Managing perimenopause joint pain: Effective treatments and relief strategies
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Created with Nataliia Yermolovych, MD, Obstetrician-Gynecologist
Joint pain is a common complaint for perimenopausal women due to decreasing estrogen levels. Luckily, there are many strategies to help manage this symptom. Physical therapy, painkillers, and hormone replacement therapy (HRT) as well as lifestyle changes like regular exercise, eating a joint-healthy diet, and reducing stress can all help alleviate pain caused by perimenopausal joint problems.
Society’s knowledge of menopause and perimenopause is growing, but there are still lots of misunderstood aspects of this phase of life. While menopausal hot flushes are mainstream, there are many less commonly known symptoms, such as vaginal dryness, sleep problems, and, of course, joint pain.
Joint pain is a common but overlooked symptom of perimenopause caused by decreasing estrogen levels. Though it can be uncomfortable, there are steps you can take at home to reduce your aches and pains.
Understanding perimenopause and joint pain
Simply put, menopause is when you stop having periods. This usually happens between the ages of 45 and 55, though some women experience it earlier. Perimenopause is the time before the menopause, as your body experiences hormonal changes in preparation for the menopause.
Perimenopause is natural, but that doesn’t mean it’s without its challenges. While some women sail through perimenopause without much fuss, others face a more difficult journey.
Why does joint pain occur during perimenopause?
Your joints are made up of muscles, bones, cartilage, tendons, ligaments, and soft tissues. And all of these components have estrogen receptors that are sensitive to estrogen changes within the body, which is why many women suffer from joint issues during perimenopause.
During perimenopause, your sex hormone levels fluctuate, and these changes cause a whole myriad of symptoms. Estrogen is not only responsible for regulating your menstrual cycle—it also lubricates your joints and decreases inflammation. So, as your hormone levels drop, you may notice joint problems that weren’t there before.,
A 2010 article published in Maturitas found that joint pain is incredibly common around the time of menopause, with over half of all women being affected. Perimenopause joint pain may feel like a dull ache, a shooting pain, stiffness, or a twinge. Symptoms vary, with some women being more affected than others.
Common areas affected by perimenopausal joint pain
1. Hip pain
Hip pain is a common complaint for women in this stage of life, caused by the hormonal changes of perimenopause and decreasing bone density. Hip pain can worsen at night, making it difficult to get a good night’s sleep.
2. Knee pain
Knee pain is another common issue during perimenopause. Your knees do a lot of work and carry a lot of weight, so it’s not surprising that these are some of the most commonly affected joints. Decreasing estrogen levels and deteriorating cartilage health as you age can leave your knees susceptible to joint problems during perimenopause.
3. General joint pain
Perimenopausal joint pain isn’t contained to the hip and knees. You may also notice problems with the following joints:
- Neck
- Spine
- Shoulders
- Elbows
- Wrists
- Hands
Perimenopause joint pain relief
If you’ve started to experience this common but distressing symptom, you don’t have to grin and bear it; you have options for perimenopause joint pain treatment, such as:
1. Lifestyle changes
Daily mindfulness could help reduce stress and improve symptoms, so try incorporating a short meditation practice into your routine or start a gratitude. A 2018 study published in Scientific Reports found that mindfulness techniques helped to reduce menopausal symptoms in women with mild to moderate symptoms.
Smoking can also exacerbate the symptoms of menopause, including joint pain, so speakto your doctor for help quitting. There are plenty of resources available for those who want to kick the habit.
2. Regular exercise
When suffering from joint pain, your first instinct may be to reduce your movements to rest your joints, but regular exercise is crucial. Physical activity helps you to stay healthy and can ease your joint pain. A 2012 study published in Obstetrics and Gynecology Clinics of North America found that many perimenopausal women were not exercising regularly.
On the bright side, staying active has lots of benefits. However, the study also points out that we need more research to fully understand how exercise affects specific menopause symptoms like hot flashes, weight gain, bone health, and mood changes.
Many women gain weight during menopause, which can put extra stress on their joints and worsen any discomfort. For this reason, paying attention to your weight and trying to maintain a healthy diet and exercise routine is essential as you enter this next stage of life.
