Peri-menopause and Joint Pain: What’s Really Causing the Aches?
Introduction
Peri-menopause is a natural hormonal transition that occurs before menopause, often beginning in a woman’s late 30s to mid-40s, or roughly 7–10 years before the final menstrual cycle. During this phase, fluctuating estrogen levels can lead to a wide range of physical symptoms — many of which are under-recognized or misattributed to aging.
One of the most common yet least discussed symptoms is joint pain during perimenopause. Women may experience new or worsening stiffness, aches, and reduced mobility that affect daily activities, exercise, sleep, and overall quality of life. Understanding the hormonal connection is key to managing symptoms and maintaining long-term joint health.
Can Perimenopause Cause Joint Pain?
Yes — hormonal changes during perimenopause can significantly affect joint health.
The Role of Estrogen in Joint Health
Estrogen plays an important role in:
Maintaining joint lubrication
Supporting collagen and connective tissue health
Regulating inflammation
As estrogen levels fluctuate and gradually decline, joints may become more sensitive, less resilient, and more prone to stiffness or inflammation. This can lead to pain in multiple joints, even in women with no prior history of joint issues.
Common Risk Factors for Perimenopausal Joint Pain
Certain factors may increase the likelihood or severity of joint pain during perimenopause, including:
Age (commonly 40–50 years)
Previous joint or soft-tissue injuries
Sedentary lifestyle or sudden changes in activity
High stress levels
Poor sleep quality
Autoimmune or inflammatory conditions
Rapid or significant weight changes
Identifying and addressing these contributors early can help prevent symptoms from becoming chronic.
Symptoms of Joint Pain During Perimenopause
Joint pain related to perimenopause may present differently from person to person.
Common Symptoms
Generalized joint aches
Morning stiffness or stiffness after rest
Pain in the knees, hips, shoulders, hands, or spine
Reduced flexibility or range of motion
Increased discomfort after prolonged sitting
Early vs. Progressive Symptoms
Early symptoms may be intermittent and mild. As hormonal changes continue, pain can become more persistent, affect multiple joints, and interfere with work, exercise, and daily activities.
How Is Perimenopausal Joint Pain Diagnosed?
There is no single test to diagnose perimenopause-related joint pain. Assessment typically includes:
A detailed health history, including menstrual changes and other hormonal symptoms
Physical examination of joint mobility, strength, posture, and movement patterns
Ruling out other causes such as arthritis, tendon injuries, or inflammatory conditions
Physiotherapy assessments focus on functional movement and musculoskeletal health, not just hormone levels.
How Physiotherapy Can Help With Joint Pain During Perimenopause
Physiotherapy plays a key role in managing joint pain by addressing both symptoms and underlying movement contributors.
Physiotherapy Treatment May Include:
Individualized strengthening programs to support joint stability
Mobility and flexibility exercises to reduce stiffness
Load management and gradual exercise progression
Manual therapy to improve joint and soft-tissue movement
Education on posture, movement strategies, and joint protection
Pelvic health considerations when relevant, as hormonal changes affect the entire musculoskeletal system
A tailored physiotherapy plan helps women stay active while minimizing flare-ups and discomfort.
Self-Management Strategies for Perimenopausal Joint Pain
Long-term symptom management is supported by education and healthy habits, including:
Regular low-impact exercise (walking, swimming, strength training)
Gradual progression of activity rather than pushing through pain
Prioritizing sleep and stress management
Staying hydrated and supporting joint health through nutrition
Being consistent with prescribed home exercises
Most importantly, joint pain during perimenopause is real, common, and treatable.
When Should You Seek Professional Help?
Joint pain is often dismissed as “just aging,” but hormonal changes during perimenopause can have a real impact on joint health. Early assessment and targeted physiotherapy can help reduce pain, maintain mobility, and prevent long-term issues.
If joint pain is unexplained, persistent, or worsening — especially alongside other perimenopausal symptoms — professional guidance can make a meaningful difference.
Book a Physiotherapy Assessment
If joint pain is affecting your daily life, physiotherapy can help identify contributing factors and create a personalized treatment plan.
Contact Integrative Physiotherapy & Wellness to book an assessment and take the first step toward moving comfortably and confidently again.
Frequently Asked Questions
Is joint pain a normal part of perimenopause?
Yes, joint pain is common during perimenopause due to hormonal fluctuations, particularly changes in estrogen.
Which joints are most affected?
The knees, hips, shoulders, hands, and spine are commonly affected.
Can physiotherapy help even if hormones are the cause?
Absolutely. Physiotherapy addresses how joints move, load, and recover — which is essential regardless of the hormonal trigger.
References
Santoro N. Perimenopause and joint pain. Journal of Women’s Health, 2016
Szoeke CEI et al. Estrogen and musculoskeletal health. Climacteric, 2014
Hunter DJ, Bierma-Zeinstra S. Osteoarthritis and hormonal influences. The Lancet, 2019
