Yes. Joint and muscle pain are recognised symptoms of perimenopause and menopause, and they are among the most common: a meta-analysis found musculoskeletal pain in about 71% of perimenopausal women. Falling and fluctuating estrogen is linked to the pain, though a direct cause has not been proven. New joint pain can also have other causes, so swelling, heat, long morning stiffness or pain after an injury always need a doctor.

A smiling woman in her fifties doing a side stretch on a yoga mat in a bright room

Why do joints and muscles hurt around menopause?

Estrogen helps keep almost every tissue of the musculoskeletal system in balance, from cartilage and tendons to muscle and bone. When it declines, many women notice more aches, stiffness and slower recovery.

Joint tissues carry estrogen receptors, and estrogen helps maintain cartilage, ligaments and muscles. Researchers also describe estrogen as a regulator of inflammation that plays a role in preventing generalised joint pain. This is why some experts now group these changes under one name, the musculoskeletal syndrome of menopause: joint pain, loss of muscle mass, bone loss, tendon and ligament problems, frozen shoulder and the progression of osteoarthritis.

It is worth being precise here. The link between menopause and joint pain is strong, but a direct causal link between estrogen loss and joint pain or arthritis has not been proven. Hormones are part of the picture, not the whole of it.

Three other everyday factors add to it:

  • Muscle. After menopause, muscle mass and strength fall faster — one review puts the loss of muscle mass at about 0.6% a year. Weaker muscles give joints less support. Read more in Strength Training During Menopause.
  • Sleep. Poor sleep is a reliable predictor of new or worsening pain — in studies, a stronger predictor of pain than pain is of poor sleep. Menopause often disturbs sleep, so the two can feed each other.
  • Body weight. Weight gain is common during perimenopause and menopause, and extra weight increases the strain on the joints and the risk of osteoarthritis.

Where does menopausal joint pain usually show up?

There is no single typical spot. Women report aches in the hands, knees, hips, shoulders and lower back, and often in several joints at once.

A few patterns are worth knowing:

  • Several joints at the same time. Pain in multiple joints has a medical name, polyarthralgia. It describes the pain, not its cause.
  • Knees, hips and the small joints of the hands are where osteoarthritis most often causes problems, and osteoarthritis is more common in women than in men.
  • Shoulder. Frozen shoulder becomes more likely from the age of 40, particularly in women, and its pain can be worse at night and disturb sleep. It is one of the conditions linked to the musculoskeletal syndrome of menopause.
  • Lower back. Some studies link perimenopause with more low back pain, but this evidence is weaker than for joint pain in general.

Is it menopause or something else? When should you see a doctor?

Menopause can explain aches and stiffness, but it does not explain everything. A swollen or hot joint, stiffness that lasts more than 30 minutes after waking, or pain after an injury needs a medical check.

The NHS lists these signs:

See your doctor if:

  • your joints are stiff for more than 30 minutes after waking up;
  • the pain has not improved after two weeks of looking after it at home;
  • back pain is worse at night, or you have lost weight without trying.

Get urgent medical advice the same day if:

  • a joint is swollen and the skin around it feels hot;
  • you have joint or back pain and feel generally unwell, have a high temperature, or feel hot, cold or shivery.

Get emergency help if:

  • you have very bad joint pain after a fall or injury, or you cannot walk or put weight on a joint;
  • you have back pain with weakness, tingling or numbness in both legs, loss of feeling around your genitals or bottom, or changes in your bladder or bowels.

Morning stiffness is a useful clue. In osteoarthritis it usually wears off within 30 minutes of getting up; in rheumatoid arthritis it often lasts longer, and the same joints tend to be affected on both sides of the body. Only a doctor can tell these conditions apart. If you are unsure whether a change belongs to perimenopause at all, Is This Perimenopause — or Is Something Else Going On? walks through other common explanations.

Does exercise help joint pain, or make it worse?

Moving is generally better than resting. Health guidelines advise staying active with back and joint pain, and exercise is a core part of osteoarthritis care.

What the guidance says:

  • Keep moving. With back pain, the NHS advises staying active and continuing daily activities; walking, swimming, yoga and Pilates may also help. With joint pain, it advises not to stop moving the affected joint completely.
  • Build strength. For adults, the NHS recommends at least 150 minutes of moderate activity a week and strengthening activities on at least two days a week. Stronger muscles support the joints and slow the muscle loss described above.
  • Expect some discomfort at the start. NICE notes that joint pain may increase when someone starts exercising, and that regular exercise is still recommended. Start gently and build up step by step.
  • Know when to stop and check. A joint that becomes swollen and hot, or pain that is not easing after two weeks, is a reason to see a doctor rather than to push on.

For a fuller picture of how to move during this life stage, see Exercise During Menopause.

