What causes joint pain during menopause?

From the Guidelines

Joint pain during menopause is primarily caused by declining estrogen levels, which can lead to inflammation and cartilage health issues, and can also be exacerbated by aromatase inhibitor medications in breast cancer survivors.

Causes of Joint Pain

• Declining estrogen levels play a key role in maintaining joint health, and when levels drop during menopause, many women experience increased joint pain, stiffness, and inflammation, particularly in the knees, hips, and hands 1.
• Aromatase inhibitor medications, used in breast cancer treatment, can also cause joint pain, with up to 50% of postmenopausal women reporting arthralgias (joint pain) and myalgias (muscle pain) that are severe enough in 20% of women to lead to treatment discontinuation 1.

Management of Joint Pain

• Regular exercise, such as walking or swimming (30 minutes daily), can help manage joint pain and improve overall health 1.
• Maintaining a healthy weight and taking anti-inflammatory medications, such as ibuprofen (400-600mg every 6-8 hours as needed) or naproxen (220-440mg twice daily with food), may also provide relief 1.
• Supplements like glucosamine (1500mg daily) and omega-3 fatty acids (1000-2000mg daily) may help some women, though evidence is mixed 1.
• Hormone replacement therapy might reduce joint pain for some women by restoring estrogen levels, but this should be discussed with a healthcare provider due to potential risks 1.
• Applying heat to painful joints and practicing good posture can also provide relief.
• If joint pain is severe or persistent, consulting a healthcare provider is important to rule out other conditions like osteoarthritis or rheumatoid arthritis.

From the Research

Causes of Joint Pain during Menopause

• Joint pain during menopause is a common complaint, experienced by more than half of women around the time of menopause 2
• The causes of joint pain in postmenopausal women can be difficult to determine, as the period of menopause coincides with the rising incidence of chronic rheumatic conditions such as osteoarthritis 2
• The reduction in estrogen levels is thought to contribute to the increase in prevalence of arthralgia during the menopausal transition 2, 3
• Various interactions between sex hormones and pain processing pathways, immune cells, and chondrocytes have been demonstrated, but require further research 2

Hormonal Influence on Joint Pain

• Estrogen-alone use in postmenopausal women has been shown to result in a modest but sustained reduction in the frequency of joint pain 4
• The decline in sex hormones, particularly estrogen, has been linked to the joint and tendon response, contributing to arthralgia during menopause 5
• Hormone replacement therapy (HRT) has been shown to have some benefit in alleviating arthralgia associated with menopausal transition 2

Other Factors Associated with Joint Pain

• Age is a significant factor associated with joint pain, with older women experiencing more severe joint pain 3
• Symptoms of hot flushes, night-time awakening, depressed mood, and difficulty concentrating are significantly associated with joint pain 3
• Poorer perceived health, more exercise, higher body mass index, and greater analgesic use are all associated with joint pain 3
• History of sexual abuse is a stress-related factor significantly related to joint pain severity 3