Joint pain menopause affects more than 70% of women as they go through this life change. About a quarter of them deal with severe symptoms. Most women notice these aches and pains especially during perimenopause as their hormones start to shift. Their bodies produce less estrogen, which naturally protects joints and keeps inflammation down.
The numbers tell a clear story - six out of ten women feel pain in their muscles and joints during menopause. They often wake up feeling stiff, notice swelling, and find it harder to move around. These problems pop up because estrogen keeps cartilage and joint tissues healthy. Less estrogen means more friction in the joints. The good news? Women have several ways to feel better. Some try hormone replacement therapy (HRT) and see results in weeks. Others find relief through gentle exercises like swimming and walking. This piece breaks down why your joints hurt during menopause and shows you practical ways to feel better right now.
What causes joint pain during menopause?
"According to a recent systematic review and meta-analysis, joint pain or aches occur in 50%-89% of perimenopausal women." — Dr. JoAnn Pinkerton, Executive Director of The North American Menopause Society
Joint discomfort during menopause stems from falling estrogen levels. Most people think of hot flashes and mood swings when they hear "menopause," but the pain in muscles and joints can disrupt daily life just as much. Learning about these mechanisms helps explain why many women deal with joint pain menopause symptoms and shows us ways to find relief.
The role of estrogen in joint health
Estrogen does much more than regulate reproduction—it protects joint health. Studies show that estrogen receptors exist in all musculoskeletal tissues, including muscle, bone, ligament, and tendon [1]. This hormone plays several key roles in keeping joints healthy:
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Anti-inflammatory properties: Estrogen naturally keeps inflammation down throughout the body and protects joints from painful swelling [2]
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Collagen maintenance: The hormone keeps collagen levels balanced in connective tissues, which helps joints work properly [3]
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Cartilage protection: Estrogen keeps cartilage healthy and prevents too much wear between joints
These protective benefits start to fade as estrogen levels go up and down during perimenopause and eventually drop during menopause. A newer study, published in 2010 showed that joint pain links directly to lower estrogen, because joints need this hormone to work their best [1]. Clinical studies also found that women with osteoarthritis, both before and after menopause, had much lower free estradiol levels than healthy women [4].
How hormonal changes affect muscles and bones
Hormonal changes don't just affect the joints—they change the entire musculoskeletal system:
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Muscle changes: Women lose muscle mass and strength quickly during menopause [3]. This makes them more likely to hurt themselves even during normal activities. Research shows that six out of ten women feel pain in their muscles and joints during menopause [5].
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Bone density reduction: Women typically lose 10% of their bone mass within 5 years after menopause due to dropping estrogen levels [3]. This means women over 50 have a 50% chance of breaking a bone due to osteoporosis, while men's risk stays at 20% [3].
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Tendon and ligament alterations: Less estrogen makes tendons harder and less stretchy. Stiffer ligaments can help keep joints stable, but stiff tendons can't stretch properly. This leads to more muscle strain and injuries [3]. These changes often show up in the hip, buttock, heel, and shoulder areas.
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Cortisol regulation: Estrogen usually helps control cortisol (our stress hormone). When estrogen drops, cortisol rises, which makes muscles tenser and increases pain sensitivity [3].
Doctors now call these symptoms "Musculoskeletal Syndrome of Menopause." This condition makes bones more likely to break and causes joint pain, movement problems, and weak muscles [6].
Why menopause increases inflammation
Joint pain during menopause ties closely to inflammation through several paths:
The body loses estrogen's anti-inflammatory benefits as hormone levels drop. This allows inflammation to develop more easily in joint tissues [2]. A recent clinical trial showed that post-menopausal women who took estrogen alone had less joint pain. These results support the idea that estrogen fights inflammation [4].
Lower estrogen can also trigger inflammatory conditions like rheumatoid arthritis [2]. Joint pain becomes particularly noticeable during menopause because this time also sees more cases of chronic joint problems like osteoarthritis [1].
Menopause-related hormonal changes often cause increased body fat, which creates inflammatory substances called adipokines [7]. These compounds can make joint inflammation and pain worse, creating an ongoing cycle of discomfort.
Clinical studies of estradiol and its byproducts show a clear connection between estrogen and joint pain, particularly regarding osteoarthritis risk [4]. Women who take estrogen replacement therapy report fewer joint problems in clinical trials, which suggests that replacing the missing hormone can help reduce inflammation-related pain [4].
The connection between estrogen, inflammation, and joint health involves many moving parts. Understanding these relationships helps explain why menopause and joint pain often happen together—and points to ways we can find relief.
Common symptoms of menopause-related joint pain
Physical signs of joint pain menopause affect women differently. Research suggests up to 60% of women deal with musculoskeletal discomfort during this life change [8]. Women who understand these symptoms can better identify what they're going through and find the right relief.
