Managing Perimenopause With Osteoarthritis
Joint pain during perimenopause can overlap with osteoarthritis. Learn how hormonal changes affect your joints and what helps.
Joint Pain: Two Causes at Once
Many women develop new joint pain or find that existing osteoarthritis becomes noticeably worse during perimenopause. The timing is not a coincidence. Oestrogen has anti-inflammatory properties and plays a direct role in maintaining cartilage health and joint lubrication. As levels fall, joints can become more inflamed and less well-cushioned. Women who already have osteoarthritis, particularly in the knees, hips, fingers, and spine, frequently report a clear worsening of symptoms as they enter the perimenopausal transition. Understanding that both conditions are contributing to joint symptoms helps you approach treatment in a more targeted and informed way rather than guessing at the cause.
How Perimenopause Affects Joints
Oestrogen receptors are found in joint tissues including cartilage, synovial membranes, and the cells that produce joint fluid. When oestrogen drops, these tissues become more susceptible to inflammation and degradation. Joint fluid may become thinner and less effective at cushioning the surfaces during movement. Many women notice that morning stiffness becomes more pronounced, that joints ache more after periods of rest, or that activity levels they previously managed without difficulty now produce pain. Distinguishing perimenopausal joint aching from the progression of osteoarthritis is genuinely difficult without clinical assessment, which is why raising new or worsening joint symptoms with your doctor matters rather than assuming it is simply age.
Exercise: Essential but Needs Adapting
Staying physically active is one of the most important strategies for managing both perimenopause and osteoarthritis, and the benefits compound. Movement maintains joint lubrication, strengthens the muscles that support and protect damaged joints, and improves mood, energy, and cardiovascular health. However, high-impact activities may aggravate affected joints, so finding the right balance matters enormously. Swimming and cycling are excellent low-impact options that raise the heart rate and build fitness without heavy joint loading. Resistance training, particularly exercises that strengthen the quadriceps, glutes, and hip muscles, reduces the force placed on the joint surfaces during everyday movement. Tracking what you do and how your joints feel afterwards helps you identify your personal optimal activity pattern.
Managing Flare-Ups Strategically
Osteoarthritis flare-ups during perimenopause can be triggered by hormonal fluctuations, physical overexertion, cold or damp weather, or sometimes no clear reason at all. On high-pain days, relative rest alongside heat or cold therapy provides short-term relief. Topical anti-inflammatory gels reduce localised pain without the gastrointestinal side effects associated with regular oral anti-inflammatories. Planning your week to alternate demanding activity with gentler movement prevents the boom-and-bust cycle, where a good day leads to overdoing things and several painful days follow as a consequence. Tracking symptom severity alongside your activity log helps you recognise these cycles and adjust before a flare becomes severe.
Weight, Inflammation, and Joint Load
Weight gain during perimenopause, particularly around the abdomen, directly increases the mechanical load on weight-bearing joints and accelerates osteoarthritis progression. Every additional kilogram of body weight places approximately three to four kilograms of additional force on the knee joint during walking, and more during stair climbing. Diet also influences systemic inflammation independently of weight. A pattern of eating that prioritises vegetables, oily fish, olive oil, whole grains, and legumes while limiting refined carbohydrates, sugar, and ultra-processed foods can reduce inflammatory markers measurably. These dietary changes benefit both the hormonal symptoms of perimenopause and the pain burden of osteoarthritis, making them doubly worthwhile.
Medical Options to Discuss
For women managing both conditions, treatment decisions need to account for both simultaneously. HRT does not treat osteoarthritis directly, but for some women, reducing severe hormonal symptoms improves overall functioning, sleep quality, and mood, which in turn supports more consistent activity and better pain management. Physiotherapy tailored specifically to your affected joints can provide targeted exercise programmes and guidance on movement modification that makes a significant day-to-day difference. Intra-articular corticosteroid or hyaluronic acid injections, and in more advanced cases surgical options, are relevant to osteoarthritis management independently. Your GP can coordinate referrals and advise on interactions between any medications you take.
Building a Realistic Long-Term Approach
Living with osteoarthritis through perimenopause requires a flexible, realistic, and self-compassionate approach. Symptoms will vary from week to week and month to month, and building routines that can accommodate bad days without abandoning good habits entirely is the key skill. Staying connected with your healthcare team, tracking your symptoms and activity over time, and adjusting your self-care accordingly gives you genuine agency over a situation that can otherwise feel out of control. Addressing both conditions through a shared set of strategies, consistent movement, anti-inflammatory eating, good sleep, and appropriate medical support, sets a stronger foundation for life after menopause.
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