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Joint Pain in Perimenopause


woman with joint pain

I hear many women complain about more knee and shoulder pain, what if I told you it’s linked to your hormones? Sounds crazy right?!


If you experience chronic joint pain, you’ve probably wondered, “Is this arthritis?”

We’ve come to think of arthritis as a common part of aging. The truth is, chronic joint pain ISN’T always arthritis.


Did you know that the human body actually has 360 joints? If you’re suffering from joint pain, you may have had an idea, as iit can feel like every single one of them hurts. 


Joint & muscle issues are actually really common in peri and menopause. And yes, genetics, past injuries and your activity level of course play a role. Pain and inflammation in old injuries can flare up in perimenopause, and sometimes it can take longer than usual for new injuries to heal too. 

But we know that hormones support joint integrity, muscle mass, bone density and inflammation levels, so losing hormones impacts your whole musculoskeletal system. Many women suffer from frozen shoulder, plantar fasciitis, and other pains and aches that can be improved with (B)HRT. 



Which hormones impact joint pain?

Mainly estrogen and testosterone play a role here, but progesterone also has an impact: 

  • Estrogen is a key hormone in maintaining joint and bone health. It has anti-inflammatory properties and helps in maintaining the integrity of cartilage, which cushions joints.

  • During perimenopause and menopause, estrogen levels decline significantly. This reduction can lead to increased inflammation and joint pain. Estrogen deficiency is also associated with decreased production of synovial fluid, which lubricates joints, potentially causing stiffness and discomfort.

  • Testosterone helps in maintaining muscle mass and strength, which also supports your joints. Decreased testosterone levels can lead to muscle weakness, increasing the strain on joints and potentially contributing to pain.

  • Progesterone plays an important role in reducing inflammation and cortisol levels in the body. When levels drop during perimenopause and menopause, it can increase inflammation and contribute to muscle aches. 


So when your hormone levels decline,  the tissues in the joints can lose moisture and elasticity, making them stiff and painful, that’s why it’s important to address hormone levels as part of your treatment.


When your joints and muscles hurt, you're naturally inclined to move less, which can often make things worse. Becoming more sedentary doesn’t help with weight management either, forcing yet more pressure onto your weight bearing joints and making them more painful. 


You don’t want to over-do it with exercise, which can just lead to more pain and frustration. The key is finding your tolerance and not overdoing it.

Some types of movement you can consider:

  • Yoga 

  • Walking

  • Swimming or Water Aerobics

  • Biking

  • Weight training


Other possible causes of joint pain

While declining hormone levels in perimenopause are most often linked to joint pain in women, there can also be other factors that will cause or contribute to joint pain.


Joint pain can also come from or be exacerbated by:

  • Inflammatory diet

  • Food sensitivities

  • Dehydration

  • Autoimmune conditions (for instance Lupus, Lyme disease or others)

  • Infection burden (I recently had this linked to a candida infection in my gut)


Inflammatory diet: if you are consuming these foods, it may be worthwhile to first reduce them before doing anything else about your joint pain:

  • Gluten

  • High sugar/refined carbs 

  • Seed oils (sunflower, canola, corn, peanut, safflower, soybean oils) or fried foods

  • Industrial & processed meats

  • Dairy

  • Alcohol or sodas

  • High oxalate foods such as spinach, kale, almonds, beets, sweet potato… 


Foods that reduce inflammation are almost always a good choice for your body in general, but particularly for your joints. Try eating more fish, nuts, vegetables, and beans instead of refined grains, sugar and dairy. Healthy fats such as olive oil, coconut oil, and avocados can also help improve joint health.


Key herbs and nutrients to reduce joint pain:In addition to a healthy diet, some supplements can also support your joints.


  • Fish oil (look for high concentration of EPA) is key to reduce inflammation and improve your fatty acid balance 

  • Glucosamine + Chondroitin are known to support your cartilage.

  • Boswellia is also very helpful for lowering inflammation and easing joint pain

  • Collagen (Type II) helps maintain cartilage and the peptides have a positive impact on inflammation. It can improve joint flexibility and reduce stiffness.*

  • Turmeric is a popular herb for reducing joint pain. It is not great for women suffering from hot flushes though. 


*Research on postmenopausal women indicated that collagen supplementation improved bone density and joint health, potentially counteracting the effects of decreased estrogen levels . Source: Zhu, Y., et al. (2018). Collagen supplementation in postmenopausal women.

Please choose high-quality supplements from a reputable source. This is particularly important for fish oil, as some fish oil supplements may contain harmful contaminants. You may also need to take a much higher dose than indicated on the package to see improvement. And if you’re taking blood thinners, be sure to check with your doctor first.


Food Sensitivities:

Developing food sensitivities during perimenopause is very common as the decline in progesterone affects your gut barrier. Eating foods you have developed a sensitivity to is highly inflammatory and can contribute to joint pain or worsening of joint pain.


Even “healthy” choices could be things that YOUR body is reacting to. With testing, we can figure out which foods are the best choices to lower your inflammatory burden—and this looks slightly different for everyone.


HydrationWhen you nourish your body properly, you can feel and move better and believe it or not, hydration plays a key role in that too! After all, our joints rely on the right amount of hydration to help us keep a healthy cushion between our bones.


So, how much water should you drink each day? Take your body weight in pounds, divide by two. Then drink that many ounces of water per day.

So for example, a person who weighs 150 pounds might need around 75 ounces of water per day to support their joint health.


Infection burden

Bacterial or viral infections such as Strep, Lupus, Lyme, but also fungal overgrowth in the gut or other pathogenic bacterial overgrowth in the gut can lead to joint pain. I’ve recently experienced this myself getting achy, red and swollen fingers due to candida overgrowth and the toxic byproducts these bastards are producing



Joint pain slows you down and keeps you from living your life to the fullest. 


I’m using lab tests to decipher what is going on in your body. We examine hormones, hydration, oxalate levels, food sensitivities, and gut health so we can address the root cause(s) of your joint pain. With that information, I help you develop a tailored plan that will give your body exactly what it needs to heal.


If you are looking to determine the root cause of your joint pain- so you can address it and feel better – book a call with me.



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