Why aging causes flu-like body aches in women

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You wake up feeling like you’ve run a marathon, even though you didn’t work out. Your body feels heavy, sore, and achy—almost like you’re coming down with something. But you’re not sick. What’s happening?

More than 70% of women in midlife experience body aches, whole-body muscle soreness, muscle fatigue, stiff or swollen joints, aching bones, and other pain symptoms.

“These kinds of discomforts are a very real and often frustrating part of the journey that can come on gradually and insidiously,” explains Natalie Kunsman, M.D., a family medicine physician who treats women in this age group.

Many chalk it up to old age or arthritis, but hormones are often to blame, Hone Health reports.

If you’re in your 40s and have never felt these sensations before, plus you’re having perimenopause symptoms—irregular periods, hot flashes, sleep disruption, mood swings, sexual dysfunction, loss of libido, and cholesterol changes—then signs point to hormonal fluctuations.

How Hormones Drive Body Aches

As estrogen and progesterone decline in midlife, the body’s balance shifts in ways that can make you more sensitive to pain.

Estrogen keeps muscles and bones strong, lubricates joints, and reduces inflammation. When levels drop, it can lead to increased stiffness, muscle soreness, and joint pain, explains women’s health expert and OB-GYN Kecia Gaither, M.D.

Progesterone has a calming effect on the nervous system and helps dial down pain. When it declines, pain receptors become more active.

Together, low estrogen and progesterone prime the body for pain.

Orthopedic surgeon and aging specialist Vonda Wright, M.D, first coined the term “musculoskeletal syndrome of menopause” in a 2024 paper to describe the constellation of muscle, joint, and bone pain that comes with declining estrogen levels during the menopausal transition. Her research was the first to validate the experiences of many women who report feeling like their bodies are “falling apart” despite no obvious injury.

The Pain–Inflammation Loop

Lower estrogen doesn’t just stiffen joints—it can also affect the immune system, ramping up chronic low-grade inflammation “When estrogen levels start to fluctuate, it can raise histamine levels [which stimulates inflammation] and disrupt the regulation of anti-inflammatory cytokines (signaling proteins), leading to muscle and joint stiffness,” Kunsman says.

Add in muscle loss from declining estrogen and reduced activity, and the pain cycle can intensify. Weaker muscles provide less support for joints, leading to instability and discomfort.

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Some women also notice heightened pain sensitivity. “Hormones, especially estrogen, modulate pain signals,” Kunsman says. “When estrogen drops, pain perception may increase.” This may explain why chronic pain conditions such as fibromyalgia often first appear or worsen during the transition to menopause.

Fluctuating estrogen levels can also disrupt gut bacteria that help regulate hormones, triggering inflammation and contributing to bloating, fatigue, and body-wide aches.

Chronic stress compounds the problem by raising cortisol and lowering recovery hormones, creating a vicious cycle where stress and pain feed each other.

Lifestyle fixes that help

Before turning to medication, both doctors recommend addressing the root cause through movement, nutrition, and stress management.

Move more
Staying active protects against muscle loss and helps control inflammation. Strength training preserves lean muscle mass, while moderate aerobic activity lowers pro-inflammatory markers. Moderate exercise also releases endorphins—the body’s natural painkillers. “If you’re starting new workouts, make sure to stretch and recover between sessions,” says Kunsman.

Adjust your diet
A Mediterranean-style diet of proven anti-inflammatory foods, including avocados, berries, broccoli, dark chocolate, fatty fish high in omega-3, mushrooms, and olive oil can help calm inflammation.

Minimize processed foods, refined sugars, and alcohol. Gaither suggests adding foods with phytoestrogens (like soy and flaxseed) to mimic estrogen’s positive effects, and plenty of calcium and vitamin D to protect bones.

Support your gut
Hormone shifts also alter gut bacteria, which can increase inflammation and pain. “Supporting gut health with probiotics and fiber helps restore balance,” says Gaither.

Manage stress
Feeling calm and in control helps keep cortisol in check, which helps prevent and ease stress-induced inflammation and body aches. Try yoga, walking, deep breathing or meditation and mindfulness. These improve mood-enhancing hormones and activate the parasympathetic nervous system, which helps your body relax.

When to Consider Hormone Therapy

Hormone replacement therapy (HRT), also commonly called menopause hormone therapy (MHT), typically involves estrogen or a combination of estrogen and progesterone. In some cases, testosterone is added to improve muscle mass, libido, mood, energy, and bone density.

MHT is proven to help relieve debilitating menopause symptoms, including hot flashes, night sweats, vaginal dryness and joint pain. A study in the journal Menopause also found that women who took estrogen-based HRT suffered less joint pain even though they had more joint swelling.

This story was produced by Hone Health and reviewed and distributed by Stacker.