Hip Pain in Menopause? Here’s What Doctors Want You to Know

It’s easy to write off aches and pains as inevitable signs of aging, but for many women in menopause, hip pain is a treatable condition related to declines in estrogen.

“When estrogen decreases, the hip can get angry or inflamed,” says orthopedic surgeon Pamela Mehta, M.D. “Not only do you have pain, but you also have a decreased range of motion.”

A 2024 study found that more than 70 percent of women experience musculoskeletal pain—including hip pain—during the perimenopause to postmenopause transition. ¹

Fortunately, experts say relief from menopause hip pain is possible with the right diagnosis and treatment plan.

About the Experts

Anthony Giuffrida, M.D., is a pain management specialist at Cantor Spine Center in Fort Lauderdale, Florida, who works with women experiencing menopause hip pain.

Pamela Mehta, M.D., is an orthopedic surgeon at Resilience Orthopedics in San Jose, California, where she treats joint arthritis, sports injuries, and hip joint pain related to menopause.

The Link Between Menopause, Estrogen, and Hip Pain

During menopause, declining estrogen decreases bone density and increases inflammation, contributing to pain in the hips and other joints. ^{2 3}

The most common types of menopause hip pain associated with low estrogen include:

• Osteoarthritis: A joint disease caused by worn-down cartilage
• Bursitis: An inflammatory condition in the joints, muscles, and tendons
• Gluteal tendinopathy: Pain in the outer hip caused by inflamed glute muscles ^{4 5}

Tissues throughout the musculoskeletal system have estrogen receptors, including bone cells, muscle fibers, and connective tissues. When estrogen dips, the muscles, bones, and connective tissues in the hip may be affected, which can create pain in these areas:

• Hip capsule, a bone structure that helps control the range of motion
• Cartilage tissue that ensures smooth motions
• Tendons, bands of tissue that connect muscles and bones
• Bursae, fluid-filled sacs that cushion the hip and facilitate smooth movements
• Gluteal muscles, which provide the strength to move the hip

When inflammation is regulated, these muscles, bursae, and joints move smoothly and without pain. Less estrogen means more inflammation and less calcium signaling, the process by which cells use calcium ions to transmit signals and regulate key functions, resulting in hip stiffness and limited mobility, says Giuffrida.

Estrogen is also essential for bone density. Dense bones don’t break or fracture as often, similar to how a well-made bookshelf can carry more books than one made of flimsy materials. During perimenopause, women have a 10 percent decrease in bone mineral density on average, which may lead to more hip fractures. ⁶

Menopausal Bursitis

Declines in estrogen can lead to menopausal bursitis, a painful inflammation of the small, fluid-filled sacs (bursae) that cushion the hip joint.

Bursitis happens when one or multiple bursae are under prolonged pressure from an injury, repetitive movements, or inflammation ⁷. The pressure causes the cushiony sacs to become swollen and tender, making it difficult or painful to move nearby hip tendons, joints, and muscles. ⁸

Decreasing estrogen during menopause leads to more inflammation in the tissues, meaning your weekly jogs or lying on your hip is more likely to result in bursitis. ⁹

Since bursae are scattered throughout the body, menopausal bursitis can occur in the shoulders, knees, ankles, and other areas. However, a large concentration of bursae are in the hip, making it a prime spot for bursitis.

Menopausal bursitis symptoms

The main symptom of menopausal bursitis is pain on the outside of the hip, especially after standing or walking for long periods. You may also experience stiffness, swelling, tenderness, or warmth around the hip. Bursitis usually causes pain when you’re moving, not at rest. ¹⁰

Unfortunately, this kind of pain may be a vicious cycle. Research suggests that bursitis and other musculoskeletal pain during menopause are linked to higher levels of anxiety, depression, and insomnia. And women with insomnia are more likely to experience more pain, as well as other menopause symptoms such as hot flashes and night sweats. ¹¹

Gluteal Tendinopathy in Menopause

Around 23 percent of women of menopause age develop gluteal tendinopathy, a condition where tendons in the hip and buttocks weaken and become inflamed, causing outer hip pain. ¹²

Without sufficient estrogen, the body produces less insulin-like growth factor 1 (IGF-1), a hormone crucial to muscle growth. When there’s less IGF-1, gluteal muscles can weaken. While gluteal tendinopathy in menopause can be caused by this decline in estrogen, it’s also just as likely to be from age-related wear and tear, Mehta says.

Gluteal tendinopathy impacts a large area from the outer hip into the iliotibial (IT) band, a tendon running down the side of the thigh, so the condition is sometimes mistaken for IT band issues or hip bursitis. The difference? Gluteal tendinopathy stems from weakness in the glutes, not the hip or the IT band. It can be tricky to differentiate, so getting the right diagnosis from a doctor is crucial.

When gluteal tendinopathy is chronic, this type of hip pain is called greater trochanteric pain syndrome. This syndrome is most common in postmenopausal women. ¹³

What gluteal tendinopathy feels like

Gluteal tendinopathy in menopause can start with a sharp pain in the outer hip that eventually settles into a dull ache. It causes difficulty walking, a clicking sensation when moving the hip, joint stiffness, and warmth or swelling in the hip. Many people with this condition find themselves walking with a limp. In severe cases, it can also lead to urinary or bowel function disruptions. ¹⁴

Often, gluteal tendinopathy is made worse by walking up stairs, getting out of a chair or bed, or sudden movements. Unlike bursitis, this pain doesn’t disappear when resting.

