Managing perimenopause joint pain: Effective treatments and relief strategies

Illustration of a woman's legs with a red target indicating perimenopause joint pain.
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Created with Nataliia Yermolovych, MD, Obstetrician-Gynecologist

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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?

During perimenopause, hormonal fluctuations can contribute to joint pain due to various factors, including increased inflammation and changes in connective tissue. Here are some key points to consider:

  • Hormonal Changes: Declining estrogen levels can lead to a decrease in collagen production, which is essential for joint health and flexibility. This reduction can make joints more susceptible to pain and stiffness.

  • Inflammation: The shift in hormone levels may trigger an inflammatory response in the body, exacerbating conditions like osteoarthritis and leading to increased joint pain.

  • Weight Gain: Many women experience weight gain during perimenopause, which can put additional stress on weight-bearing joints, contributing to discomfort and pain.

  • Reduced Physical Activity: Fatigue and mood changes can lead to decreased physical activity, which can weaken muscles and support structures around the joints, resulting in more pain.

  • Autoimmune Conditions: The risk of developing autoimmune disorders, such as rheumatoid arthritis, may increase during this period, further contributing to joint inflammation and pain.

Understanding these changes can help women manage joint pain effectively during perimenopause.

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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. Hormone replacement therapy (HRT) for joint pain relief

Hormone Replacement Therapy (HRT) can be an effective option for alleviating joint pain associated with perimenopause and menopause. By replenishing declining estrogen levels, HRT may help reduce inflammation, improve joint lubrication, and enhance overall joint function. Here are some key points regarding HRT for joint pain relief:

  • Reduction in Inflammation: HRT may help decrease inflammatory markers in the body, leading to less joint pain and stiffness.

  • Improved Collagen Production: Restoring estrogen levels can support collagen synthesis, which is crucial for maintaining the strength and elasticity of connective tissues.

  • Enhanced Mobility: Many women report improved joint mobility and function after starting HRT, allowing for a more active lifestyle.

  • Individualized Treatment: HRT should be tailored to each woman’s specific health needs and risks, making it essential to consult with a healthcare provider for a personalized approach.

  • Potential Risks: While HRT can provide relief, it’s important to discuss potential risks and side effects with a doctor to ensure it’s the right choice for your health.

Overall, HRT may offer significant benefits for joint pain relief during the transitional phase of menopause.

2. 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. 

If you’re considering pregnancy during perimenopause, it’s important to note that while fertility declines, it is still possible to conceive. Women in this stage should be aware of their menstrual cycles and consult a healthcare provider for guidance on fertility and potential risks associated with pregnancy in their 40s. Understanding your options can help you make informed decisions about family planning during this transitional period.

3. Regular exercise

When experiencing joint pain, the instinct may be to reduce movement, but regular exercise is crucial for maintaining health and alleviating discomfort. A 2012 study published in Obstetrics and Gynecology Clinics of North America found that many perimenopausal women were not exercising regularly, highlighting the need for increased physical activity.

Regular exercise can help:

  • Ease joint pain
  • Manage weight
  • Improve bone health
  • Enhance mood

While more research is needed to understand how exercise affects specific menopause symptoms like hot flashes, it’s clear that an active lifestyle has numerous benefits.

Recommended exercises

To effectively manage joint pain and improve overall well-being, consider incorporating the following activities into your routine:

  • Low-Impact Aerobics: Activities like swimming and walking can provide cardiovascular benefits without stressing the joints.
  • Yoga: Helps strengthen muscles, improve flexibility, and promote relaxation.
  • Pilates: Focuses on core strength and stability, beneficial for overall body support.
  • Weight Training: Improves bone density and muscle maintenance. Seek a personal trainer specializing in women’s health for tailored guidance.

Avoid high-impact exercises, such as running, which can strain your joints. By prioritizing a balanced exercise routine, you can manage joint pain and enhance your quality of life as you navigate this stage.

4. 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.

5. Supplements

In addition to regular exercise and a balanced diet, certain supplements may help alleviate joint pain and support overall health during perimenopause. Here are some of the best supplements to consider:

  • Omega-3 fatty acids: Found in fish oil, these essential fats have anti-inflammatory properties that can help reduce joint pain and stiffness. Omega-3s may also improve cardiovascular health, which is particularly important during menopause.

  • Glucosamine and chondroitin: These natural compounds are often used together to support joint health. Glucosamine may help rebuild cartilage, while chondroitin can reduce pain and improve joint function.

  • Turmeric (Curcumin): This spice contains curcumin, a potent anti-inflammatory compound. Studies suggest that curcumin can help reduce joint pain and improve mobility by decreasing inflammation in the joints.

  • Vitamin D: Essential for bone health, vitamin D can help prevent bone loss and support immune function. Many women may experience deficiencies, especially during menopause, so supplementation can be beneficial.

  • Calcium: Important for maintaining bone density, calcium supplementation can help prevent osteoporosis, a risk that increases during perimenopause.

  • Boswellia serrata: This herbal supplement has been shown to have anti-inflammatory effects and may help alleviate joint pain associated with arthritis and other inflammatory conditions.

