getting dizzy, my joints ache, my migraines are back, and I wonder whether any of it is menopause" gets another.
What a supporter does
Believe it. That is the whole job, and it is rarer than it should be. If she says her hands hurt, they hurt.
Help her keep track only if she wants help. A written timeline of what started when turns four complaints into one picture, and if she logs symptoms in the app, those logs can help her build it. It is hers to share. What you can do is remember what she has told you, so that when she says "I don't know, it's probably nothing" you can say "You mentioned the dizziness last month too."
Encourage a clinician when a symptom is new, severe, persistent or getting worse, once and gently. A migraine pattern that has changed, a joint that is swollen rather than stiff, dizziness that keeps returning, or a bladder infection that keeps coming back is worth a proper look, because each may need its own evaluation rather than a menopause label. Go with her if she wants company. A second person in the room who nods when she describes the symptoms makes them harder to dismiss.
Then the practical remedies. Heat for stiff joints, a hot shower first thing and a warm pack for the evening. Rest that is not questioned. Carrying, so that the heavy bags, the laundry basket and the toddler are yours, or if you do not live with her, schedule the lifts and the errands. Lord knows I love when my adult boys are home and just help me lift some of the groceries and heavier things.
The signs that are emergencies
A handful of symptoms are never menopause until a doctor says so, and they mean calling 911 now, not a conversation.
- Chest pain or pressure, with or without pain in the arm, jaw or back, and likewise fainting, severe breathlessness, or a racing heart that does not settle.
- Sudden weakness or numbness in the face, arm or leg, especially on one side, or sudden trouble speaking, seeing or walking.
- A sudden, severe headache with no known cause, unlike any she has had before.
Do not wait to see if it passes, and do not let her talk you out of calling. If an episode like that has already passed, she still needs a same-day assessment. If it is accompanied by fever please call your doctor.
Where to start this week
- The next time she mentions an ache, believe it out loud.
- Take over the carrying for a week without announcing it, or the lifts and errands if you live apart.
- Put a warm pack where she can reach it in the morning and the evening.
- Learn the emergency signs and agree that you will call, not debate.
- If a symptom is new, severe, persistent or getting worse, say once that a clinician could sort out what is what.
Related reading
- When symptoms need help now
- Anxiety, panic and palpitations
- Encouraging her to get care without pushing
Frequently asked questions
Does menopause cause joint pain?
Joint and muscle pain is one of the most common and least expected parts of the menopause transition. In the Study of Women's Health Across the Nation, women in perimenopause and after menopause reported aching, stiff joints more often than women who had not started the transition. Stiffness that lasts more than an hour in the morning, or joints that are swollen, hot or red, deserve their own evaluation.
Can menopause cause dizziness?
Light-headedness and feeling faint sit on the standard questionnaire for menopause symptoms, but dizziness in a woman in her late forties is not always menopause. Dizziness that keeps returning may need its own evaluation rather than a menopause label, and faintness that has settled still needs same-day assessment. Chest pain or pressure, fainting, severe breathlessness, or a racing heart that does not settle means calling 911, and so does sudden weakness, numbness or trouble speaking, seeing or walking.
Does menopause cause itchy skin?
Some women notice dry, itchy skin, sometimes with a crawling sensation, as estrogen's effect on the skin fades during the menopause transition. Moisturizer often helps. Itching all over without a rash that does not settle is worth a visit, because thyroid, liver, kidney and iron problems can cause it too. A new skin change, such as a changing mole, is a reason to be seen rather than something to put down to hormones.
Sources
- Dugan SA, Powell LH, Kravitz HM, et al. Musculoskeletal pain and menopausal status. Clinical Journal of Pain. 2006;22(4):325-331. SWAN cohort.
- Martin VT, Pavlovic J, Fanning KM, et al. Perimenopause and menopause are associated with high frequency headache in women with migraine: results of the American Migraine Prevalence and Prevention Study. Headache. 2016;56(2):292-305.
- Greene JG. Constructing a standard climacteric scale. Maturitas. 1998;29(1):25-31.
- The Menopause Society. The 2020 genitourinary syndrome of menopause position statement of The North American Menopause Society. Menopause. 2020;27(9):976-992.
- Kling JM, MacLaughlin KL, Schnatz PF, et al. Menopause management knowledge in postgraduate family medicine, internal medicine, and obstetrics and gynecology residents: a cross-sectional survey. Mayo Clinic Proceedings. 2019;94(2):242-253.
- Centers for Disease Control and Prevention. Signs and Symptoms of Stroke.
- Centers for Disease Control and Prevention. About Heart Attack Symptoms, Risk, and Recovery.
Disclaimer
This article is for education and support. It is not medical advice, and it is not a substitute for care from a qualified healthcare provider. Decisions about treatment, including hormone therapy and other prescription medicines, belong to the person experiencing menopause and her clinician. If someone is in immediate danger, contact local emergency services.
