Abstract Background A rising number of women will go through menopause while working. We aimed to examine the association of menopausal status with multisite pain and pain interfering with work ability. Methods We analysed cross sectional data collected in the Helsinki Health Study. Female full-time municipal employees aged 45, 50, 55 or 60 years and of at least normal weight were studied. Premenopausal group included 2420 and postmenopausal group 1364 participants. First, we examined the associations between menopausal status and multisite pain. Second, among those with pain (n = 1481), the association between menopausal status and change in work ability due to pain was studied. Age, health behaviour (including the use of hormone replacement therapy) and work-related factors were controlled for. Results Postmenopause was associated with multisite pain (OR 1,44; 95 % CI 1,11 − 1,87) as compared with premenopause. Postmenopause was also associated with a large change in self¬-perceived work ability caused by pain (OR 1,53; 95 % CI 1,01 − 2,32). Conclusions The results underline the importance of menopause to the experience of multisite pain and its contribution to the change in self¬-perceived work ability. Key messages This study adds evidence to the underresearched topic of menopause and work. Support for women in menopause and further attention in work issues of women in midlife are necessary.