Before starting any new supplements, it’s essential to consult with a healthcare provider to determine the appropriate dosages and ensure they fit well with your overall health plan. Incorporating these supplements can enhance your joint health and provide relief during perimenopause.

llustration of three supplement bottles labeled Glucosamine, Omega-3, and Chondroitin.

6. 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.

7. Alternative therapies for joint pain relief

In addition to traditional treatments, various alternative therapies can help alleviate joint pain during perimenopause. Here are some effective methods to consider:

  • Acupuncture: This ancient Chinese practice involves inserting thin needles into specific points on the body to relieve pain and promote healing. Research suggests that acupuncture can help reduce joint pain and improve mobility by stimulating the body’s natural pain-relief mechanisms and reducing inflammation.

  • Essential oils: Certain essential oils possess anti-inflammatory and analgesic properties, making them beneficial for joint pain relief. For instance:

    • Peppermint Oil: Known for its cooling sensation, it can help reduce pain and inflammation when applied topically.
    • Eucalyptus Oil: This oil has analgesic properties that may help soothe aching joints when massaged into the skin.
    • Lavender Oil: Often used for relaxation, lavender oil can also provide pain relief and reduce inflammation.

  • Massage therapy: Regular massage can help improve circulation, reduce muscle tension, and relieve joint pain. Techniques such as deep tissue or trigger point massage can target specific areas of discomfort.

  • Chiropractic care: Chiropractors can help realign the spine and joints, which may alleviate pain and improve mobility. Gentle adjustments can be particularly beneficial for those experiencing joint issues during perimenopause.

  • Hydrotherapy: Warm water baths or soaking in hot tubs can provide relief by relaxing muscles and improving circulation. Hydrotherapy can also reduce stiffness and pain in the joints.

  • Mind-body practices: Techniques such as yoga, tai chi, and qigong combine movement, meditation, and breathing exercises, which can enhance flexibility, reduce pain, and improve mental well-being.

Incorporating these alternative therapies into your routine can complement traditional treatments and contribute to better joint health and pain management during perimenopause. Always consult with a healthcare provider before starting any new therapy.

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

  1. Lie down flat on your back on the floor, using a yoga mat for comfort. Ensure your lower back is flat against the floor. 
  2. Keeping your left leg straight, bend your right leg and bring the foot closer to your body. 
  3. Slowly lift your left leg, keeping it straight as you do so. Do not raise it higher than your right knee. 
  4. Hold for the count of five. 
  5. Slowly take your leg back down to the floor. 
  6. Repeat twice more, then switch legs. Aim for three reps with each leg.

Wall squats

  1. Position yourself with your head, shoulders, back, and hips against the wall.
  2. Step your feet out away from the wall, ensuring your back is still touching the wall. Keep your feet hip-width apart. 
  3. Slide down the wall into a squat position with your body slightly higher than a typical sitting position. 
  4. Hold for the count of five. 
  5. Slide back up the wall. 
  6. 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.

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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.

Six icons representing ways to manage perimenopause joint pain: regular exercise, diet and nutrition, supplements, heat therapy, consultation with healthcare provider, and stress reduction.

Questions from the Femia community

  • How can I tell if joint pain is due to perimenopause or arthritis?

    To distinguish between joint pain from perimenopause and arthritis, consider the following: Perimenopausal pain often accompanies symptoms like hot flashes and mood swings and may fluctuate in intensity, improving with activity. In contrast, arthritis pain is usually persistent, localized, and may involve swelling or redness, often worsening with movement. If you're unsure of the cause, consult a healthcare provider for a thorough evaluation and appropriate treatment.

  • What are the early signs of perimenopause joint pain?

    Early signs of perimenopause joint pain may include intermittent discomfort or stiffness, particularly after inactivity or in the morning, as well as localized pain in weight-bearing joints like the knees and hips. You might also experience worsening pain during hormonal fluctuations and general fatigue accompanying the joint discomfort. If you notice these symptoms, it’s advisable to consult a healthcare provider for guidance and management options.

  • Does perimenopause joint pain go away?

    There’s no set amount of time that perimenopause joint pain will last. For some women, the discomfort is short-lived, but for others, the symptoms stick around after the menopause is over. Luckily, there are things you can do to manage your symptoms, such as lifestyle changes, physical therapy, and hormone replacement therapy.

  • Is it normal to experience pain during sex after menopause?

    Pain during sex is rather common among menopausal women. It can occur because of vaginal dryness and thinning tissues that are easier to damage. To eliminate pain and boost your chances for squirting, consider using lubrication and other treatments for vaginal dryness. Also, consider getting personalized advice from a healthcare provider.

  • Does lack of estrogen cause joint pain?

    Yes, a lack of estrogen can cause joint pain, particularly during perimenopause and menopause. Estrogen plays a crucial role in maintaining joint health by supporting collagen production and reducing inflammation. When estrogen levels decline, it can lead to increased inflammation, decreased joint lubrication, and weakened connective tissues, resulting in stiffness and discomfort. This hormonal change can contribute to joint pain in many women during this transitional phase.

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.

  • 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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