Menopause can introduce a range of uncomfortable symptoms, from hot flashes to urinary urgency. There’s one issue that’s just as common and taxing, but not as well-known: joint pain. This ache can affect the whole body, especially during the perimenopausal period.

Let’s explore what drives joint pain in menopause and which interventions doctors commonly prescribe to treat it.

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The connection between menopause and joint pain

Menopausal hormone changes, especially declining estrogen levels, can lead to joint pain. Here’s why:

• Inflammation: An estrogen deficiency can cause your body to produce inflammatory proteins called cytokines. This rise in inflammation can contribute to joint pain. 
• Cartilage: Estrogen helps regulate the cells that maintain cartilage, which is the tissue that cushions your joints. Declining estrogen may contribute to the breakdown of cartilage, limiting this tissue’s protective effects. 
• Pain threshold: Some research shows that estrogen deficiency might make the central nervous system more sensitive to pain. But more studies are needed on this topic.

It’s important to note that menopause isn’t the only potential driver of joint pain as you age. Natural wear and tear can contribute, too. 

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Treating joint pain in menopause

Joint pain during perimenopause and menopause can be more common than vasomotor symptoms (night sweats and hot flashes). Thankfully, many get it under control through targeted therapies. Care plans can involve a mixture of medication-based and holistic approaches. Here are a few examples of how to treat menopause joint pain.

Medication-based treatments

Your doctor might recommend over-the-counter pain relievers, such as ibuprofen or acetaminophen. These ease joint pain through their anti-inflammatory and pain-relieving properties. Depending on severity, doctors may consider prescription-strength pain relievers. 

These medications work at the symptom level. If the root cause of your joint pain is lower estrogen levels, your doctor may consider hormone replacement therapy (HRT). HRT works by supplementing the hormones that naturally fluctuate and decline in menopause, including estrogen. 

Holistic treatments

For some people, holistic treatments play a key role in helping with joint pain. A 2024 systematic review looked at the benefits of manual therapy like massage, stretching, and joint mobilization. 

In four of the five trials researchers assessed, menopausal women who received manual therapy reported a meaningful reduction in pain. This includes the following:

• Knee osteoarthritis
• Thumb carpometacarpal (thumb-based) osteoarthritis
• Chronic neck and back pain
• Sternocostal (rib-to-sternum) joint pain

These studies involved a small sample size, and some may carry a risk of bias. Researchers note that further investigation is needed to confirm these findings. 

Yoga also may offer benefits. In a 2024 trial in Holistic Nursing Practice, 62 menopausal women practiced yoga for 60 minutes twice-weekly for 10 weeks. At the start and end of the trial, participants reported the severity of their somatic symptoms, including joint pain, on a scale from zero to 16. Participants’ scores dropped from seven to one over the course of the study. 

Holistic interventions aren’t limited to manual therapy and yoga. Doctors might suggest changing other parts of your lifestyle to address joint pain.

Can hormone replacement therapy help with joint pain?

HRT can ease joint pain from menopause, but not in all cases. HRT’s benefits are better established for treating other common menopause symptoms, such as hot flashes and painful sex. It’s not as established for treating joint pain.

One 2025 review article published in Post Reproductive Health examined multiple previous studies about HRT and musculoskeletal pain. Here’s what researchers found: 

• 10 studies found that HRT had a neutral effect. 
• 8 studies reported reduced pain.
• 3 studies reported increased pain. 

Across these studies, women on HRT were about as likely to report musculoskeletal pain as those who were not. But the largest trial in the set points to a few benefits. About 47% of participants on HRT reported less joint pain after one year, compared to 38% on placebo. While it’s not a huge difference, it is an improvement.

HRT might also support joint pain indirectly. It reduces the frequency and severity of night sweats, which can help you sleep. Sleeping poorly can worsen joint pain, so getting a better night’s rest may improve it.

As mentioned above, low estrogen levels can cause inflammation, making joints feel more achy. By bringing estrogen levels closer to a normal baseline, HRT may reduce this inflammation, easing pain. 

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Is HRT safe?

For most women, HRT is safe and effective when prescribed appropriately. A key part of that equation is contraindications. These refer to conditions or circumstances that make any treatment potentially dangerous.

Contraindications vary between different FDA-approved HRT products. For example, your doctor won’t prescribe Estrace®, a local form of estrogen, if any of the following contraindications apply to you: 

• Abnormal genital bleeding
• Breast cancer
• Estrogen-dependent neoplasia
• Deep vein thrombosis or pulmonary embolism
• Arterial thromboembolic disease
• Liver dysfunction or disease
• Thrombophilic disorders
• Allergy or hypersensitivity to Estrace
• Pregnancy 

But even if you don’t have these contraindications, HRT products might not be suitable. Other factors—from your age to the medications you take—matter, too. Your doctor will look at your full health picture to determine if it’s right for you.

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When should you talk to a specialist?

It’s never too early to seek help for your joint pain. If you’re not sure where to start, talk to your primary care physician (PCP). They can refer you to the right specialist for your needs. 

Our team at Maven Clinic can help, too. We’ll place a multidisciplinary team of specialists in your corner, each carrying dedicated expertise in women’s health. 

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Experience a personalized approach with Maven Clinic

Your menopause journey is unique. Your care plan should be, too. At Maven Clinic, our specialists build care plans around what’s actually happening beneath the surface—not just your symptoms. That’s why millions of women trust us with their care. 

Debbie, a Maven Clinic patient, says, “I started using Maven because I was looking for answers and support during perimenopause. What stood out immediately was how understood I felt. The providers didn't dismiss my symptoms. They helped me make sense of the changes happening in my body and gave me practical, personalized support.”

Discover our approach to hormone care.