Hot flushes, night sweats and mood changes are among the most recognised symptoms of menopause, but they're not the only changes women may experience.
For many women, aching knees, stiff fingers, sore hips and general joint discomfort begin during perimenopause or menopause, often without warning. These symptoms can make everyday activities, exercise and even getting out of bed in the morning feel more challenging.
The good news is that joint pain during menopause is common, and understanding why it happens is the first step towards managing it.
Is Joint Pain a Symptom of Menopause?
Yes. Joint pain, stiffness and muscle aches are commonly reported during both perimenopause and menopause.
This type of discomfort is sometimes referred to as menopausal arthralgia, describing joint pain associated with the hormonal changes that occur during menopause.
Some women experience occasional stiffness, while others notice persistent discomfort that affects mobility, sleep and quality of life.
The joints most commonly affected include:
- Knees
- Hands and fingers
- Hips
- Shoulders
- Neck
- Lower back
- Feet
Many women also find that symptoms are worse first thing in the morning or after sitting for extended periods.
Why Does Menopause Cause Joint Pain?
The primary reason is the natural decline in oestrogen levels.
Although oestrogen is best known for its role in reproductive health, it also influences many other tissues throughout the body, including cartilage, bone, muscle and connective tissue. It also plays a role in regulating inflammatory processes.
As oestrogen levels decline, several changes may contribute to joint discomfort.
Increased Inflammatory Activity
Oestrogen helps regulate the body's inflammatory response.
As hormone levels decrease, some women may experience increased inflammatory activity, which can contribute to joint stiffness and discomfort.
Research is ongoing, but inflammation is considered one of several factors that may influence menopausal joint pain.
Reduced Collagen Production
Collagen is the primary structural protein found in cartilage, tendons and ligaments.
Natural collagen production declines with age and may accelerate during menopause.
Lower collagen levels may contribute to:
- Joint stiffness
- Reduced flexibility
- Slower recovery following physical activity
- Changes in connective tissue health
Loss of Muscle Mass
Women naturally lose muscle mass as they age, with the rate of loss increasing after menopause.
Muscles help stabilise and support joints. As muscle strength declines, additional pressure may be placed on the knees, hips and spine, potentially contributing to discomfort and reduced mobility.
Changes in Bone Health
Declining oestrogen also affects bone remodelling.
While changes in bone density do not directly cause joint pain, maintaining healthy bones and strong muscles plays an important role in supporting long-term mobility and overall musculoskeletal health.
Other Factors That May Contribute to Joint Pain
Hormonal changes are only one part of the picture.
Several other factors may contribute to joint discomfort during midlife, including:
- Poor sleep
- Chronic stress
- Reduced physical activity
- Weight gain
- Previous joint injuries
- Osteoarthritis
- Vitamin D deficiency
- Reduced muscle strength
These factors often occur together, making symptoms more noticeable during menopause.
Is It Menopause or Arthritis?
Joint pain during menopause can feel similar to arthritis, making it difficult to distinguish between the two.
Menopausal joint pain often:
- Begins during perimenopause or menopause
- Affects multiple joints
- Changes as hormone levels fluctuate
- Occurs alongside other menopausal symptoms, such as hot flushes, sleep disturbances or mood changes
However, persistent swelling, redness, severe pain or symptoms affecting only one joint should be assessed by a healthcare professional, as they may indicate another underlying condition.
How to Support Joint Health During Menopause
Although there is no single solution, a combination of healthy lifestyle habits can help support joint, muscle and bone health throughout menopause.
Keep Moving
When your joints ache, exercise may be the last thing you feel like doing.
However, regular movement is one of the most effective ways to reduce stiffness and maintain mobility.
Low impact activities such as:
- Walking
- Swimming
- Cycling
- Pilates
- Yoga
can help improve flexibility while supporting muscle strength and joint function.
Prioritise Strength Training
Strength training becomes increasingly important during and after menopause.
Maintaining muscle mass helps:
- Support joints
- Improve balance
- Maintain bone health
- Support mobility
- Promote healthy ageing
Even two or three resistance training sessions each week can provide meaningful long-term benefits.
