Simple Solutions for Menopause Joint Pain 

You haven’t injured yourself. Nor are you over-exercising. So why, suddenly, can you not sit through your niece’s middle school performance of Shrek: The Musical without your hips aching so much that you need to get up and stretch? Come to think of it your knees aren’t exactly Salsa-ready, either. And that sound you hear is you, making those old-lady grunt-y noises of relief when you take a load off. Blame the joint pain that’s a common symptom of menopause. 

About the Experts

Jim Staheli, D.O. is the medical director of Broad Health, and a family medicine doctor in Atlanta. His areas of expertise include hormone health, metabolic and nutritional medicine, anti-aging, and functional medicine.

Julie Holland, M.D., is a psychiatrist and psychopharmacologist in private practice in New York City. She is the author of Moody Bitches: The Truth About the Drugs You’re Taking, The Sleep You’re Missing, the Sex You’re Not Having, and What’s Really Making You Crazy.

Menopause and Joint Pain

The menopause transition is one long lesson in learning how much estrogen means to your body. During your reproductive years, your ovaries produce the hormone, which optimizes hundreds of functions and activities in your body. As you age, your estrogen levels decline, which can cause symptoms like stiffness, tenderness, loss of flexibility, grating sensations, numbness, swelling, and pain in your hips, knees, and other joints. In short, ouch. 

Until recently, evidence that estrogen had much to do with joint function was slim. “However, ongoing research shows a positive estrogen influence on joint tissue — bone, synovial lining, muscles, and ligaments—which can lead to a reduction of inflammation and pain,” says James Staheli, D.O., the medical director of Broad Health, Hone’s affiliated practice,  and a family medicine doctor in Atlanta. 

Women appear to have more musculoskeletal symptoms starting in perimenopause, and as estrogen declines, it may get worse (1). “Current studies show that osteoarthritis —one of the main causes of arthritic pain in menopause — is related to lower levels of estrogen…and increases around the peak time of menopausal age,” Staheli says. This is different than, but can be in addition to, osteoporosis, which is a deterioration of the bone structure.

So that’s nice for us. Hip pain in menopause (and general menopause joint pain) appears to be more common the older and heavier you are, and among folks who’ve had previous joint injuries. Also, as with so many things, genetics plays a role. If your mom was constantly icing her knees and elevating her ankles, odds are you’ll be sitting there with a bag of frozen peas as well. 

What Does Menopause Joint Pain Feel Like?

Julie Holland, M.D., a psychiatrist and psychopharmacologist in private practice in New York City and author of Moody Bitches: The Truth About the Drugs You’re Taking, The Sleep You’re Missing, the Sex You’re Not Having, and What’s Really Making You Crazy, laughs ruefully when asked this question. “I was in a yoga class in early perimenopause, and I noticed that every time I did a twist, I could hear every single vertebra in my spine click. I’d never had that before. Overnight I became someone with clicky joints!” 

Her and countless other yoginis. Over half of women report joint pain around the time of menopause, research shows. Conditions like osteoarthritis often show up at this time too, making how much joint pain is estrogen-related hard to parse (2). 

Sore joints, stiffness, pain upon getting up from a chair – these symptoms can come on quickly. “I got tennis elbow, my knee hurt after a short hike, I got a groin pull getting out of my car — what are all these old people injuries!?” Holland laughs. “I’d do a little lunge in pickleball and whoa, pain!” 

Common Areas Affected by Menopause Joint Pain

If you’re feeling stiffness and general unpleasant vibes from these areas of the body, it might be associated with hormone changes during perimenopause:

• Neck
• Shoulders
• Jaw
• Elbows
• Wrists
• Fingers
• Knee
• Hips

Is My Joint Pain from Menopause or Something Else?

The best way to distinguish joint pain in menopause from another joint condition is, of course, to see your doctor. She may give you some tests, perform some imaging, or refer you to a specialist, such as an orthopedist. “A simple x-ray can diagnose arthritis,” Holland says, and an exam can point to inflammation or bursitis, for example. 

Estrogen and Joint Pain

Joint pain can also just be a factor of aging, perhaps made worse by the loss of estrogen in perimenopause. “It could be that you had inflammation before, when you were younger, and didn’t notice it, because of estrogen,” Holland says. “Estrogen helps oxytocin work better, and oxytocin helps in wound healing.” 

In other words, estrogen has a beneficial anti-inflammatory function, and as it recedes, our bodies can’t repair themselves the way they used to. It’s also possible, Holland says, that we process pain differently as we age. We just don’t know, because even though menopause affects half the world’s population, it remains woefully understudied, she says.  

