Patients Playbook | Menopause Isn’t the End – It’s a New Performance Phase

Why Warrior Women need more than a yoga mat and a fan.

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This post is a guide only and should not be taken as medical advice. It does not replace assessment and recommendations from a registered and regulated healthcare professional.

Ask me 10 years ago if I’d be writing this article — as one of four boys, raised in a house where the word “menopause” was never even whispered — a male Physiotherapist writing to a female audience, running the very real risk of mansplaining how their female system work...

I’d slap myself in the face, punch myself in the nuts, and yell:
“STAY OUT OF IT!!!”

But frankly?
I’ve got a growing caseload of middle-aged Women, who are struggling to find understanding of this phase of life, and many of them are incredibly grateful that I’ve taken the time to understand menopause and perimenopause and is impact on their Musculoskeletal condition. But more importantly, that I can point them to the right people to help them thrive through it.

Why have I upskilled?
Because perimenopause and menopause are often major mediators in musculoskeletal conditions — things like tennis elbow, plantar fasciitis, gluteal tendinopathy, frozen shoulder, and persistent joint pain. I have to address it head-on on a daily/weekly basis, as part of setting expectations/prognosis for many of the above conditions.

So I’ve surrounded myself (by accident) with a brilliant group of Women — clinicians, researchers, and educators — who know this space better than anyone. I’ve learned from them, I’ve applied it in clinic, and now I want to make sure you can access the same support.

If you’re a patient of mine, this might just be your "further info" resource in case we’ve already had this chat in session.
If you’re a reader from the other side of the world — maybe even a paying subscriber — this is your no-BS introduction to Menopause and HRT.

Let’s get into it.

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The Hormonal Rollercoaster

Most people associate menopause with symptoms like hot flushes, brain fog, and disrupted sleep, but under the hood, there’s a whole cascade of musculoskeletal, metabolic, and cardiovascular changes going on.

📉 Bone density drops
📉 Muscle mass shrinks
📈 Injury risk increases
📉 Recovery slows down

This isn’t about vanity or "getting back to your old self." It’s about preserving strength, mobility, independence, and brain function for decades to come.

If you’re 45 and entering perimenopause, you're not winding down — you're just entering your next performance phase.

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What Doesn’t Work Anymore?

"Just go for walks."
"Do some gentle yoga."
"Cut back on food and exercise harder."

They don’t address the real physiological shifts happening during menopause, and they definitely don’t equip Women to thrive through it. In fact, these can backfire — increasing injury risk, losing more muscle, and worsening fatigue.

So what does work?

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🔒This is where the free preview ends. Paid subscribers now get access to the full post, including the clinical pearls, key takeaways, and practical recommendations.