Menopause joint pain: why your joints and muscles ache, and what can help

Your fingers are stiff when you wake up. Your knees complain on the stairs. Your neck, shoulders or hips ache for no reason you can think of, and you feel older than you did a year ago. Some days it's everywhere at once.

If this has crept up on you in your 40s or 50s, menopause joint pain is a real possibility. The NHS lists muscle aches and joint pains among the symptoms of perimenopause and menopause. NICE, which writes the guidance doctors follow, names joint and muscle pain as menopause symptoms too.

So yes, perimenopause can make your joints ache. You're not imagining it. But joint pain has lots of causes, so it's worth knowing what else it could be, and when to get it checked.

What does menopause joint pain feel like?

Women describe it in different ways:

• aching or stiffness, often worse first thing in the morning or after sitting still
• sore hands and fingers, knees, hips, shoulders or neck
• muscles that feel tired, sore or weaker than they used to
• a general "I ache all over" feeling

A 2018 review by Oxford rheumatologist Dr Fiona Watt found that joint pain is a menopause symptom in at least half of women. The review says the pain often comes with tiredness, low mood, poor sleep, anxiety or stress. Each of these can make the others worse.

Why does menopause cause joint pain?

The short answer is that nobody knows for sure. Here's what we do know.

Oestrogen falls and swings. Oestrogen does far more than run your periods. In perimenopause, levels go up and down unevenly before they fall for good.

Muscle and bone get harder to keep. Women's Health Concern, the patient arm of the British Menopause Society, says falling oestrogen causes muscle mass to drop and speeds up bone loss.

It's a pattern, not a proof. In 2024, a review in the journal Climacteric gave this group of aches a name: the musculoskeletal syndrome of menopause. The authors say more than 70% of women get muscle or joint symptoms during the menopause transition. But the Oxford review points out that the link with low oestrogen looks strong, while direct proof that it causes the pain is still missing. Joint pain is common at every age, which makes it hard to study.

Age plays a part too. The NHS says osteoarthritis gets more likely as you get older, and extra weight puts more strain on your joints. The Oxford review adds that poor sleep, stress and low mood can make joint pain worse, and joint pain can make them worse in turn.

What else could be causing my joint pain?

It's easy to blame everything on the menopause. Please don't assume. Other common causes include:

Cause	Clues
Osteoarthritis	More common in women and as you get older. Most often in the knees, hips and small joints of the hands
Rheumatoid arthritis	Pain, swelling and stiffness, often in the hands, feet and wrists. Women are more at risk. Early treatment matters
Gout, bursitis, a strain or sprain	The NHS lists these as common causes of joint pain. A strain often follows an injury or a lot of exercise
Breast cancer medicines	Aromatase inhibitors are a common cause of joint pain. The Oxford review says up to half of users get it
Thyroid problems or low vitamin D	Can cause aches in muscles and joints. Your GP can check with a blood test

The NHS says rheumatoid arthritis needs diagnosing quickly, because early treatment can stop it getting worse. That's why stiffness lasting more than half an hour each morning, or swollen joints, should always be checked.

If you take a breast cancer medicine and your joints hurt, talk to your cancer team. Don't stop or change it on your own.

What helps menopause joint pain?

There's not much research on menopause joint pain itself. Most advice comes from what helps joint pain in general. The good news is that it's practical, and most of it you can start this week.

Keep moving, gently and often

It sounds odd when you hurt, but movement is one of the best things you can do. Women's Health Concern says regular exercise can ease joint and muscle pain, and that strength exercise is the best way to build muscle. The Oxford review also found some evidence that moderate activity helps perimenopausal joint pain.

• Build up slowly. A sudden burst of hard exercise can flare painful joints. Start small, such as a 15-minute walk, and add a little each week.
• Add strength work. Women's Health Concern suggests squats, box press-ups and bicep curls. NICE says doctors should explain the importance of keeping muscle mass and strength through activity at menopause.
• Try something restful too. Women's Health Concern suggests yoga and Pilates for strength and flexibility.
• Avoid heavy lifting or doing the same movement over and over if your hands are sore.

Look after a sore joint

The NHS joint pain advice includes:

• rest the joint if you can, but don't stop moving it completely
• hold an ice pack or a bag of frozen peas wrapped in a towel on it for up to 20 minutes every 2 to 3 hours
• ask a pharmacist which painkiller is right for you
• keep to a healthy weight, eat a balanced diet and don't smoke

Protect your sleep

Pain and poor sleep feed each other. Women's Health Concern lists joint aches as one of the menopause symptoms that disturb sleep. Its tips include going to bed and getting up at the same time each day, keeping your bedroom cool, dark and quiet, and having a relaxing wind-down routine. The Oxford review says good care for joint pain should include help with sleep if that's a problem too.

Will joint pain from menopause go away?

For many women, it settles. The Oxford review describes menopause-related joint pain as usually short-lived. But it can last for some women, and the NHS says joint pain is one symptom you may still have after menopause.

If it doesn't settle, ask your GP to look at it again. Sometimes a new cause turns up over time.

What can your GP offer?

It's worth booking an appointment if joint pain is getting you down. Your GP can examine your joints, and may suggest blood tests to rule out other causes. Things to talk about include:

• Physiotherapy. A physio can give you exercises for the joints that hurt most.
• Pain relief. Your GP or pharmacist can advise what's safe for you.
• HRT. NICE says doctors should offer HRT for hot flushes and night sweats. Doctors don't usually prescribe it for joint pain alone, and the evidence is limited. In a large US trial, women taking oestrogen had slightly less joint pain than women taking a dummy pill: 76% compared with 79% after one year. The Oxford review suggests HRT may be worth discussing if the pain is bad, hasn't eased with other help, and came on with other menopause symptoms.

Take a list of your symptoms with you. The Menopause Charity's symptom checker includes muscle and joint pain, and you can score each one before your appointment.

When to see a GP

Book an appointment if:

• your joints are swollen, or stiff for more than 30 minutes each morning
• the pain hasn't improved after 2 weeks of looking after it at home
• it stops you working, sleeping or doing everyday things
• you have other menopause symptoms and want to talk about your options
• you feel generally unwell, are losing weight without trying, or have a fever

Where relaxation fits in

If aching joints are keeping you awake at night, our menopause sleep hypnosis, Deep Sleep Through the Change, is a bedtime recording to help you relax and drift off. It won't do anything for the aches themselves, so keep moving and keep talking to your GP. It's a relaxation recording, not a treatment, and it doesn't replace advice from your GP.

Related

You might also find our pages on frozen shoulder and menopause, hip pain in menopause and the musculoskeletal syndrome of menopause useful, or see all the perimenopause symptoms.

This page is general information, not medical advice. If you're worried about any symptom, please talk to your GP or pharmacist.

See all perimenopause symptoms