Joint pain during perimenopause and menopause
If your joints have started hurting in ways you cannot explain, you are not imagining it. Joint pain is one of the most common experiences of perimenopause and menopause, and one of the least talked about. More than 70% of women in this life stage report joint and muscle pain, and for many there is nothing on a scan to explain it. Research strongly links this to estrogen loss, though the full picture is still being understood.
Why it happens
You might be wondering why your joints have started playing up now, when nothing has changed in your life to explain it. The answer is estrogen. Estrogen plays a protective role in cartilage, the tissue that cushions your joints, and as your levels fall that protection changes. Research strongly links estrogen loss to increased joint inflammation and a higher rate of osteoarthritis in women after menopause compared to before it.
It can show up anywhere. It can move around. It can show nothing on a scan. That does not make it any less real.
Why it matters
Muscle does more than move you. It supports your joints, helps regulate your metabolism, contributes to your balance and coordination, and plays a role in how your body manages blood sugar. Keeping your muscle mass strong during perimenopause and menopause supports all of those things.
You might already recognise it. Groceries that feel heavier than they used to. Stairs that take more out of you. It is more common than most women realise.
Most women are surprised by how much muscle has to do with how they feel day to day.
Should you keep moving?
Movement is one of the best things you can do for joint pain during perimenopause and menopause. Keeping active supports the tissue around your joints, builds muscle strength that takes load off them, and can reduce inflammation over time.
If something hurts during exercise, modify it rather than push through. A different movement, a lighter load, or a shorter session is often exactly what your body needs right now.
What tends to help
Swimming, walking, cycling and water based exercise are often easier on joints, particularly on days when pain is higher. They let you keep moving without adding to the load your joints are already managing.
Strength work is still worth doing. Building the muscles around your joints helps protect them and can reduce pain over time. Starting gently and building gradually is the approach that tends to work best.
If mornings are your hardest time, some gentle movement or stretching before you get going can make a real difference to how the rest of the day feels.
When to get support
If joint pain is affecting your daily life, your sleep, or your confidence to keep moving, it is worth talking to your doctor. There are good treatment options available, and you do not have to manage this alone.
A women’s health physiotherapist or exercise physiologist can also help you find a way to keep moving that works for your joints right now. If cost or access is a barrier, ask your GP about a chronic disease management plan, which can provide subsidised allied health sessions.
References
Boyan, B.D., Tosi, L.L., Coutts, R.D., Enoka, R.M., Hart, D.A., Nicolella, D.P., Berkley, K.J., Tashman, S., Havill, L.M., Zumwalt, A., & Bhavna, J. (2013). Addressing the gaps: sex differences in osteoarthritis of the knee. Biology of Sex Differences, 4, 4. https://doi.org/10.1186/2042-6410-4-4
Nedergaard, A., Henriksen, K., Karsdal, M., & Christiansen, C. (2013). Menopause, estrogens and frailty. Gynecological Endocrinology, 29, 418-423. https://doi.org/10.3109/09513590.2012.754879
Watt, F. (2017). Musculoskeletal pain and menopause. Post Reproductive Health, 24(1), 34-43. https://doi.org/10.1177/2053369118757537
Wright, V.J., Schwartzman, J.D., Itinoche, R., & Wittstein, J. (2024). The musculoskeletal syndrome of menopause. Climacteric, 27(5), 466-472. https://doi.org/10.1080/13697137.2024.2380363
Xu, C., Li, Q., Wei, W., Li, X., Shang, X., Hu, Y., Ge, Z., & He, M. (2025). Global burden of osteoarthritis attributable to high body mass index from 1990 to 2021. RMD Open. https://doi.org/10.1136/rmdopen-2024-004972
WHEN Position Statement: Resistance Training Across the Menopausal Transition (April 2026). Women’s Health Education Network. www.when.org.au
Developed by the WHEN Clinical Team
Clinically reviewed by the WHEN Clinical Governance Committee
Last reviewed: July 2026
