Why Your Body Hurts or Feels Different During Pregnancy, After Birth and Around Menopause, and When to See a Physiotherapist
Your body can feel different during pregnancy, after birth or around menopause, but a life stage alone cannot tell you why. When symptoms persist or affect movement and daily life, assessment can help clarify the appropriate next step.
⚠ Clinical Note
This article is for educational purposes only. It is based on current clinical practice guidelines and peer-reviewed research and is not a substitute for personalised medical advice, diagnosis, or treatment. If you are experiencing severe, sudden, or rapidly worsening symptoms - or symptoms described in this article as urgent - seek immediate medical attention. For all other concerns, consult a qualified healthcare professional before starting any exercise or treatment program.
Key Facts
✔ Pregnancy-related muscle and joint pain can affect the back, hips, legs, pelvic area or genitals, and may make movement difficult. [1]
✔ When there are no contraindications, Australian guidance supports physical activity during pregnancy and after birth, with modifications as pregnancy progresses. [2]
✔ Physical birth trauma can affect pelvic-floor muscles, the perineum, connective tissues, nerves or bones, and may contribute to pain, impaired mobility, incontinence or prolapse. [3]
✔ Structured pelvic-floor muscle training during pregnancy probably reduces urinary-incontinence risk in late pregnancy and slightly in the 3–6 months after birth, but later effects and treatment of established leakage are less certain. [4]
✔ In a 2026 meta-analysis of 37 observational studies involving 93,021 women, muscle or joint pain was reported by about 40% of premenopausal, 57% of perimenopausal and 59% of postmenopausal women. The studies were highly heterogeneous, so these figures do not identify the cause of an individual’s pain. [5]
30-Second Summary
Your body can feel different during pregnancy, after birth or around menopause, but a life stage alone cannot tell you why. When there are no contraindications, keep activity symptom-guided and adapted to your health status; seek assessment when symptoms persist, limit movement or daily life, or include pelvic-floor concerns. [1,2,3,4,5]
Introduction
Pregnancy, the months after birth, and the years around menopause can make familiar movements feel unfamiliar. You may notice pain, stiffness, weakness or less confidence without knowing whether to wait, adapt or ask someone to assess it. The difficult part is separating a change in circumstances from a problem that deserves attention.
This guide gives you a way to think about those changes without forcing them into one diagnosis. It explains possible contributors, recognisable symptoms, what activity and physiotherapy guidance can and cannot tell you, and when another health professional may be the better first contact. By the end, you should have clearer language for a conversation about what your body is experiencing.
What Is Happening When Your Body Feels Different?
There is no single explanation for pain or altered movement across these three stages. Pregnancy-related symptoms, physical effects of birth, and muscle or joint pain around menopause are different clinical contexts, even when the experience feels similar. [1,3,5,6]
The pelvic floor is a group of muscles at the base of the pelvis. It supports the pelvic organs and contributes to bladder control, bowel function, posture and sexual function. Injury or altered function in this area can therefore affect more than one part of daily life. [3]
During pregnancy, current guidance recognises pregnancy-related musculoskeletal symptoms. After birth, physical birth trauma may involve muscles, perineal tissue, connective tissue, nerves or bones. Around menopause, studies show that muscle and joint pain is common, but prevalence research cannot establish that menopause caused a particular person’s symptoms. [1,3,5,6]
That distinction matters. A life stage can help a clinician ask better questions, but it should not close down the assessment before other possible contributors have been considered. [5,6]
What May Be Contributing to the Change?
This is an illustrative case. A woman in her 30s develops pelvic and lower-back pain during pregnancy, then notices urine leakage and a dragging sensation after birth. Years later, another woman develops new muscle and joint pain during perimenopause. The word “pain” appears in both stories, but the clinical questions are different.
During pregnancy, symptoms may occur in the pelvis and lower back and may interfere with movement. The current Australian fact sheet describes these symptoms as common conditions that may be uncomfortable or severe, while encouraging people with persistent or severe symptoms to seek more detailed advice. [1]
After birth, a different set of contributors may need consideration. Physical birth trauma can involve the pelvic floor, perineum, connective tissues, nerves or bones. Not every injury leads to long-term dysfunction, but some people experience pain, impaired mobility, urinary or faecal incontinence, prolapse, bowel or sexual-function problems. [3]
Around menopause, the evidence is about association rather than a single proven mechanism. A 2020 review included 16 studies, 14 of them cross-sectional, and estimated high musculoskeletal-pain prevalence during perimenopause. Cross-sectional evidence can show that symptoms and life stage occur together; it cannot show that one caused the other in an individual. [6]
What Symptoms Might You Notice?