What else in daily life can make a difference?

Sleep, muscle-friendly nutrition and body weight all affect how much joints hurt — and each of them can be influenced day to day.

  • Sleep. Because poor sleep predicts more pain, protecting sleep is part of looking after your joints.
  • Protein. Muscles need enough protein to get stronger from strength training. How much women need after 40 is covered in Protein After 40.
  • Body weight. For people with osteoarthritis who are overweight, NICE says weight loss improves physical function and reduces pain. This is something to plan with your doctor, not a target to chase alone.

What should you write down about your joint pain?

Note which joint hurts, when, how badly, and what happened before — sleep, activity and where you are in your cycle. Patterns are easier to see, and easier to explain to a doctor, when they are written down.

Useful details to record:

  • Where: which joint or area, one side or both;
  • When: morning, evening, at night; how long morning stiffness lasts;
  • How strong: mild, moderate, severe;
  • What came before: a poor night, a long sit, a workout, a long walk;
  • Cycle: if you still have periods, whether the pain gathers around them;
  • Anything new: swelling, heat, redness, fever — these belong in a doctor's appointment, not just a diary.

In the Menoup app you can log joint pain, muscle aches and back pain as symptoms, with an optional intensity, trigger (for example lack of sleep, lack of exercise or your period) and duration. Sleep and cycle have their own diaries, and workouts can be imported from Apple Health or Health Connect, so the pain sits next to the things that might affect it.

What should you ask your doctor?

Bring your notes and a few clear questions, so the appointment ends with a plan rather than a guess.

Questions you might take with you:

  1. Could my joint or muscle pain be related to perimenopause or menopause?
  2. Are there signs of arthritis or another condition that should be checked, and do I need any tests?
  3. Is the morning stiffness I have something to look into further?
  4. What kind of exercise is safe for me right now, and should I see a physiotherapist?
  5. Could my sleep, weight or any medicine I take be playing a role?
  6. Which changes should make me come back sooner?

Frequently Asked Questions

Can perimenopause cause lower back pain?

It may. A review of studies found that women reported more low back pain as they entered perimenopause, but the evidence is weaker than for joint pain overall, and back pain has many other causes. Back pain with leg numbness or weakness, or changes in bladder or bowel control, needs emergency help.

Is muscle pain a symptom of perimenopause?

Yes. Muscle aches are listed among menopause symptoms by the NHS and NICE, and muscle mass and strength decline faster after menopause. Aches that linger longer after activity than they used to are a common description.

Why do my hips hurt during perimenopause?

Hip pain can be part of menopausal joint aches, but the hip is also one of the joints osteoarthritis most often affects, and it is more common in women. Pain that keeps you from walking, follows a fall, or comes with stiffness lasting more than 30 minutes in the morning should be checked by a doctor.

What is polyarthralgia?

Polyarthralgia simply means pain in several joints at once. It describes what you feel, not why — it can occur around menopause, but also with other conditions, which is why a doctor should look at persistent pain in multiple joints.

Author: Fejsztámer Marianna

Last updated: October 10, 2026

Medical Note: This article is for informational purposes only and does not replace professional medical advice. If you experience severe, persistent or concerning symptoms, consult your doctor or healthcare provider.

References

  • National Institute for Health and Care Excellence (NICE). Menopause: identification and management (NG23).
  • NHS. Symptoms of menopause.
  • The Menopause Society. Menopause symptoms.
  • The Menopause Society. Sleep apnea and joint pain (press release, 2 March 2022).
  • Wright VJ, Schwartzman JD, Itinoche R, Wittstein J. The musculoskeletal syndrome of menopause. Climacteric. 2024;27(5):466–472.
  • Lu CB, et al. Musculoskeletal Pain during the Menopausal Transition: A Systematic Review and Meta-Analysis. Neural Plasticity. 2020;2020:8842110.
  • Watt FE. Musculoskeletal pain and menopause. Post Reproductive Health. 2018;24(1):34–43.
  • Kozinoga M, Majchrzycki M, Piotrowska S. Low back pain in women before and after menopause. Prz Menopauzalny. 2015;14(3):203–207.
  • Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. Journal of Pain. 2013;14(12):1539–1552.
  • NHS. Joint pain.
  • NHS. Back pain.
  • NHS. Osteoarthritis.
  • NHS. Rheumatoid arthritis: symptoms.
  • NHS. Frozen shoulder. Kingston and Richmond NHS Foundation Trust. Frozen shoulder (patient leaflet).
  • NHS. Physical activity guidelines for adults aged 19 to 64.
  • NICE. Osteoarthritis in over 16s: diagnosis and management (NG226).
  • MSD Manual Professional Version. Pain in multiple joints.

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