Before you think that the PMS joint aches mean you’re ovulating even though you’re postmenopausal, there’s a more probable explanation.

You’re postmenopausal but one day awaken feeling like you’re about to have a period, due to the familiar joint aches you used to have as part of PMS: premenstrual syndrome.

This happened to me. I was four months out from completing menopause, with a fsh value (taken nine months into menopause) having been over 100, yet (four months out after completion) I awakened feeling the exact same way I’ve always felt just prior to a period.

This can’t be, I thought. The next day the joint aches of what seemed like PMS were back, this time with a pelvic cramp. I felt very “hormonal.”

If this has been happening to you, hold off on spending hours googling whether or not a younger postmenopausal woman can actually ovulate.

The more likely explanation is that you have early signs of an inflammatory bowel disease, or a flare-up of an IBD that you’ve already been diagnosed with.

Yes, that’s right: inflammatory bowel disease. IBDs can cause “extra-intestinal” symptoms.

Though joint aches seem so far removed from a colon disease, it’s well-documented in medical literature that the following IBDs are associated with joint pain or aches: Crohn’s disease, ulcerative colitis and microscopic colitis.

When, after a few weeks of feeling like I was going to get my period any day, I still didn’t start spotting, I abandoned the idea that my ovaries wanted one last hurrah.

However, early on into the “PMS” joint aches (low back, ankles, wrists, occasionally neck, and also upper leg aches), I several times wondered if this could be a flare-up of my own inflammatory bowel disease: microscopic colitis (which I had been diagnosed with three and a half years prior, though back then, the first-time bout lasted only two months).

The kink in the chain was that I was not experiencing any of MC’s diarrhea. “WHERE’S the diarrhea?!” I kept asking myself.

If this “hormonal” feelings IS microscopic colitis, wasn’t there supposed to be diarrhea with it?

I couldn’t find information about this online: “Can joint aches precede the diarrhea in a microscopic colitis flare-up?”

On Day 27 of the mysterious PMS feeling like I was going to have a period, the diarrhea finally came !!


The differential diagnosis at that point was celiac disease!

A few weeks into this situation, I had seen a gynecologist, and exams ruled out a gynecological cause, even though it felt so much like a period was coming.

My extensive online research into rheumatic disease ruled out another strong differential, psoriatic arthritis (which my brother has). Psoriatic arthritis does not cause pelvic or abdominal cramping.

Ironically, my first flare of microscopic colitis was accompanied by considerable joint aches, which was why I had suspected MC for the postmenopausal PMS feeling, but again, my suspicion had been weak because there hadn’t been any diarrhea.

Until Day 27. A few days later the joint aches subsided considerably. Check the second last link below; one of the very few sites that I found that clearly states that arthralgia can PREcede gut symptoms.

The precession can actually last a few years before an inflammatory bowel disease begins manifesting digestive symptoms.

If you’re postmenopausal and suddenly feel like you’re going to have a period, you may actually have a period, but this is exceedingly rare.

My gynecological nurse told me she’s had a handful of patients over the years, postmenopausal, experience ovulation that was confirmed via testing.

If a gynecological explanation for your symptoms is ruled out, consider that this is your first revelation of inflammatory bowel disease.

There is no test that confirms that arthralgia is caused by IBD (“enteropathic arthropathy”).

However, this is the conclusion by savvy doctors after other causes (such as rheumatological arthritis and celiac disease) are ruled out with testing.

Treatment of the “PMS” joint aches or feeling you’re going to have a period involves direct treatment of the inflamed colon.

The reason these symptoms feel like you’re going to have a period is because they involve the same hormones (prostaglandins) as does PMS.

“Aching joints can be a symptom of microscopic colitis, but not necessarily. Many patients with aching joints don’t have microscopic colitis, but aching joints and gut problems often go hand-in-hand. They’re both associated with inflammation, and many doctors speculate that cyclo-oxygenase (COX 2) or prostaglandins are involved because of the function they provide. Prostaglandins are chemicals that generally cause inflammation of our joints.”

– Dr. Jeffrey Fine, MD, the chief of gastroenterology at the Medical Surgical Clinic of Irving, from an interview for another article of mine, Why Does Microscopic Colitis Cause Joint Pain?

Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  
Sources: (prostaglandins and MC) (prostaglandins and MC) (prostaglandins and PMS) (prostaglandins and IBD) (flare-up of joint aches can occur separate from gut problem flare-ups)