Menopause and Joint Pain: What’s the Connection?

You may anticipate hot flashes and mood swings during menopause. But arthralgia (joint pain) is a common symptom that you might not expect. Changing hormones and other factors play a role in causing joint pain, muscle aches, and stiffness. Luckily, there are things you can do to help.

Menopause is a normal part of aging. It’s when your body gradually produces fewer hormones and your ovaries eventually stop releasing eggs. Most women go through menopause between the ages of 45 to 56. It naturally occurs in stages, starting with perimenopause. Perimenopause is when the hormones start to decline, and symptoms start. You’re in menopause when you haven’t had a menstrual cycle for 12 consecutive months. 

Along with joint pain, other symptoms of menopause include hot flashes, irregular periods, mood changes, and difficulty sleeping. Joint pain affects over 50% of women. It may affect your hands, knees, hips, or back.

Why does menopause cause joint pain?

Hormones play a significant role in causing joint pain. But other factors contribute to menopause joint pain as well. 

Let's explore some reasons why menopause can lead to achy joints.

Hormonal changes 

Many hormone changes occur during menopause that affect joint health. Lower estrogen levels are the main culprit. Estrogen reduces inflammation and protects and promotes joint cartilage growth. It also protects muscles and bones, as well as tendons and ligaments.

As estrogen levels decline during menopause, it can result in:

• Joint pain

• Muscle aches

• Stiffness 

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• Joint pain can have many different causes. Here are a few common reasons you may have swelling or stiffness in your joints.

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• Is your medication causing your joint pain? It’s possible. These common medications are linked to joint pain.

Progesterone is another hormone that decreases during menopause. Experts say this hormone helps protect the cartilage in your joints and maintain bone strength. This drop in progesterone can lead to joint pain and arthritis. 

Also, testosterone levels naturally decline with age. This can contribute to decreased bone and muscle strength. This loss may increase the risk of joint pain and injury.

Bone and muscle loss

Declining hormone levels also affect bone density, which can lead to osteoporosis. This can cause joint pain and increase your risk of fractures. 

Your muscles are also affected by lower levels of:

• Estrogen

• Progesterone

• Testosterone

This can cause decreased muscle mass and strength, which is also called sarcopenia. Reduced bone and muscle strength can leave joints vulnerable and at risk for pain and injury. 

Weight gain and water retention 

Weight gain is common during menopause due to aging, slower metabolism, and hormone fluctuations. 

Changing hormones can also cause increased:

• Weight around your midsection

• Bloating

• Water retention

This extra weight puts added stress on your joints and can result in pain and muscle aches. 

Inflammatory conditions 

Estrogen helps reduce inflammation in your:

• Joints

• Muscles

• Bones

• Soft tissue 

As estrogen declines during menopause, it can cause an increase in inflammatory conditions. This includes osteoarthritis, which causes joint pain. 

You may also be more likely to get tendonitis, which is an injury to your muscle tendons. This can cause pain and stiffness in your:

• Shoulders

• Knees

• Ankles

Some researchers found that menopause may also increase the progression of rheumatoid arthritis (RA), but more research is needed. Rheumatoid arthritis is an autoimmune disease that causes symptoms in the joints like:

• Pain

• Swelling

• Stiffness 

Lifestyle factors

Inactivity and lack of exercise can also cause joint stiffness and pain. Menopause can also cause sleep disruptions, which is linked to an increase in pain symptoms. 

Mental health factors

Anxiety, depression, and other mental health symptoms are also common in menopause. People with depression or anxiety in menopause tend to report more joint and muscle pain. 

How do you treat joint pain from menopause?

Menopause is a natural part of life, and there are several ways to handle the symptoms. With the right approach, you can make this transition smoother and healthier. 

Exercise

Exercise regularly to build muscle strength, bone density, and flexibility. Exercise also helps you manage your weight and protect your joints. Experts suggest a mix of:

• Aerobic activity

• Strength training

• Stretching

• Balance exercises

Aim for 150 minutes of moderate aerobic activity weekly, and strength training 3 times a week. 

High-impact exercises can help build bone mass. This includes:

• Running

• Jumping rope

• Climbing stairs

Make sure to talk with a healthcare professional before doing these high-impact activities if you have osteoporosis.

If you’re looking for low-impact exercises, these are good alternatives: 

• Walking

• Swimming

• Yoga

• Pilates 

Wearing a weighted vest while walking can also help strengthen bones and muscles.

Anti-inflammatory foods

Adding anti-inflammatory foods to your diet may help with joint pain. 

Anti-inflammatory foods to consider include:

• Fruits

• Vegetables

• Nuts

• Fish

The Mediterranean diet is a good option to try, since it has many health benefits, including keeping inflammation low. 

Hydration

Drinking water and staying hydrated may help treat joint pain and stiffness. Avoid sugary drinks or too much alcohol. Sip on water, tea, and sparkling water throughout the day whenever you get thirsty. You should also increase your water intake after exercise or when it’s hot outside.

Over-the-counter pain relievers

Over-the-counter (OTC) pain relievers can help with joint pain and inflammation. Common medications to try include:

• Ibuprofen (Motrin)

• Acetaminophen (Tylenol)

• Naproxen (Aleve) 

But you should only take them for a short time. If you feel like you need long-term pain management, talk with a healthcare professional for more guidance. 

Supplements

Menopause supplements are a popular choice for managing menopause symptoms. Although many people find them helpful, not all supplements have the research to back them up. Make sure you talk to a healthcare professional to see which ones are right for you. 

Some supplements that may help prevent or treat joint pain include:

• Turmeric

• Fish oil or omega-3

• Vitamin D

• Glucosamine

• Collagen

• Creatine 

Consider menopausal hormone therapy

New research shows that, for many people, the benefits of menopausal hormone therapy — also known as hormone replacement therapy (HRT) — are greater than the risks. HRT may help improve bone density. When combined with exercise, HRT may help prevent the loss of muscle. Both of these factors can help keep your joints healthy and pain-free. HRT does have risks, so talk to a healthcare professional to see if it’s an option for you.

Use heat or cold therapy

Using a heat pad or ice pack at home is an easy way to help with joint and muscle pain. A cold pack helps with newer injuries by decreasing pain and inflammation. Heating packs are useful for chronic pain. Heat helps increase circulation and promote healing.

Practice stress management

Finding a stress management technique that works for you is important. Some ideas include:

• Walking in nature

• Getting a massage

• Practicing deep breathing

• Talking to a therapist

When should you see a doctor about joint pain from menopause?

If your joint pain is worsening and interfering with your daily activities, you should talk to a healthcare professional for treatment options. You should also make an appointment if you notice:

• Sudden swelling

• Numbness

• Stiffness

• Sharp pain

Joint pain can be caused by other conditions besides menopause, so it’s important to get an accurate diagnosis. 

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Written by:

Kim Grundy, PT

Kim Grundy, PT, is a licensed physical therapist and an experienced writer and editor. She worked at an outpatient orthopedic facility, where she treated patients with chronic conditions and post-surgical athletes working towards recovery.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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