@sarajaneho: In Chinese medicine, chronic lower back pain is often associated with Kidney deficiency because the Kidneys are closely connected to the lumbar region. And as we age, Kidney Yin naturally declines—which is one reason TCM may view new or worsening lower back pain during perimenopause and menopause through a Kidney-deficiency lens. I experienced this change myself. In my 20s, I had virtually no cramps or back pain—I could barely tell whether I was on my period. Then seemingly overnight, I started getting intense lower back pain right before my period. Dr. Suzanne added the Western medicine perspective: there’s also a hormonal and inflammatory explanation for why this can happen. When the uterine lining sheds during your period, inflammatory molecules are released. Depending on the position of your uterus and your individual anatomy, that inflammatory process can contribute to pain in the surrounding area. And during perimenopause, fluctuating and declining estrogen can make the musculoskeletal system more vulnerable to pain. We often think of estrogen in terms of periods, fertility, or hot flashes—but estrogen also plays an important role in our bones, joints, tendons, ligaments, and muscles. Researchers have even proposed the term “musculoskeletal syndrome of menopause” to describe the constellation of musculoskeletal changes associated with declining estrogen. Just as we talk about the genitourinary syndrome of menopause—the vaginal and urinary changes associated with estrogen loss—we need to talk more about what can happen to the rest of the body. It’s not only about increased bone fragility and fracture risk. Women may also experience more aches and pains, greater susceptibility to certain injuries, and changes in recovery during the menopause transition. So if your lower back or joints suddenly seem to hurt in perimenopause, it may not be as random as it feels. Listen to the episode “The Menopause Nobody Prepared You For — with Dr. Suzanne Gilberg” on my podcast HOT WATER

Sara Jane Ho

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Friday 21 August 2026 22:25:28 GMT