During pregnancy
You may notice muscle or joint pain in your back, hips, legs, pelvic area or genitals. The discomfort may be manageable, or severe enough to make moving around difficult. If the pain is persistent or severe, discuss it with your chosen healthcare provider rather than assuming it must simply be endured. [1]
When lower-back pain is the main concern, the lower-back pain guide covers that symptom in more detail. It is useful to keep the pregnancy context in view because activity advice and assessment may differ from a typical lower-back presentation. [1,2]
After birth
Symptoms after birth may include pelvic or lower-back pain, reduced mobility, urine or faecal leakage, a feeling of pressure or dragging in the pelvis, or symptoms of pelvic organ prolapse. Prolapse refers to pelvic organs moving down towards or beyond the vaginal opening when supporting tissues are affected. Bowel-emptying difficulty and pain with vaginal sex can also be relevant symptoms to mention. [3]
These symptoms do not follow one fixed timetable. The APA statement notes that some appear immediately after birth while others develop later, which is why a symptom that has persisted or newly appeared still deserves attention. [3]
Around menopause
Some women notice new or ongoing muscle or joint pain during perimenopause or after menopause. The pooled estimates are useful for showing symptom burden in populations, not for deciding whether an individual symptom is caused by menopause. [5,6]
If joint pain is accompanied by prominent morning stiffness or swelling, the joint pain and morning stiffness guide discusses patterns that may need medical assessment before rehabilitation. [5,6]
Treatment Options Depend on the Pattern
Assessment is the starting point because similar words can describe different problems. For pregnancy-related pelvis or lower-back pain, current Australian guidance lists exercise, physiotherapy and pelvic support belts or underwear among options, with extra healthcare advice when symptoms are persistent or severe. [1]
For women without contraindications, Australian physical-activity guidance supports activity during pregnancy and postpartum, modification as pregnancy progresses, pelvic-floor exercises, and shared decisions with health professionals. [2] WHO guidance also supports regular postpartum activity and a mixture of physical and muscle-strengthening activity. It does not recommend routine postpartum pelvic-floor training solely to prevent urinary or faecal incontinence in every woman. [7]
The evidence on pelvic-floor muscle training is narrower than the phrase “do pelvic-floor exercises” suggests. A Cochrane review of 46 trials involving 10,832 women found that antenatal training probably reduced urinary-incontinence risk in late pregnancy and slightly reduced risk in the 3–6-month postnatal period. It found little information beyond 12 months and uncertain effects when training was used to treat established incontinence. [4]
An umbrella review of nine systematic reviews, representing 89 original studies, reached a similar qualified conclusion. The strongest evidence supported antenatal exercise and pelvic-floor training for preventing postpartum urinary incontinence, moderate evidence supported reducing urinary-incontinence symptoms, and evidence for reducing prolapse symptoms was low certainty. [8] These findings support assessing pelvic-floor symptoms rather than managing them with a universal programme copied from someone else. [8]
After birth, the APA recommends a postnatal physiotherapy consultation around six weeks to assess possible injury and establish pelvic-floor and abdominal-wall rehabilitation. This is a reference point for assessment, not a deadline by which recovery must be complete; the statement also says ongoing symptoms may need access beyond the early postnatal period. [3]
Around menopause, international and Australasian guidance supports regular aerobic and resistance exercise for muscle, bone and physical function. The suggested amount is at least 150 minutes of moderate-intensity activity each week, with resistance exercise on two additional days, adjusted to fitness, symptoms and health status. [9,10]
RHECORE’s physiotherapy programme is designed with reference to the general principles outlined in the guideline cited below and does not guarantee any specific clinical outcome.