Testosterone and arthritis in women

Estrogen isn’t the only hormone that fluctuates during the menopause transition. Your testosterone levels take a hit, too. What’s that got to do with joint health, you ask?

Data from the National Health and Nutrition Examination Survey suggests that low testosterone may be linked to greater arthritis risk, especially for women and people with obesity. However, researchers note that this link doesn’t necessarily confirm that low testosterone causes joint pain.

Bone health and joint health

Your bone and joint health are closely linked. Bone turnover or “remodeling”—the process in which your bone reabsorbs old bone and creates new bone—speeds up during menopause.

Getting new bones sounds like it would be a good thing, right? Sorry to burst your bubble, but increased bone turnover can lead to bone loss as your body reabsorbs bone faster than it can create new (6). This can lead to weaker bones and may impact your joints, too.

Increased bone absorption often goes hand in hand with some skeletal pain, too, which could be the source of your menopause aches (7).

MORE MENOPAUSE

What Causes Brain Fog in Menopause—And What Helps? 

8 Signs You Might Need Menopause Hormone Therapy

Menopause Joint Pain Relief

So what can you do about hip pain during menopause or any other joint pain? 

Essentially the same things that help with joint pain when you’re not in perimenopause. Namely, ice, heat, creams and ointments containing analgesics, and stretching and exercise to strengthen your muscles to support your joints better.

Holland, now in her late 50s, shares her own treatment regimen: “I started taking CBD internally and using it topically, covering my knee and elbow with it.” There is no good data to say whether CBD works, but it’s generally considered safe to try, says Holland, and some people swear by it: One study found that CBD users do find that it helps with pain and function (3) Holland also recommends drinking lots of water. “Keep your whole body lubricated; that helps,” Holland says. 

The biggest thing is to keep moving. “If you stop moving, things wind up hurting more when you do,” says Holland. “For me, bikram yoga and hot yoga help. Cardio helps. Black cohosh, taken as a supplement, helps me, but check with your doctor first.” Many people use black cohosh for menopausal symptoms, but there’s mixed evidence that it helps and no solid evidence to support it for joint pain. (4)

Talk to your doctor before taking any supplements, and be sure you’re buying a reputable brand with a third-party testing logo on the label since supplements are not well-regulated. Some dietary supplements have been found to contain unsafe levels of hormones. And even “natural” remedies can interact with other medicines you’re taking for other conditions you may have. 

Does Menopause Joint Pain Go Away?

Your joint pain may not go away entirely, because there are so many factors involved and osteoarthritis is common as we age. But there is a ton you can do to reduce and relieve your pain. And if you keep moving, you can strengthen your muscles so that your joints are better supported. 

Staheli recommends a panoply of options for treating menopause joint pain:

Heat or ice

Heat works dilates blood vessels so more oxygen and nutrients can get to the painful area, speeding healing and relief. Use a heating pad or take a warm bath. Cold is better for acute pain, as it does the opposite, numbing the area and slowing inflammation.

Low-impact exercise

Think walking or swimming or gentle stretching. Movement replenishes lubrication to the joint, easing stiffness and pain.

Physical therapy

PT is designed to stabilize the muscles that support your joints and improve joint mobility.

An anti-inflammatory diet

The Mediterranean Diet—heavy in fish, olive oil, fruits and veggies, whole grains, nuts, and seeds—is especially helpful in reducing joint pain and inflammation. Avoid fried foods, sugar, and ultra-processed foods, which contribute to inflammation.

OTC pain meds

Acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can ease joint pain. Stick with the recommended dosages; NSAIDs can cause stomach issues, even at normal doses, and taking too much can lead to kidney issues, high blood pressure, or other problems. If you are taking them regularly, talk to your doctor about other ways to manage your pain.

Supplements

These supplements have some research behind them, although some of it is inconclusive or extremely preliminary. 

• Glucosamine 
• Chondroitin 
• Omega 3 Fatty Acids 
• Boswellia 
• Turmeric 
• B3 (Niacinamide) 
• Collagen
• SAM-e

Hormone replacement therapy (HRT)

The jury is out on whether hormone therapy helps with joint pain specifically, but estrogen’s anti-inflammatory properties may help soothe discomfort.

One study in the journal Menopause found that women who took estrogen-based HRT for a year had less joint pain compared to the placebo group (5). However, the women who took estrogen had more joint swelling.

When to See a Doctor

If your joint pain or stiffness doesn’t go away during the menopause years and is interfering with your daily life activities, absolutely make an appointment with your physician. After you’ve exhausted all more conservative options, you can explore things like joint injections and surgery, if there is damage to the joint.