You expect unpredictable periods. You expect hot flashes. But one menopause symptom you may not expect is the feeling that your bones are made of rusted metal. Joint pain, though not widely discussed, is actually a fairly common consequence of all the hormonal shifts during the menopause transition — and it can greatly impact quality of life. Luckily, there are plenty of science-backed ways to treat it so your joints can feel unbothered and un-creaky again. Here's a closer look at some of the causes, symptoms, and treatment options.
What is menopause joint pain?
Joint pain is any pain, stiffness, aching, or sharp pain you may feel at the spot where two or more bones connect. This pain varies, and can be intermittent or constant, and may be severe and debilitating, or just a low-level ache that’s uncomfortable.
Generally, you can experience joint pain at pretty much any moment in your life due to many causes, ranging from infection to age-related changes. And this can make it particularly hard to pinpoint as menopause-related. After all, sleeping in a weird position can cause it. Pushing yourself too hard during pickleball or power yoga can cause it. But hormones can also cause it.
When this happens during the years leading up to menopause or right after, it’s likely menopausal joint pain, says Dr. Rachael Lopez, M.D., OB/GYN and medical director of women's services at MemorialCare Saddleback Medical Center's Women's Health Pavilion in Laguna Hills, CA.
How common is joint pain during menopause?
Research suggests that joint pain affects up to 50% of women during menopause. But “that number may actually be higher, since some women may not connect stiffness and pain in their joints with menopause and its changes,” says Lopez. “We see this as one of the most common effects of menopause.”
Causes of menopause joint pain
Your aching joints could be due to the physiological changes that start in perimenopause and continue for years after.
Hormonal changes and increased inflammation
One of the main culprits for menopause joint pain is declining estrogen, a hallmark of the menopausal shift. This hormone plays a number of roles in the body, including regulating the menstrual cycle and maintaining bone density.
A big task for estrogen is maintaining cartilage and lubrication in the joints — which keeps inflammation within the joint low. So, as estrogen levels begin decreasing during perimenopause, your joints can be notably affected.
"Estrogen is protective of the cartilage in our joints in a similar fashion to the way it protects our bones," says Dr. Natasha Trentacosta, M.D., sports medicine specialist and orthopedic surgeon at Cedars-Sinai Orthopaedics in Los Angeles, CA. When those levels start to dip during the menopause transition, cartilage starts to break down.
“Cartilage acts as a kind of shock absorber, and keeps bones from rubbing against one another,” says Trentacosta. Without that buffer, “it can speed up arthritis because the bones are getting stressed. That can also lead to increased inflammation and joint pain.”
Decreased muscle mass
As you age, muscle mass naturally declines, and this is true for both men and women. This happens due to a decrease in muscle-building hormones like testosterone (which women have, too), at the same time that muscle proteins begin breaking down faster due to age. Estrogen plays a part here, too, so the speed of muscle loss can speed up as you approach menopause.
How does this impact joints? Well, muscles support your joints. As you lose muscle, your joints have to work harder, raising inflammation levels and causing pain and stiffness.
Bone loss and osteoporosis
The risk of developing osteoporosis — a disease where you have decreased bone density and, as a result, weaker and more brittle bones — increases with age for both men and women, but may be particularly high for menopausal women due to declining estrogen, says Trentacosta. That’s because estrogen helps slow bone loss as we age, and also improves how the body strengthens bone overall. When estrogen declines, so does that function.
Research suggests up to 20% of bone loss can happen during perimenopause and menopause, and that half of postmenopausal women will have osteoporosis — boosting the chances of fractures and joint pain, since bone loss doesn’t just affect the larger bones in the body, it also impacts the smaller bones in the joints.
Lifestyle factors
In terms of other menopausal shifts, the biggest that might play a role for joint pain is increased weight, says Trentacosta.
"Weight gain is often seen in menopausal women, and increased joint pain, particularly of the lower extremity, are seen in patients with higher BMI," she adds. This menopausal weight gain is due to a number of factors. For example, as estrogen levels drop, the body’s metabolism may slow down so calories aren’t burned as efficiently. Estrogen also affects where fat is stored, so it tends to accumulate around the midsection during menopause more than it does when you’re younger. Lifestyle changes might play a part as well, if someone becomes more sedentary.
More weight puts additional pressure on joints, and in the tissue surrounding a joint. It’s estimated that if you have overweight or obesity, every additional pound of weight puts four to six pounds of pressure on each knee joint — which is why those with obesity are 20x more likely to need a knee replacement compared to those who do not have overweight.
Symptoms of menopausal joint pain
Pain in the joints during menopause can range from mild to severe, and may come and go or be continuous. According to Lopez, symptoms can include:
- Cracking or popping sounds as the joint moves
- Decreased range of motion
- Sudden, shooting pains inside and around the joint
- Stiffness in the joint, especially after sitting or lying down for a while
- Swelling in and around a joint
- Pain that extends into the muscles surrounding a joint
Treatment for menopause joint pain
Menopause-related joint pain, in general, is treated like other causes of joint pain, according to Trentacosta. If it begins to interfere with everyday life, your healthcare provider will likely evaluate it to conclude it is, in fact, related to menopause and then may recommend treatments to alleviate the pain and swelling.