Stiffness and swelling
Joint stiffness stands out as one of the most common menopause-related muscle and joint complaints. This condition affects nearly 40% of women between 45 and 65 [9]. The stiffness gets worse after staying still or right after waking up [7]. Lower estrogen levels create inflammation that makes joints swell and hurt, especially in the neck, shoulders, elbows, and knees [10].
Most women describe a constant ache that feels better with movement during the day [11]. You might notice swelling around the affected joints—a clear indicator of inflammation or fluid buildup [4]. These symptoms can feel just like various types of arthritis, which makes getting the right diagnosis tricky.
Reduced range of motion
Women notice they can't move their joints as freely during menopause. This happens because connective tissues become less elastic as estrogen levels drop [7].
Daily tasks become harder. Reaching up, climbing stairs, or turning your neck can hurt or feel restricted. This loss of mobility sneaks up slowly. Women usually notice mild limitations first, which can get worse without proper care.
Joint and muscle problems work together to reduce flexibility and movement [7]. Some women develop more serious conditions like frozen shoulder (adhesive capsulitis), which severely limits shoulder movement [7]. This condition most often shows up in women aged 40 to 60, with most cases starting around 55 [12].
Muscle aches and fatigue
Research suggests over 70% of women experience menopausal musculoskeletal pain at some point [13]. The pain feels like a general achiness, similar to having the flu.
Muscle pain can show up in several areas:
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Lower, mid, or upper back
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Neck and shoulders
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Around the rib cage
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Hips and legs
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All-over body aches [13]
Women also report feeling more tired with weaker muscles. Lower estrogen levels affect muscle mass and strength. This leads to discomfort and tiredness even during simple activities [7]. The loss of muscle mass puts extra stress on joints by reducing their support, which can make symptoms worse over time.
Morning discomfort and joint cracking
Joint pain hits hardest in the morning hours. The pain feels worst when you wake up but improves as joints warm up throughout the day [11]. This happens because inflammation and stiffness build up during sleep.
Women often hear cracking, grinding, or popping sounds (called crepitus) in their affected joints [4]. These sounds might worry you, but they usually come from air bubbles in joint fluid or tendons moving across bones.
Morning stiffness lasting more than 60 minutes after getting up might point to serious joint inflammation. This needs medical attention [7]. You should also see a doctor if severe or ongoing pain disrupts your daily life. These symptoms could signal conditions like rheumatoid arthritis, which can start or get worse during menopause [7].
Learning about these symptoms helps women tell the difference between normal menopausal joint pain and more serious conditions that need specific treatment. Spotting menopause and joint pain patterns early leads to better management and care.
Other conditions that may mimic menopause joint pain
"Aging increases the risk of developing degenerative joint conditions, such as osteoarthritis. Over time, joint wear and tear can lead to the breakdown of cartilage, resulting in joint pain and discomfort." — Dr. Vonda Wright, Orthopedic Surgeon and Sports Medicine Specialist
The symptoms of joint pain menopause and other rheumatic conditions often overlap by a lot, making them hard to tell apart. Women frequently get wrong diagnoses or delayed treatment because these symptoms are so alike. Research shows that almost half of the people diagnosed with rheumatoid arthritis actually had menopausal arthralgia or menopausal osteoarthritis [14].
Rheumatoid arthritis
Rheumatoid arthritis (RA) happens when your immune system attacks your joint's lining by mistake. This causes pain, swelling, and stiffness. RA can affect your organs and soft tissues throughout the body, unlike menopause-related joint pain [15].
Menopause and RA share a complex and sometimes contradictory relationship:
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Women are three times more likely than men to get RA, which suggests hormones play a role [3]
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Research shows that early menopause (especially when you have it before age 40) more than doubles the risk of developing RA [15]
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A 2022 study linked lower estrogen levels to higher RA risk and severity [6]
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Some studies show no clear connection between RA and menopause [16]
RA differs from typical menopause joint pain. It causes symmetrical joint involvement that affects the same joints on both sides of your body. You might feel stiff for over an hour each morning and notice obvious joint swelling. RA also often causes systemic symptoms like fatigue, fever, poor appetite, and weight loss - things you might not see with menopause joint pain [15].
Osteoarthritis
Osteoarthritis (OA) causes joint inflammation and bone changes that affect more than one-third of people over 65 [5]. Separating OA from menopause-related joint pain can be tough because:
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Women get OA more often than men
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OA becomes more common, frequent, and severe after menopause
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Women's risk of hip and knee OA rises sharply between ages 50-75
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Hand OA peaks in women after menopause, with rates ≥3.5 times higher in women aged 50-60 compared to men [5]
Estrogen plays a big role since 17β-estradiol boosts glycosaminoglycan synthesis in joint cartilage [5]. This explains why OA often starts or gets worse as estrogen drops during menopause.
