Massage for Perimenopause: Why Your Body Hurts & How to Find Relief

It is a truth universally acknowledged that an aging woman in possession of little estrogen must be in want of a massage therapist. 

When chronic neck, shoulder, or low back pain sends you searching for the nearest massage therapist, especially in your forties or fifties, you are not alone. After 15 years of working primarily with women, I’ve noticed consistent patterns of chronic tension in the neck and shoulders, low back and hips, and even the arches of the feet. There are several physiological reasons for this pattern, many of them linked to shifting hormone levels during perimenopause.

Estrogen influences far more than reproductive health. Research shows that it plays an important role in musculoskeletal tissues such as muscle, tendon, and ligament, affecting their structure and mechanical properties (Chidi-Ogbolu & Baar, 2019). As estrogen levels fluctuate and gradually decline, collagen metabolism and tissue responsiveness may change.  For many women, this may translate into increased stiffness, altered recovery time, or a greater awareness of physical strain.

Estrogen also plays a complex role in regulating inflammation. It helps modulate immune and inflammatory signaling in the body, and when hormone levels shift, tissue sensitivity and recovery patterns may change as well (Straub, 2007). This does not mean the body is breaking down. It means the body is adapting.

Fascia, the connective tissue network that surrounds and interweaves through muscles and joints, plays an important role in force transmission and movement coordination (Schleip et al., 2012). I often describe it to clients as a web that supports structure while allowing the body to move fluidly and gracefully. Because connective tissues function as an integrated system, hormonal shifts that influence musculoskeletal tissues may be felt in commonly loaded areas such as the neck and shoulders, the low back, or the hips. These patterns are not random. They reflect a larger transition occurring within the body.

When I work with a client experiencing hip discomfort, I am not focusing on a single muscle. I am addressing the relationship between the tissues surrounding the joint. Using slow, intentional techniques, I aim to reduce tension in muscles such as the gluteus medius and piriformis, which, when tight or overactive, may irritate nearby structures including the sciatic nerve. My goal is not to force change, but to create space within the tissue, restore healthy glide, and support movement that feels more natural again.

Massage therapy has been shown to provide benefits for certain types of musculoskeletal pain, including low back pain (Furlan et al., 2015). While research continues to explore the precise mechanisms, clinical outcomes suggest that hands-on therapy can support pain reduction and improved function. In my treatment room, I witness this in the women who walk through my door.  A woman arrives saying something feels stuck and leaves feeling lighter, steadier, and more at ease in her body.  Stiffness softens. Movement returns. The body remembers how to flow.

The body in midlife is not failing. It is recalibrating. With the right support, connective tissue can soften, movement can feel fluid again, and strength can return in new ways. Massage during perimenopause is not indulgence. It is intelligent care for a changing body.

Book your session at Pink Moon Massage and Wellness Boutique.

Jamie McKee

Licensed Massage Therapist

Pink Moon Massage and Wellness Boutique, LLC

The following research informed this article and reflects current understanding of connective tissue, hormone shifts, and musculoskeletal pain.

References

Chidi-Ogbolu, N., & Baar, K. (2019). Effect of estrogen on musculoskeletal performance and injury risk. Frontiers in Physiology, 9, 1834. https://doi.org/10.3389/fphys.2018.01834

Furlan, A. D., Imamura, M., Dryden, T., & Irvin, E. (2015). Massage for low-back pain. Cochrane Database of Systematic Reviews, (9), CD001929. https://doi.org/10.1002/14651858.CD001929.pub3

Schleip, R., Findley, T. W., Chaitow, L., & Huijing, P. A. (2012). Fascia is able to contract in a smooth muscle-like manner and thereby influence musculoskeletal dynamics: A historical review and implications. Frontiers in Physiology, 3, 255. https://doi.org/10.3389/fphys.2012.00255

Straub, R. H. (2007). The complex role of estrogens in inflammation. Endocrine Reviews, 28(5), 521–574. https://doi.org/10.1210/er.2007-0001