Medications
"We try to treat the symptoms of pain by decreasing inflammation in the joint," Trentacosta says. This may be done through nonsteroidal anti-inflammatory drugs (NSAIDs), which can be oral pills or topical creams. You may be advised to start with over-the-counter strengths and, if those aren’t doing enough, switch to prescription strength. “In the office, we may offer injections to help bring down inflammation, such as steroids or hyaluronic acid injections," says Trentacosta.
Hormone replacement therapy
As menopause may be the significant risk factor of the joint pain, working with your primary care doctor or gynecologist on treating the menopause may help to decrease joint symptoms. This may involve menopause hormone therapy (MHT) — more commonly known as hormone replacement therapy (HRT) — but should be discussed with your medical provider (you can also talk about MHT with a clinician at WeightWatchers Clinic for Menopause).
HRT replaces estrogen and sometimes another hormone, progesterone, to alleviate symptoms of menopause. Research suggests it may have some benefit for joint pain, particularly if used along with lifestyle changes like exercise and weight management.
Physical therapy
If joint pain is isolated to just a few joints — for example, your knees or your hips — physical therapy may be a helpful complement to other treatments and lifestyle changes to strengthen the muscles around those joints specifically, says Carol Mack, D.P.T., C.S.C.S., doctor of physical therapy and strength and conditioning coach at CLE Sports PT & Performance in Cleveland, Ohio. For example, if your knees are aching, a physical therapist may focus on strengthening your quadriceps (the large thigh muscles in front of your thigh), which would take pressure off the knees as you move.
"A physical therapist can provide exercises specific to the joint and the person's symptoms," and this can be done alongside other treatments and lifestyle changes, she adds.
Lifestyle modifications
Apart from tapping into the advice of medical professionals, you can do plenty on your own to address menopause-related joint pain.
Weight management and diet
Since increased weight is associated with increased joint pain, weight loss is encouraged for those who have excessive weight, says Trentacosta.
One way to address weight and lower inflammation at the same time is by considering a Mediterranean-style eating plan — which, like WeightWatchers for Menopause, prioritizes nutrients like protein, fiber, and hydration. Research has found that eating this way can reduce inflammation (a cause of joint pain) and help with body composition — meaning less fat and more muscle — and also provides other health benefits like improved cardiovascular function.
Exercise
A common misstep with joint pain is to rest more often, in the belief that this will help the joint "recover" in some way. But in fact, too much sedentary time can often make the problem worse because the muscles around the joint will become weaker, which puts more pressure on the joints. Regular exercise — both strength training and low-impact cardio — can be important for joint health, says Mack.
"You may need modifications to make some activities pain-free, but in general, it's best to keep joints moving because when there's too much rest, it makes the issue worse in the long run," she adds.
Other therapies
Complementary approaches that may help alleviate pain to some degree can include massage, acupuncture, and some supplements such as omega-3 fatty acids, collagen, and vitamin D.
Before relying on supplements, however, Lopez suggests focusing on diet and exercise first and using those only as a secondary support. Also, keep in mind that supplements aren’t regulated by the FDA, so tread with caution and be sure to talk with your doctor before trying any alternative therapies like these.
How long does menopause joint pain last?
Much like other menopausal symptoms, this answer is highly individualized, says Lopez. For some women, joint pain may occur for just a few months when their estrogen begins to decline, while others might experience occasional pain for years.
And remember: You aren’t just stuck hurting. "If the pain is mild and intermittent, doing more movement and maintaining a healthy weight can help keep it controlled," she adds. For some, replacing estrogen with hormone therapy may cause pain to be alleviated almost immediately, while others might find relief with physical therapy.
When to see a doctor for menopausal joint pain
If pain is persistent, interferes with daily life, or worsens over time, it's best to talk to your doctor, suggests Lopez. Your health team can rule out other potential causes for your pain, such as damage within the joint, and advise you on what treatments are likely to be most effective for you.
The bottom line
While joint pain can occur in about half of menopausal women — due in large part to changes in estrogen, but also because of factors like weight gain and reduced physical activity — that doesn't mean you need to put up with it. Taking action in the form of getting more movement, reducing weight if needed, and focusing on an anti-inflammatory diet may help. If pain persists despite making these changes, talk with your doctor to see what other strategies may be helpful, so you can maintain your joint health as you age.
FAQs
Yes it can. Menopause can affect any joint in the body since estrogen plays a role in maintaining function for all joints, says Trentacosta.
Supplements that may be helpful for supporting your joints during menopause include vitamin D, collagen, and omega-3 fatty acids, Lopez says. But your primary focus should be diet and lifestyle changes like healthy eating, exercise, and weight management, as well as talking to your doctor about any treatments that may be appropriate.
The Mediterranean diet has been shown to improve menopause joint pain. Load your plate up with lean protein, fruits and vegetables, and healthy fats like olive oil and fatty fish.
This content is for informational purposes only and does not constitute medical advice, diagnosis or treatment. It should not be regarded as a substitute for guidance from your healthcare provider.