OA differs from typical menopause joint pain in several ways:
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It focuses on weight-bearing joints or hands
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It gets worse over time instead of changing with hormone levels
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X-rays show characteristic changes
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Advanced stages might show bone spurs and joint deformity
Women who take hormone replacement therapy (HRT) need fewer hip and knee joint replacements than those taking placebos, which suggests HRT might help protect joints [17].
Fibromyalgia and chronic pain syndromes
Fibromyalgia makes pain signals stronger than they should be (hyperalgesia) and creates pain from harmless touch (allodynia) [18]. This condition makes menopause diagnosis harder because:
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Menopause often makes fibromyalgia symptoms worse [18]
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Some women's fibromyalgia starts after menopause [18]
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Both conditions affect sleep, which makes pain worse [19]
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Women with menopause symptoms are nearly twice as likely to have chronic pain diagnoses, including fibromyalgia [20]
Fibromyalgia usually causes pain throughout your body rather than just in joints. People with fibromyalgia are often more sensitive to smells, lights, sounds, temperatures, and medication side effects [18].
Fibromyalgia often comes with chronic headaches, irritable bowel syndrome, painful bladder syndrome, temporomandibular joint pain, and multiple chemical sensitivities [18]. These extra symptoms help doctors separate fibromyalgia from regular menopause joint pain.
Doctors need to do a full medical evaluation to get the right diagnosis. They look at joint symptoms, how long morning stiffness lasts, whether you have systemic symptoms, and how you respond to treatments [14].
Lifestyle changes that can ease joint pain
Simple lifestyle changes can help manage joint pain menopause effectively. Studies show that physical activities and stress management techniques reduce discomfort without medication. These natural methods ease joint pain and boost overall menopausal wellbeing at the same time.
Low-impact exercises like walking and swimming
Physical activity helps reduce joint pain and stiffness [10]. The saying "motion is lotion" [21] explains why movement is vital even with sore joints—the right exercise lubricates joints instead of damaging them.
Women experiencing menopause and joint pain can start with walking. This weight-bearing activity makes bones stronger and improves heart health without straining joints [22]. A March 2016 study in Musculoskeletal Care revealed that arthritis patients who kept up regular walking felt better and more confident about managing their condition [2].
Swimming and water aerobics are excellent choices for menopausal joint relief. The water offers natural resistance to build muscle while taking pressure off painful joints [10]. Just 10-15 minutes of daily water movement can stop stiffness and lower inflammation [1].
Strength training and stretching routines
Muscle mass preservation matters during menopause because women lose muscle strength rapidly during this time [23]. UK government guidelines suggest 150 minutes of weekly exercise with two strength training sessions [24].
You don't need to lift heavy weights at a gym for strength training. Here are some effective options:
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Resistance band exercises (easier on joints than regular weights)
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Pilates (helps flexibility and core strength)
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Climbing stairs or hill walking
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Carrying groceries or gardening
A mix of strength work and stretching protects joints completely. Yoga and tai chi help joint flexibility and balance [25]. These activities use deep stretches and controlled movements to reduce stiffness, boost circulation, and relieve joint soreness [1].
Stress reduction techniques that help with pain
Your mental state can affect joint discomfort. Research links high stress to worse joint pain during menopause [26]. This happens because stress raises cortisol levels, which makes fatigue, inflammation, and pain sensitivity worse [1].
These stress-management methods work well:
Cognitive behavioral therapy (CBT) helps menopausal women deal with low mood, anxiety, and sleep issues [22]. A 2018 study showed that mindfulness-based stress reduction lowered anxiety during menopause [26]. Short daily meditation can create a calmer mindset to handle physical symptoms better [27].
Deep breathing triggers the body's relaxation response, which lowers cortisol and reduces muscle tension that adds to joint pain [27]. Regular relaxation becomes vital when progesterone drops because it can affect pain threshold levels [10].
Many women find relief from joint pain during menopause without depending only on medications by mixing the right physical activity with good stress management.
Medical treatments and hormone therapy options
Medical treatments give women effective options to deal with stubborn joint pain menopause symptoms when lifestyle changes don't work well enough. Studies show hormone therapy and pain medications can substantially reduce discomfort and make life better.
How HRT may help with joint pain
Hormone replacement therapy (HRT) serves as the main medical treatment to help with menopause and joint pain by replacing lost estrogen. HRT offers several key benefits to joint health:
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Reduces inflammation through estrogen's natural anti-inflammatory effects, which tackles the root cause of joint pain [28]
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Makes joint lining healthier, which helps reduce pain and discomfort [28]
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Keeps bones strong and helps prevent osteoporosis that leads to joint pain [28]
Studies show that women who had joint pain as their only menopause symptom felt complete relief after they started HRT [29]. Doctors usually suggest starting HRT as soon as symptoms show up. Women who get menopause before 45 might need treatment right away, whatever their symptoms [28].
