Menopause and Joint Pain
Your body doesn’t move like it used to. Aches and pains, creaky joints—it’s all part of getting older, right?
In healthy joints, a smooth tissue called cartilage prevents the ends of the bones from rubbing together. Over time, this cartilage can break down, causing pain and leading to osteoarthritis. Osteoarthritis occurs equally in men and women until age 50, according to the Arthritis Foundation. After that, it more commonly and severely affects women. Women also are more likely than men to have joint replacement surgery for osteoarthritis.
Between the ages of 45 and 55, most women go through menopause, where they stop having a menstrual cycle. It turns out the hormone changes of menopause also can affect the bones and joints.
“Hormones like estrogen affect the joints. Estrogen can have anti-inflammatory properties. When estrogen levels decrease during menopause, it can lead to more inflammation in the body, which can contribute to pain in joints and muscles,” says Candace Feldman, MD, MPH, ScD, a Mass General Brigham rheumatologist who cares for patients at Brigham and Women’s Hospital. Studies suggest that more than 2 in 5 women experience muscle or joint pain in the time leading up to menopause as well as during the transition to menopause.
Learn more about how menopause can affect the joints, and what you can do to prevent or manage joint pain.
Menopause signs and symptoms
A woman has officially reached menopause once she goes without a menstrual period for a full year. The signs and symptoms of menopause can include:
- Hot flashes
- Night sweats
- Muscle and joint pain
- Problems with sleep
- Vaginal dryness and other sexual changes
- Mental health challenges like depression or anxiety
- Fatigue or brain fog
- Changes in body composition (like losing muscle mass or gaining weight)
- Bone density loss, known as osteoporosis
“Most people associate menopause with the classic presentation of hot flashes and night sweats. But musculoskeletal pain is highly prevalent among menopausal women as well,” Dr. Feldman adds.
Low estrogen and joint pain
During menopause, the ovaries slow their production of the hormones estrogen and progesterone, which control the reproductive cycle. After the menopause transition is complete, women can no longer get pregnant.
Both hormones are key to the functioning of both men and women’s bodies. Estrogen in particular plays an important role in maintaining tissues in the bones, muscles, and joints. It also prevents inflammation, which can add to joint pain if left unchecked.
Types of joint pain in menopause
A joint is where two bones make contact in the body. Cartilage, a tough and flexible tissue, provides cushioning between the bones and allows for smooth movement of the joint. In osteoarthritis, cartilage wears away and causes friction as the bones to rub together. Lower estrogen levels can hasten the breakdown of cartilage, and sometimes, there is increased inflammation that can lead to swelling. This results in stiffness and pain.
Places women may experience joint pain that may be heightened around menopause include:
How to treat menopause joint pain
Joint pain during menopause can be uncomfortable and limit daily activities. Fortunately, women have options when it comes to managing and relieving their symptoms. Here’s what you can do:
Stay active.
It might sound counterintuitive, but regular exercise is one of the best treatments for joint pain and osteoarthritis. When done correctly, physical activity can decrease stiffness and joint pain. It also helps maintain your mental health and heart health. Try low-impact exercise like swimming, walking, strength training, Pilates, or yoga.
“Movement and muscle strengthening and stability exercises can help with joint and muscle pain, and are especially important during the perimenopausal and menopausal transitions,” Dr. Feldman explains.
Exercise can also help manage weight gain and muscle mass loss, both of which can happen during menopause. Excess weight gain puts more pressure on your joints, which can further increase pain and cartilage and joint damage.
Another option to help you stay active and build strength safely is physical therapy. Physical therapists are health care providers who specialize in managing and relieving pain and increasing stability and strength through carefully planned, targeted exercises. They can develop a plan to help address your joint pain, including stretches and strength training to reduce the stress on the joint from movement.
Eat healthy.
Choose well-balanced meals with foods like vegetables, whole grains, and lean protein. Avoiding high cholesterol foods, which are often high in sugar, sodium, and fats, can also help prevent excess weight gain. A dietitian can help you develop a healthy eating plan if you don’t know where to start.
Manage your joint pain.
Your care team might recommend different medications or procedures to help with your joint pain. This can include:
- Over-the-counter pain relievers, like acetaminophen or ibuprofen
- Topical therapies applied directly to painful joints, like diclofenac gel
- Injections to help with joint pain and inflammation, like cortisone
- Braces or orthotics like shoe inserts, for added support
If non-surgical options don’t relieve your pain and it is related to advanced osteoarthritis, your care team might recommend considering a joint replacement.
Menopausal hormone therapy (hormone replacement therapy) for joint pain
Menopausal hormone therapy (MHT) can include estrogen, or estrogen combined with progesterone, depending on the needs of the patient, and is used to help reduce some of the symptoms associated with menopause. The main use of MHT is to treat hot flashes and night sweats (“vasomotor symptoms”).
While MHT is not recommended solely for treating joint pain without vasomotor symptoms, several studies suggest modest improvement in joint pain and reduced incidence of new musculoskeletal symptoms, according to The Lancet Rheumatology.
“More research needs to be done to understand whether MHT results in sustained improvement in joint and muscle pain, but at this time, the recommendation is still primarily for treatment of vasomotor symptoms,” Dr. Feldman says. “If you are interested in considering MHT, it is important to have a careful conversation with your care team about risks and benefits, the timing, and the different options available, which may also include nonhormonal therapies depending on your medical history.”
Even though joint pain may be seen as a natural part of the aging process, for women, it’s also related to the changes of menopause. Fortunately, there are strategies to help manage this lesser known but all too common symptom.