Self-Management: Small, Symptom-Guided Steps
If you are pregnant and have no contraindication to activity, current Australian guidance supports staying active and adjusting how you move as pregnancy progresses. If pain, a health concern or uncertainty about intensity affects what you do, shared decision-making with a health professional is appropriate. [2]
For pregnancy-related pelvis or lower-back pain, use the Australian Government guidance as a prompt to discuss exercise, physiotherapy or a pelvic support option with your provider. It specifically advises more detailed healthcare guidance when symptoms are persistent or severe. [1]
After birth, let your symptoms and advice from your maternity or health team guide the pace of activity rather than following someone else’s schedule. Leakage, pressure, pain or reduced mobility are reasons to seek individual assessment, particularly because universal pelvic-floor routines have uncertain benefits for preventing incontinence. [3,4,7]
Around menopause, use general activity guidance as a starting framework rather than a test you must pass immediately. Aerobic activity and resistance exercise are recommended in midlife, but the intensity and progression should reflect your current fitness, symptoms and health status. [9,10]
When to See a Physiotherapist
A physiotherapy assessment is worth considering when pain limits walking, lifting, exercise, work, sleep or other daily activities. Pregnancy-related pain that is persistent, severe or making movement difficult is also a reason to discuss the symptom with a healthcare provider. [1]
After birth, seek assessment for ongoing pelvic or lower-back pain, urine or faecal leakage, pelvic pressure or dragging, prolapse symptoms, bowel-emptying difficulty, pain with vaginal sex, or reduced mobility. These symptoms are recognised in the APA statement as possible effects of physical birth trauma, and they may arise immediately or later. [3]
Around menopause, a physiotherapist can assess new or persistent pain affecting movement or function. A doctor may be the more appropriate first contact when the overall pattern suggests a medical condition outside physiotherapy. Menopause-stage prevalence evidence should prompt a thoughtful assessment, not an automatic explanation. [5,6]
Seek immediate medical attention for severe, sudden or rapidly worsening symptoms, as stated in the Clinical Note. A physiotherapist can be part of the assessment pathway, but urgent symptoms should not wait for a routine appointment. [3]
Key Takeaways
✔ Treat pregnancy, the postnatal period and menopause as different contexts, not as one diagnosis. [1,3,5,6]
✔ Keep activity symptom-guided and adjust it to contraindications, health status, symptoms and current capacity. [2,5,7,9]
✔ Mention urine or faecal leakage, pelvic pressure, bowel or sexual-function changes, and reduced mobility rather than hoping they will resolve without discussion. [3]
✔ Seek assessment when pain persists, affects daily life, recurs, or leaves you unsure how to move or exercise safely. [1,3,5]
References
- Australian Government Department of Health and Disability and Ageing. Common conditions during pregnancy. Pregnancy, Birth and Baby. 2025.
- Brown WJ, Hayman M, Haakstad LAH, Lamerton T, Mena GP, Green A, Keating SE, Gomes GAO, Coombes JS, Mielke GI. Australian guidelines for physical activity in pregnancy and postpartum. Journal of Science and Medicine in Sport. 2022;25:511–519.
- Australian Physiotherapy Association. Physiotherapy and physical birth trauma. Australian Physiotherapy Association. 2025.
- Woodley SJ, Lawrenson P, Boyle R, Cody JD, Mørkved S, Kernohan A, Hay-Smith EJC. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews. 2020;5:CD007471.
- Kruse C, McKechnie T, Dworsky-Fried J, Sardar A, Hacker G, Rattansi S, Fang E, Sprague S, Shea AK, Bhandari M. Musculoskeletal manifestations of perimenopause: a systematic review and meta-analysis of 93,021 women. JBJS Open Access. 2026:e25.00254.
- Lu C-B, Liu P-F, Zhou Y-S, Meng F-C, Qiao T-Y, Yang X-J, Li X-Y, Xue Q, Xu H, Liu Y, Han Y, Zhang Y. Musculoskeletal pain during the menopausal transition: a systematic review and meta-analysis. Neural Plasticity. 2020;2020:8842110.
- World Health Organization. WHO recommendations on maternal and newborn care for a positive postnatal experience: executive summary. World Health Organization. 2022.
- Ryhtä I, Axelin A, Parisod H, Holopainen A, Hamari L. Effectiveness of exercise interventions on urinary incontinence and pelvic organ prolapse symptoms in pregnant and postpartum women: umbrella review and clinical guideline development. JBI Evidence Implementation. 2023;21:394–408.
- Panay N et al. International Menopause Society recommendations and key messages on women’s midlife health and menopause. International Menopause Society. 2025.
- Australasian Menopause Society. Maintaining your weight and health during and after menopause. Australasian Menopause Society. 2024.
Frequently Asked Questions
Physical changes and symptoms can occur during pregnancy, after birth and around menopause, but “normal” does not mean you should ignore problems affecting movement or daily function. The evidence describes different contexts and does not support diagnosing the cause from life stage alone. [1,3,5,6]
When there are no contraindications, guidance supports physical activity during pregnancy and postpartum, with adjustments as circumstances change. Pain, health concerns or uncertainty about intensity are reasons to discuss the activity with a health professional. [2,7]
Yes. Leakage, prolapse symptoms, pelvic pressure and pelvic pain can occur with birth-related pelvic-floor problems, and assessment can clarify whether physiotherapy or medical referral is appropriate. [3,8]
A review of menopausal-transition pain noted that many women had no significant MRI findings, but the review was mainly cross-sectional and could not explain each person’s symptoms. A clinical history and examination remain important when symptoms persist or affect function. [3,6]
Severe, sudden or rapidly worsening symptoms need immediate medical attention; persistent pain, movement problems and pelvic-floor symptoms can be assessed by a physiotherapist. The most appropriate pathway depends on the symptom pattern and whether medical or specialist input is also needed. [1,3,6]
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