Treating Menopause Hip Pain

Treatment for menopause hip pain can include:

• Estrogen replacement therapy
• Physical therapy to strengthen hip muscles
• Anti-inflammatory medication for pain and swelling
• Strength exercises for bone density
• Corticosteroid injections

Combination approaches often work best for menopause hip pain, especially if the pain has multiple causes.

Menopause hip pain stretches and exercises

Certain stretches and exercises can relieve menopause hip pain. “We often think if a joint hurts, we should rest it, and that’s the wrong move,” says Mehta. “The right move is to start a good routine involving range of motion, stretching, and strengthening that joint.”

Giuffrida and Mehta often recommend these stretches for menopausal hip pain (do them on both sides to prevent muscle imbalances):

• Hip flexor stretch: Kneel on one knee with the other foot in front, then gently push your hips forward to stretch the front of the hip. Hold this pose for about 15 seconds; then switch to the other leg.
• Runner’s lunge: Start in a plank position. Pull one foot forward so the heel of the foot aligns with your hands, and lean forward. Hold for about 20 seconds; then switch sides. “It really opens up the hips,” says Mehta.
• Figure-four stretch: Lie on your back with the right leg straight and the left knee bent. Take your right ankle and cross it over the left knee. Pull the left knee toward your leg, creating a stretch in the glutes and hips. Hold for about 15 seconds; then switch to the other side.
• Standing quad stretch: While standing, grab one ankle and pull it toward the glute on the same side. Hold for about 15 seconds before switching sides. Place your hand on the wall for balance as needed.

Strengthening muscles with targeted resistance training (i.e., bodyweight or weighted exercises) can also improve hip function and mobility while decreasing pain over time. ¹⁵ A personal trainer or physical therapist can help you identify which exercises and level of resistance will help you strengthen the hip without causing flare-ups.

Dietary changes

A high body mass index (BMI) is a risk factor for many types of hip pain and can worsen osteoarthritis symptoms in the hips. ¹⁶ More fat deep in the abdomen—known as visceral fat or “menopause belly”—can also increase inflammation throughout the body, increasing the risk of hip pain and osteoarthritis. ¹⁷ A diet high in deep-fried foods, packaged snacks, processed meats, and added sugar can also increase inflammation.

Making some changes to your diet may help reduce inflammation. The essentials of an anti-inflammatory perimenopause diet include:

• Anti-inflammatory foods, like leafy greens, almonds, salmon, blueberries, and oranges
• High-fiber foods, such as vegetables, beans, apples, and lentils
• Healthy protein, like cottage cheese, turkey, chicken, tofu, and eggs
• Magnesium-rich foods, such as dark chocolate, legumes, and whole grains
• Iron-rich foods, like lean red meat, spinach, and fish

Physical therapy

Research suggests that no matter the cause of menopause hip pain, physical therapy can improve mobility and decrease discomfort. ¹⁸ “I always recommend physical therapy as a first-line treatment,” says Mehta, who adds that a physical therapist can help you find the movement that works best for your lifestyle and pain severity.

Limit certain activities

Most women with menopause hip pain will benefit from limiting high-impact activities, sitting less, and adjusting how they sleep.

• Limit high-impact workouts: “Activities with high impact, like running or jumping, can make hip pain worse,” explains Giuffrida.
• Take breaks from your work station: Sitting or standing for 30 or more minutes without breaks can increase hip pain and stiffness.
• Switch up your side-sleeping position: You don’t need to sleep on your back—just place a pillow or bolster between the knees. That will release tension in the hip of the leg that’s resting on top of the pillow. “Sleeping on your side without support under or between your knees may aggravate hip pain,” says Giuffrida.

Medications

If menopause hip pain persists, medication may help. The most commonly used medications for hip pain:

• OTC anti-inflammatory medications: Ibuprofen, naproxen, and other over-the-counter anti-inflammatories are an accessible option, especially during flare-ups
• Steroid injections: In some cases, a corticosteroid injection into the hip bursa can bring longer-lasting relief, says Giuffrida.
• Muscle relaxants: If muscle tension is part of the problem, a short course of muscle relaxants may help.

HRT

Replacing lost estrogen through hormone replacement therapy (HRT) may reduce menopause hip pain from bursitis and tendinopathy. A randomized, controlled study of 10,000 menopausal women found that estrogen replacement modestly reduced joint pain frequency and severity ¹⁹.

Another study found that postmenopausal women with gluteal tendinopathy experienced less hip pain and better hip mobility after HRT. ²⁰ HRT also reduces the risk of osteoporosis, a condition that increases the risk of hip fractures and hip pain.

“Hip pain related to menopause occurs because there’s a decrease in estrogen,” says Mehta. “If you’re replacing the estrogen, then you’re going to have less of this pain.”

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About the author

Angela Myers is a health writer, award-winning health communications researcher, and digital marketing consultant for health companies. She covers healthy aging, women's health, and mental health for outlets including Forbes, AARP, and Well+Good, among others.

About the reviewer

Carol Lynn, MD is a board-certified OB/GYN who specializes in menopause management. She is a member of the American Board of OB/GYN (ABOG) and the North American Menopause Society (NAMS).