Perimenopause and Joint Pain: Why It Happens and What Helps

Joint pain is one of the most common symptoms of perimenopause—yet it’s rarely discussed in the same way hot flashes or night sweats are. Research shows that between 51–70% of women in the menopause transition experience joint pain, stiffness, or backache, and for about one in four, it can be severe enough to disrupt daily life.

I know this one firsthand. For me, it started with lower back pain that became a near-constant part of my life. Over the years, that pain has shifted—into my hips, then my elbows and wrists, and more recently, my knees. Some symptoms fade, new ones show up, and others (like my back pain) stick around.

This “traveling” joint pain is frustrating—and confusing. For a long time, I tried everything: chiropractors, acupuncture, physical therapy, even lumbar ablation. Nothing worked. And not once did a provider suggest that perimenopause could be the root cause.

Why Perimenopause Affects Your Joints

It can feel strange to suddenly deal with achy, stiff joints in your late 30’s and 40s—especially if you’ve always been active. But hormones play a big role in how your joints, muscles, and connective tissues function.

Here’s what’s happening:

• Estrogen Decline → Estrogen helps keep inflammation in check and lubricates your joints. When it drops, joints can feel “dry,” stiff, and more inflamed.

• Progesterone Decline → Progesterone also has anti-inflammatory effects. Its decline removes another layer of protection.

• Muscle + Bone Changes → Perimenopause often comes with muscle loss (sarcopenia) and lower bone density. That means less cushioning and more stress on your joints.

Pain Sensitivity → Estrogen may help “turn down the volume” on pain signals. When it declines, pain that was once masked can become more noticeable.

Is It Arthritis? Or Perimenopause?

Not all joint pain in midlife is arthritis—but the two can overlap. Osteoarthritis is more common in postmenopausal women due to the drop in estrogen.

Signs of osteoarthritis include:

• Ongoing stiffness, especially in the morning

• Pain in weight-bearing joints (hips, knees, spine, hands)

• Swelling, redness, or warmth

• Reduced range of motion

If you’re unsure, check in with your healthcare provider. Sometimes perimenopausal joint pain improves as hormone levels settle after menopause; sometimes it’s the start of longer-term conditions.

What About HRT?

Hormone replacement therapy (HRT) can help some women with joint pain thanks to its anti-inflammatory effects—but it’s not a universal fix.

• Some women notice relief within months of starting HRT.

• Others see no improvement in their pain, even if HRT helps with other symptoms.

If joint pain is affecting your quality of life, HRT can be part of the conversation with your provider—but it shouldn’t be the only tool in your toolbox.

Lifestyle and Natural Relief Strategies

The good news: there are steps you can take that do make a difference in pain, stiffness, and mobility.

• Keep moving. Low-impact movement like yoga, Pilates, walking, and swimming supports mobility and flexibility.

• Strength training. Building muscle protects your joints, supports bone health, and improves stability.

• Hot and cold therapy. Use ice for swelling and heat for stiffness.

• Anti-inflammatory diet. Reduce sugar, refined carbs, and processed foods. Load up on fish, leafy greens, berries, avocado, olive oil, and green tea.

• Stay hydrated. Dehydration worsens joint pain. Aim for at least 2.5–3L (85–100 oz) daily.

• Maintain a healthy weight. Even small weight loss reduces strain on joints, especially knees and hips.

Supplements That Can Help

Based on research and what I’ve shared before on Instagram, here are four options that may help reduce inflammation and support joint health:

• Curcumin (Turmeric Extract): Natural anti-inflammatory; look for versions with black pepper (piperine) for absorption.

• Magnesium: Relaxes muscles, reduces stiffness, and supports bone/cartilage health. Choose magnesium glycinate for best absorption.

• Glucosamine + Chondroitin (with MSM): Supports cartilage and improves flexibility over time.

• Fish Oil (Omega-3s): Reduces systemic inflammation and improves joint mobility.

You can find my personal recommendations for the above in my Amazon Shop. As always—check with your healthcare provider before starting supplements, especially if you take other medications.

Bottom Line

Joint pain in perimenopause is real—and it’s not just “getting older.” For some, it’s a temporary phase. For others, it lingers or overlaps with arthritis. Either way, you don’t have to just put up with it.

From lifestyle changes and supplements to HRT and physical therapy, there are options. And the more we talk about this symptom, the easier it gets for women to recognize what’s happening—and find relief.