Does your neck ache when you wake up in the morning? Do your hands hurt throughout the day? It’s estimated that around one in two women gets joint and muscle pain when they go through the perimenopause. The symptoms often clear up after two to five years, once your hormone levels stabilise, but may also be a sign of an underlying health condition.

This article was included in issue 97 (Summer 2023) of The Menopause Exchange newsletter.

Why it happens?

Joint and muscle pain at the perimenopause is often due to falling oestrogen levels. Oestrogen helps to keep your joints flexible and reduces inflammation. When your oestrogen levels fluctuate (or drop), you may get some pain, especially first thing in the morning or after long periods of rest. Joint pain at this time of life may also be due to a loss of muscle strength associated with getting older. You may be more prone to pain in your neck, shoulders, spine, elbows, hands and knees.

Hot flushes, a lack of good-quality sleep, and mood changes, can make the pain seem much worse. Weight gain at the menopause can also have an impact, putting more pressure on your joints and making your muscles work much harder – especially your ankles, knees and hips.

Easing the pain

There are lots of things you can try to ease your joint and muscle pain:

  • gentle stretching exercises
  • hot or cold packs (or a hot water bottle)
  • a TENS machine
  • warm baths or showers
  • acupuncture
  • paracetamol or ibuprofen (tablets or capsules) or anti-inflammatory gels (e.g. containing ibuprofen or diclofenac); Tiger Balm Red (containing camphor and menthol) may also help.

Lifestyle tips

  • Keep as active as possible – walking and swimming should be more gentle on your joints than high-impact activities such as running and jumping.
  • Avoid repetitive tasks or sitting or standing for too long – take regular breaks and change your position.
  • Aim to eat a healthy diet, with plenty of fresh fruit and vegetables, and reduced amounts of processed foods.
  • Drink plenty of water-based fluids to keep your joints and muscles hydrated.
  • Keep your weight within a healthy range to reduce the pressure on your joints.
  • Reduce alcohol and smoking as these can make you more sensitive to pain and increase inflammation.
  • Do strengthening, resistance and balance exercises to build up the muscles around your joints – a physiotherapist or personal trainer can give you advice.
  • Practise relaxation techniques and mindfulness to keep you calm and reduce muscle tension.
  • Yoga and pilates can help to improve your flexibility.
  • Get plenty of sleep.
  • Make sure you’re wearing well-fitting, supportive footwear to reduce the stress on your legs and feet.

Useful supplements

  • Joint pain may be associated with vitamin D deficiency – you may need to take a vitamin D supplement.
  • Turmeric contains curcumin, which has anti-inflammatory properties.
  • Omega-3 fatty acids (fish oils) may help to reduce inflammation in the body.

The role of HRT

According to NICE guidelines on Menopause: diagnosis and management, there’s some evidence that HRT improves muscle bone and muscle mass and strength during the menopause. The NHS website states that HRT may help to ease joint pain at the menopause, but there hasn’t been much research looking into this. Some research suggests that HRT may help to prevent or manage osteoarthritis (especially hand osteoarthritis).

Is it something else?

If your joint or muscle pain is severe enough to affect your daily activities, speak to your GP. Your GP may check for signs of osteoarthritis and other conditions, or may refer you to a rheumatologist.

Going through the menopause lowers your bone density, increasing your risk of osteoporosis. Unlike arthritis, osteoporosis doesn’t cause any pain. So you usually only know you have it if you break a bone after a minor injury.

Long-term conditions that may cause joint pain and stiffness include:

Osteoarthritis tends to occur in people over 50 and is usually related to wear and tear. It generally causes pain and stiffness in your knees, hips, hands or base of your spine. Hand osteoarthritis occurs in twice as many women than in men, especially from the age of 50.

Rheumatoid arthritis causes pain, swelling, heat and stiffness in the joints, which can lead to permanent damage. The condition usually affects the hands, feet and wrists. It’s an autoimmune disease, which means that your immune system attacks the lining of your joints. The disease is more common in women than in men and usually starts between the ages of 40 and 50, but the role of oestrogen is still unclear. It runs in families and is more common in smokers.

Gout tends to affect men more than women, but it can become more common in women after the menopause. It occurs when tiny urate crystals form in and around your joints, causing sudden flares of severe joint pain, heat and swelling. It can affect any joint but tends to affect toes, knees, ankles and fingers.

Fibromyalgia is a chronic pain syndrome, causing widespread pain and stiffness, fatigue, tender areas, sleep problems and other symptoms similar to those at the menopause. This condition is particularly common in women aged 40 to 65.

About the author

Victoria Goldman is a health journalist and editor, and freelance health editor for Bupa. She edits and proofreads fiction and nonfiction for UK publishers, and is the author of two crime novels, The Redeemer and The Associate.

Created Summer 2023
Copyright © The Menopause Exchange 2023

Tags: easing the pain, Fibromyalgia, Gout, HRT, joint and muscle pain, Lifestyle tips, menopause, osteoarthritis, perimenopause, Rheumatoid arthritis, Useful supplements