Joint aches in midlife: could menopause be part of the picture?

A familiar walk starts to feel less comfortable. Your hands ache when opening a jar, or your knees complain after a busy day. When these changes arrive in midlife, it can be tempting to put them down to getting older and carry on.

World Menopause Day, on 18 October, has chosen Chronic Pain At Midlife as its 2026 theme. It highlights a less familiar part of the menopause conversation: joint and muscle pain.

How menopause can affect your joints

Hot flushes and changing periods tend to get most of the attention, but joint and muscle aches are also recognised symptoms of perimenopause and menopause. They can affect areas such as the hands, knees, hips and shoulders, including before periods have stopped.

Oestrogen has effects throughout the body. It helps regulate inflammation and supports the maintenance of cartilage, the cushioning tissue in our joints. It also influences muscle maintenance and repair. As oestrogen levels fluctuate during perimenopause and fall after menopause, these processes can change. Alongside age-related changes, this may contribute to aches, stiffness and changes in the tissues that support our joints.

There is another part to the picture: oestrogen also influences how the nervous system processes pain. Changing hormone levels may alter pain sensitivity. Meanwhile, night sweats and disrupted sleep can make pain feel worse, and pain can make sleep more difficult. Several influences can therefore build on one another.

The International Menopause Society's patient factsheet on pain at midlife (PDF) explains these connections in more detail. The relationship is complex, and menopause may be one contributor rather than the whole explanation.

Finding a plan that fits your life

The effect on your day matters as much as the word used to describe the pain. Your GP can assess your symptoms, examine the affected areas and decide whether investigations or referral would be useful. It helps to discuss other changes, such as disturbed sleep, hot flushes or irregular periods, too.

Imagine someone who has stopped taking their usual walks because their knees ache, while night sweats are leaving them exhausted. Both concerns deserve attention. A useful discussion would consider the joint symptoms, the sleep disruption and how a treatment plan could fit around work or caring responsibilities.

Depending on the cause, options may include suitable exercise and strengthening, physiotherapy, pain relief and support for other menopause symptoms. Menopausal hormone therapy may help some of those symptoms, but it does not reliably treat joint or muscle pain on its own. Treatment needs to reflect the whole picture. Our earlier article, Understanding Menopause: Support Is Available, introduces the broader discussion.

If joint pain is affecting your sleep, work or the activities you enjoy, book an appointment with us at Summers Family Practice. Tell us what has changed and what you would like to get back to doing. Your GP can help you understand what is contributing and discuss a plan that fits your life.