You wake up and your hands are stiff. Your knees ache going down the stairs. Your hips feel tight in a yoga class that used to be easy. You mention it to your doctor and hear that it's just aging — or an X-ray shows nothing alarming. What many women aren't told is that aches and stiffness are among the most commonly reported experiences of the menopause transition.
Joint and muscle aches show up often in surveys of women in midlife, and researchers think changing estrogen levels play a part.
How estrogen relates to joints and muscles
Estrogen has anti-inflammatory effects in the body, and estrogen receptors are found in joint tissue, the lining of joints and muscle. When estrogen levels fluctuate and decline, some of that effect may lessen — which may be one reason tissues can feel more reactive to everyday wear and strain.
The collagen connection
Estrogen also plays a role in collagen, which isn't just in skin. Tendons, ligaments and cartilage are collagen-rich too. Changes in collagen turnover may help explain why some women notice tendon irritation or slower recovery from exercise in midlife.
Hands, hips and knees
The small joints of the hands, the hips and the knees are commonly mentioned, possibly because of the load they carry. Many women describe morning stiffness that eases after moving around.
What helps
Movement has the strongest support. Low-impact activity keeps joints moving, and strength training helps maintain the muscle that supports and protects them — especially important in midlife, when muscle mass naturally declines. Start gently and build up.
Some people also look into nutrition, such as omega-3 fatty acids, and research on these is ongoing. Talk with your healthcare provider before adding supplements, especially if you take medications such as blood thinners.
When to get checked
New joint pain isn't always hormonal. See your healthcare provider if pain is severe or getting worse, if a joint is swollen, red or warm, if stiffness lasts more than about an hour in the morning, or if you also have fever, a rash or fatigue. These can point to other conditions worth checking.
Educational content, not medical advice.
Jenna Sorrells, Ed.D., MPH
Founder of Her Rhythms. Public health expert and women's wellness advocate helping women navigate perimenopause with science-backed, phase-specific support.