Eat a Nutrient-Rich Diet
A balanced diet provides the nutrients needed to support overall musculoskeletal health.
Aim to include:
- Colourful vegetables
- Fruit
- Oily fish
- Extra virgin olive oil
- Nuts and seeds
- Wholegrains
- Lean protein
These foods provide vitamins, minerals and healthy fats that contribute to overall health and wellbeing.
Prioritise Quality Sleep
Poor sleep may increase pain sensitivity and reduce the body's ability to recover from physical activity.
Simple habits such as maintaining a regular bedtime, limiting caffeine later in the day and creating a relaxing evening routine may help support better sleep.
Maintain a Healthy Weight
Maintaining a healthy body weight can help reduce the load placed on weight-bearing joints, particularly the knees and hips.
Combined with regular physical activity, this may support mobility and overall joint comfort.
Nutrients That Have Been Studied for Joint, Bone and Muscle Health
While a balanced diet should always form the foundation of good nutrition, several nutrients have been investigated for their role in supporting musculoskeletal health.
Vitamin D
Vitamin D contributes to normal muscle function and supports bone health by assisting calcium absorption.
Because vitamin D deficiency is relatively common in Australia, maintaining adequate levels is an important consideration throughout menopause.
Vitamin K2
Vitamin K2 works alongside vitamin D by helping regulate calcium utilisation within the body, supporting normal bone health.
Magnesium
Magnesium contributes to normal muscle function, nervous system function and energy production.
Maintaining adequate magnesium intake is important for overall musculoskeletal health.
Creatine
Emerging research suggests creatine, when combined with resistance training, may help support muscle strength and lean muscle mass in older adults.
Maintaining muscle mass is an important part of protecting joint function and supporting mobility throughout ageing.
Natural Eggshell Membrane (NEM®)
Natural Eggshell Membrane (NEM®) has been investigated in clinical studies for its potential role in supporting joint comfort, flexibility and stiffness.
It naturally contains collagen, glycosaminoglycans and other structural components found in joint tissue.
While some studies have reported improvements in joint comfort over several weeks, research is ongoing and responses may vary between individuals.
Looking at the Bigger Picture
Joint pain during menopause is common, but it should not simply be accepted as an inevitable part of ageing.
Looking after your muscles, bones, nutrition, sleep and overall health can have a meaningful impact on how you feel each day.
If your symptoms are persistent, worsening or affecting your quality of life, speak with your doctor or pharmacist. They can help determine whether your symptoms are related to menopause or another underlying condition and discuss appropriate management options.
The Bottom Line
Joint pain is one of the lesser-known symptoms of menopause, yet it affects many women during midlife.
The combination of hormonal changes, reduced collagen production, declining muscle mass and changes in inflammatory activity may all contribute to stiffness and discomfort.
Although menopause cannot be prevented, healthy lifestyle habits, including regular exercise, strength training, good nutrition and adequate sleep, can help support long-term joint, muscle and bone health.
Understanding the changes taking place during menopause empowers women to take proactive steps towards maintaining mobility, strength and quality of life for years to come.
References
- Szoeke CEI, Cicuttini FM, Guthrie JR, Dennerstein L. The relationship of reports of aches and joint pains to the menopausal transition: A longitudinal study. Climacteric. 2008.
- Watt FE. Musculoskeletal pain and menopause. Post Reproductive Health. 2018.
- Cagnacci A, Venier M. The Controversial History of Hormone Replacement Therapy. Medicines. 2019.
- National Institute on Aging. Menopause: Time for a Change.
- National Institutes of Health Office of Dietary Supplements. Vitamin D Fact Sheet for Health Professionals.
- National Institutes of Health Office of Dietary Supplements. Magnesium Fact Sheet for Health Professionals.
- Ruff KJ, Winkler A, Jackson RW, et al. Effects of Natural Eggshell Membrane on Joint Pain and Stiffness. Clinical Interventions in Aging. 2009.