Yoga and pilates are perfect for strengthening muscles and improving flexibility. Try including them in your regular exercise routine to see the benefits. Additionally, focus on low-impact activities like swimming, walking, and yoga. Avoid high-impact exercises such as running, which may put too much strain on your joints.
Weight training is good for bone density and will help you maintain your muscles as you reach menopause. Look for a personal trainer who focuses on women’s health and understands the impact of perimenopause on the body.
3. Diet and nutrition
As you age, the food you eat becomes more important for maintaining good health. A good diet for perimenopause is high in fresh vegetables, protein, and whole grains.
Joint-healthy foods include:
- Dairy products. Dairy products are high in calcium, potassium, and other vitamins and minerals. Calcium is a fantastic food for healthy joints.
- Oily fish. Salmon and sardines are a great source of Vitamin D and omega-3 fatty acids.
- Colorful fruits. Berries and cherries are high in Vitamin C, which reduces inflammation and promotes healthy joints.
- Leafy greens. High in Vitamin K, Vitamin C, and calcium, leafy greens such as kale and spinach fight inflammation and protect bone health.
- Protein. Chicken, eggs, beans, nuts, seeds, and tofu contain protein, which promotes muscle strength and can alleviate joint issues.
4. Medications and supplements
Over-the-counter medicines
Over-the-counter medicines can help reduce inflammation and ease the pain of perimenopausal joint problems. Nonsteroidal anti-inflammatory drugs (NSAIDs) can also treat joint pain, and anti-inflammatory gels can be applied directly to the affected area for targeted relief.
Supplements
Supplements can complement a healthy lifestyle for joint pain relief. A 2020 study published in Complementary Therapies in Clinical Practice found daily Omega-3 supplementation reduced postmenopausal symptoms, including joint pain. However, it’s important to note that while the study showed a general improvement in menopausal symptoms, it didn’t specifically mention a reduction in joint pain.
Glucosamine and chondroitin supplementation may protect cartilage and reduce joint pain. Though scientific studies have found mixed results, many women anecdotally claim glucosamine and chondroitin supplements help alleviate their joint issues.
Hormone replacement therapy
Hormone replacement therapy (HRT) can help to manage the symptoms of menopause. HRT restores estrogen levels in the body, reducing the unpleasant symptoms of menopause. Speak to your doctor about whether HRT might alleviate your joint pain and whether it is a good treatment option for you.
5. Heat and ice therapy
Heat therapy can be effective for stiff and aching joints, while ice packs can help reduce inflammation and swelling of the joints. A warm bath can help ease painful joints.
Effective treatments for perimenopause hip pain
Perimenopause increases your likelihood of suffering from gluteal tendinopathy, a condition that affects the tendons in the buttocks and hip area. Perimenopause hip pain treatment can help to manage your condition and reduce symptoms.
1. Proper positioning
Improper positioning could be making your hip pain worse. You should avoid sitting with your legs crossed or standing with one hip jutted out, as both these positions can put additional strain on your joints. Ensure that you stand evenly, and use a pillow to support your knees in bed at night, as this will encourage better positioning of your hip joints.
2. Physical therapy
Physical therapy can strengthen the muscles around the hips and reduce strain on them. A physiotherapist can recommend a simple exercise program to strengthen muscles, improve flexibility, and reduce hip pain.
3. Medications
Over-the-counter pain relief, such as acetaminophen and ibuprofen, can help to reduce pain in the short term. HRT can also be considered for painful joints, as estrogen can help alleviate the aches and pains associated with perimenopause. HRT replaces the hormones estrogen and progesterone that you lose during perimenopause. HRT can reduce menopause symptoms such as hot flushes, brain fog, and anxiety. Potential side effects are usually mild but include leg cramps and headaches. Speak to your doctor to find out more about HRT and whether it is right for you.
Managing perimenopause and knee pain
1. Exercise and strength training
Generally speaking, strengthening the muscles around the joint is vital for improving and maintaining joint health. Your knees undergo a lot of strain as you go about your daily business, so it’s essential to support these joints. The following exercises will help to strengthen the muscles around your knees:
Leg lifts
- Lie down flat on your back on the floor, using a yoga mat for comfort. Ensure your lower back is flat against the floor.
- Keeping your left leg straight, bend your right leg and bring the foot closer to your body.
