Why You Get More Aches and Pains Around Ovulation and Menstruation
A Perfectly Human Physiotherapy Guide - Holistic Physiotherapy Freshwater.
Many women notice that their body feels very different at certain stages of their cycle. You might feel strong and stable during one week and sore, tight or inflamed the next. These changes are not random. They are driven by the natural hormonal shifts that influence your fascia, collagen production, joint stability and pain sensitivity.
Understanding what happens inside your body during ovulation and menstruation helps you make sense of your symptoms and gives you clarity about what kind of movement, treatment or recovery your body needs.
Fascia Rebuilds Twice Every Month
Women’s fascia undergoes two significant periods of rebuilding. One occurs around ovulation and the other during menstruation. Even though fascia is always adapting, these two windows create noticeable changes in the way your tissues feel. The reason is that collagen production fluctuates in response to hormonal levels, influencing stiffness, elasticity, hydration and overall tissue resilience.
These shifts explain why some people feel stronger and more stable during mid-cycle, while others feel looser or more sensitive. It also explains why pain can increase at the end of the cycle when hormones are naturally at their lowest.
What Happens During Ovulation
Oestrogen rises sharply in the days leading into ovulation. Elevated oestrogen increases the production of collagen types 1 and 3. Collagen strengthens fascia, tendons and ligaments and improves their elasticity. Many women notice better skin tone, improved suppleness and a general feeling of structural support during this time.
For some people this increased elasticity can reduce pain. For others, particularly those who are hypermobile, tissues may become too elastic and create feelings of instability or irritation. This can lead to more aches or discomfort around ovulation, especially in load-bearing areas such as the hips, pelvis, lower back and knees.
When tissues are well hydrated and collagen rich, healing also tends to occur faster. This is why strength work, tendon loading and stability exercises often feel easier and are well tolerated during the ovulatory phase.
Luteal Phase into Menstruation
After ovulation both progesterone and oestrogen begin to fall. Lower hormone levels reduce collagen production. Fascia becomes less hydrated and tissues lose some of their elasticity and strength. Many women describe feeling tight, inflamed, heavy or less flexible during this phase.
When collagen is low, tendons, ligaments and joints can feel weaker or irritated. Small movements can create discomfort that is not present during the mid-cycle window. People who are usually flexible may suddenly feel restricted. People who normally feel strong often report a sense of vulnerability or internal tension.
During this phase tissue healing is slower. The body is less responsive to high load and more sensitive to compression, stretching or sudden directional change.
Why Aches and Pains Increase Around the Cycle
Pain during ovulation and menstruation is most often linked to four key physiological factors.
Rapid hormonal changes that alter tissue hydration and stiffness
Fluctuating collagen levels that influence fascia and tendon behaviour
Changes in joint stability in hypermobile or structurally sensitive individuals
Variations in nervous system sensitivity influenced by the menstrual cycle
These patterns are normal. They do not necessarily reflect injury. They reflect a body that is continuously adapting to hormonal cycles.
How to Support Your Body During Each Phase
Your treatment and training approach should shift depending on the hormonal environment your tissues are in.
During Ovulation
Focus on movements that use the natural increase in collagen and elasticity.
Stability training
Tendon loading
Postural activation
Strength and performance sessions
Your body is primed for quicker healing and better tolerance to load.
During the Luteal Phase and Menstruation
Focus on reducing tension and supporting slower tissue repair.
Gentle stretching
Soft tissue release
Restorative mobility
Lower load strength or stability work
The priority is easing stiffness and supporting hydration of fascia.
What This Means for Physiotherapy and Training
Your cycle influences how your body responds to treatment, movement and stress. When physio, rehab or strength work aligns with the hormonal environment of your cycle, your results improve. Pain reduces faster, tissues respond better and your overall sense of wellbeing and control increases.
At Perfectly Human Physiotherapy we assess your symptoms through a holistic lens that includes hormonal fluctuations, fascia behaviour, nervous system tone and the biomechanics of your daily life. Your body is never wrong. It is always adapting intelligently to its internal environment.
Understanding your cycle is one of the most powerful ways to understand your pain patterns and reclaim trust in your body.