“Chronic pain in midlife is a very important subject and highly neglected,” said Rossella Nappi, president of the International Menopause Society and an obstetrician and gynaecologist at the University of Pavia in Italy. The society’s new report estimates that about half of all middle-aged women experience chronic pain — defined as pain lasting more than three months or recurring — and that women are up to 70 per cent more likely than men to experience it, ABC News Australia reported.
The report describes chronic pain in women as “often under-recognised, underdiagnosed and inadequately treated.” Nappi said it aims to empower women and health workers to talk about the condition, adding: “Sometimes the pain becomes widespread and it’s present in every day of their life.”
Why women carry a heavier pain burden
Researchers do not know exactly why chronic pain is more common in women. Jane Chalmers, a senior lecturer in pain science at the University of Adelaide, called it one of the “hardest questions to answer” in her field. “Trying to understand why certain people or certain groups are more vulnerable to others is often multi-factorial and very layered,” she said. “And that’s because we can’t separate a human’s psychology and sociology from their biology.”
Women often experience several overlapping chronic pain syndromes at once, such as fibromyalgia and chronic pelvic pain. Some research, published in The Lancet Rheumatology, suggests women may be more likely than men to experience central sensitisation, which makes the brain more likely to produce pain signals. Social factors also weigh in: Nicollette Ellis, chair of Chronic Pain Australia, said women often manage most caregiving responsibilities, which may add to stress levels, and stress may worsen pain intensity for some people.
What changes in midlife
Hormones play a role. During menopause, the body produces much lower amounts of oestrogen and progesterone, and lower oestrogen can lead to joint pain, stiffness and weakening of muscles. According to the IMS, nearly three in four women experience joint or muscle pain during perimenopause. But hormone levels can also fluctuate day to day, and Sharon Vasey, chair of the Royal Australian College of General Practitioners’ menopause health subgroup, said this fluctuation can lead to migraines.
It is not all hormones. Nappi said lifestyle factors shape how women age: “If we do not exercise properly, if we don’t eat adequately and if we are not active very much in our life, pain will be an issue.” Sleep disturbances and mood changes that come with menopause also affect the experience of pain.
Multiple pains, not one
The IMS report focuses on three common symptoms: musculoskeletal pain, migraine and pelvic pain. But figures from Chronic Pain Australia’s 2026 National Pain Report, which surveyed more than 6,000 Australians, paint a more complex picture: women reported an average of 4.6 different types of chronic pain, including migraines, back, pelvic, joint and nerve pain. With so many women reporting multiple symptoms, Ellis said it is important not to treat types of pain in a “silo” but to consider the whole body and how different systems interact.
What women can do about it
Vasey, who is also a practising GP, said the first step for anyone experiencing pain symptoms is to speak to their doctor. “There’s lots of things that can be done, women don’t have to put up with chronic pain,” she said. For women approaching midlife, she recommends enough sleep, staying active and a healthy diet. Menopausal hormone therapy can ease the severity of some symptoms for some women, but medication is not the only option — seeing an allied health worker such as a physiotherapist can also help. Because many people with chronic pain experience a delayed diagnosis, Ellis said health workers must take pain symptoms seriously: “The earlier we can treat [chronic pain] the better the outcomes.”
At a broader level, Monash University professor of occupational rheumatology Karen Walker-Bone said more needs to be done to support women approaching midlife — including financial stability to retire when they want and emotional household labour shared equitably.
Questions readers ask about chronic pain in midlife
How common is chronic pain among middle-aged women? The IMS report estimates about half of all middle-aged women experience chronic pain, and women are up to 70 per cent more likely than men to experience it. Chronic pain is pain that lasts more than three months or keeps recurring.
Why do women experience more chronic pain than men? The exact reason is unknown. Jane Chalmers of the University of Adelaide said vulnerability is shaped by layered biological, psychological and social factors, and women often experience multiple overlapping syndromes such as fibromyalgia and chronic pelvic pain.
What can women do to reduce the severity of symptoms? Sharon Vasey of the RACGP advises speaking to a GP first, getting enough sleep, staying active and eating a healthy diet; menopausal hormone therapy and physiotherapy can help some women. Early treatment leads to better outcomes, according to Chronic Pain Australia’s Nicollette Ellis.
Looking ahead, Chronic Pain Australia’s 2026 National Pain Report — based on a survey of more than 6,000 Australians — shows women now report an average of 4.6 different chronic pain types, a figure that underscores how much remains to be addressed in diagnosis and treatment.
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