- Slowly lift your left leg, keeping it straight as you do so. Do not raise it higher than your right knee.
- Hold for the count of five.
- Slowly take your leg back down to the floor.
- Repeat twice more, then switch legs. Aim for three reps with each leg.
Wall squats
- Position yourself with your head, shoulders, back, and hips against the wall.
- Step your feet out away from the wall, ensuring your back is still touching the wall. Keep your feet hip-width apart.
- Slide down the wall into a squat position with your body slightly higher than a typical sitting position.
- Hold for the count of five.
- Slide back up the wall.
- Repeat twice more.
A physical therapist can advise you on more exercises you can try at home to strengthen your muscles and relieve pressure on your knees.
which is designed to meet your unique health goals and lifestyle
2. Supportive devices
Orthotic inserts may provide knee joint relief by ensuring proper foot positioning while walking. Speak to your physical therapist for advice about orthotic inserts and whether they may help your knee problems.
Knee braces and supports may help by reducing swelling and supporting the knee as you move. Many women find that knee support reduces pain and allows them to move more easily. Different types of knee support are available, so it’s essential to seek advice from your doctor or physical therapist to determine which suits you.
3. Massage
Massage may be helpful in the treatment of joint pain in perimenopausal women. A 2024 study published in Explore found aromatherapy massage with Bergamont essential oil was effective at treating the symptoms of menopause in women with knee osteoarthritis. If you want to try massage as a treatment option, find a masseuse with experience in treating perimenopausal aches and pains. It’s not advisable to experiment with essential oils at home, so ensure you use a masseuse who understands aromatherapy as a treatment option.
When to see a doctor?
If you think you might be suffering from perimenopausal joint pain, you should speak to your healthcare provider for advice. Don’t delay seeking medical attention for joint pain; your doctor may be able to recommend treatments that can improve your daily life.
Your doctor will also want to rule out other conditions, such as rheumatoid arthritis and fibromyalgia.
Questions from the Femia community
Can hormone replacement therapy help with joint pain?
What types of exercises are best for managing perimenopausal joint pain?
Are there any dietary supplements that can help with joint pain?
Does perimenopause joint pain go away?
The bottom line
Joint pain is a common symptom of perimenopause, but that doesn’t mean you need to suffer in silence. There are many lifestyle changes and treatment options that can help reduce your discomfort and manage your symptoms.
References
- Magliano, Malgorzata. “Menopausal arthralgia: Fact or fiction.” Maturitas vol. 67,1 (2010): 29-33. doi:10.1016/j.maturitas.2010.04.009 https://pubmed.ncbi.nlm.nih.gov/20537472/.
- Arnot M, Emmott EH, Mace R (2021) The relationship between social support, stressful events, and menopause symptoms. PLOS ONE 16(1): e0245444. https://doi.org/10.1371/journal.pone.0245444.
- Wong, Carmen et al. “Mindfulness-Based Stress Reduction (MBSR) or Psychoeducation for the Reduction of Menopausal Symptoms: A Randomized, Controlled Clinical Trial.” Scientific reports vol. 8,1 6609. 26 Apr. 2018, doi:10.1038/s41598-018-24945-4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5919973/.
- Sternfeld, Barbara, and Sheila Dugan. “Physical activity and health during the menopausal transition.” Obstetrics and gynecology clinics of North America vol. 38,3 (2011): 537-66. doi:10.1016/j.ogc.2011.05.008 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3270074/.
- Purzand et al. “The comparison of the effect of soybean and fish oil on supplementation on menopausal symptoms in postmenopausal women: A randomized, double-blind, placebo-controlled trial” Complementary Therapies in Clinical Practice, Volume 41, 2020, 101239, ISSN 1744-3881, https://doi.org/10.1016/j.ctcp.2020.101239.
- Chien, Tsai-Ju et al. “Effect of acupuncture on hot flush and menopause symptoms in breast cancer- A systematic review and meta-analysis.” PloS one vol. 12,8 e0180918. 22 Aug. 2017, doi:10.1371/journal.pone.0180918 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5568723/.
Doner et al. “The effects of aromatherapy massage in menopausal women with knee osteoarthritis: A randomized controlled study” EXPLORE, 2024, ISSN 1550-8307, https://doi.org/10.1016/j.explore.2024.05.012.
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