Over-the-counter pain relief
Over-the-counter medications help you get quick relief from joint pain during menopause:
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen work well against inflammation-driven joint pain [28]. These medications block your body's production of prostaglandins—chemicals that in part cause pain and inflammation [30].
Paracetamol works as another option, especially when you have trouble taking NSAIDs [30]. While it doesn't fight inflammation, paracetamol helps with pain by changing how pain signals work in your brain and spinal cord [30].
Anti-inflammatory gel rubs give targeted relief with fewer side effects than pills [29]. You can find these products as gels, creams, or patches to put right on the painful spots [30].
When to think about prescription medications
Some women need stronger treatments even after trying HRT and over-the-counter medicines. You might need prescription options if:
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Pain gets in the way of your daily life after trying lifestyle changes and OTC medications
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Joint pain keeps you from sleeping well
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You notice worrying symptoms like bad swelling or trouble moving
Doctors might prescribe clonidine (a blood pressure medicine) or gabapentin (an epilepsy medicine), which help with hot flushes that often come with joint pain [31]. Women who have ongoing joint pain plus depression or anxiety might find antidepressants helpful for both issues [31].
You should talk to your healthcare provider about persistent aching joints menopause symptoms to find the right treatment [32].
Supplements and natural remedies to consider
Many women find natural relief from joint pain menopause through targeted supplements, beyond lifestyle changes and medical treatments. Research shows these supplements can work alongside proper diet and exercise to reduce inflammation, support bone health, and ease joint discomfort naturally.
Vitamin D and calcium for bone support
Vitamin D behaves uniquely compared to other vitamins and acts more like a hormone that our body produces with sun exposure [33]. This vital nutrient helps the body absorb calcium, which builds strong, healthy bones. The combination becomes especially important at the time of menopause [33].
Women lose approximately 10% bone mass during their first five years after menopause due to declining estrogen levels. Vitamin D and calcium supplements help boost bone formation and prevent fractures [33]. Notwithstanding that, studies indicate doses of 400-800 IU daily show little impact on bone mineral density unless someone has vitamin D deficiency [34].
Omega-3s and anti-inflammatory herbs
Omega-3 fatty acids are standout anti-inflammatory supplements. These healthy fats maintain good cholesterol levels and reduce joint pain and inflammation [7]. Studies suggest they protect cartilage in osteoarthritis patients and decrease joint inflammation that causes pain and stiffness [7].
Fish oil supplements deliver EPA and DHA—omega-3s that support bone and joint health through powerful anti-inflammatory properties [12]. Vegetarians can choose algae-based alternatives instead. These compounds help boost collagen production, which is a vital component for joint flexibility [12]. The British Heart Foundation suggests taking about 450mg daily [7].
Popular supplements for menopause joint pain
The most effective joint supplements during menopause include:
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Glucosamine and chondroitin: These natural cartilage compounds help reduce joint pain and improve flexibility [35].
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Curcumin: Turmeric's active ingredient provides strong anti-inflammatory benefits that may reduce joint pain [28].
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Collagen: Research indicates collagen supplements support joint health by strengthening cartilage [28].
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Magnesium: This mineral maintains muscle and nerve function while supporting bone strength [28].
Black cohosh, evening primrose oil, and red clover are marketed for menopause symptoms, but scientific evidence doesn't support their effectiveness for joint pain [36]. You should talk to your healthcare provider before starting any supplements since some might interact with medications or cause side effects [12].
Conclusion
Joint pain ranks among the most common but often overlooked symptoms of menopause. About 70% of women deal with it during this phase of life. This piece looks at how lower estrogen levels disrupt joint health. The hormone drop reduces anti-inflammatory protection, changes how collagen maintains itself, and shifts muscle mass. The typical signs of menopausal joint pain include stiff joints in the morning, limited movement, and tired muscles. These symptoms set it apart from conditions like rheumatoid arthritis and osteoarthritis.
The pain women feel during menopause can really mess with their daily life. The good news is several approaches work well to ease the discomfort. Walking and swimming are great low-impact exercises that build muscle strength and help lubricate painful joints. Mindfulness meditation and other stress-busting techniques help manage increased pain sensitivity that comes with hormone changes.
Medical options can make a big difference too. Hormone replacement therapy tackles the root cause - not having enough estrogen. Over-the-counter anti-inflammatories help quickly when pain flares up. Natural supplements like vitamin D, omega-3s, and collagen support joint health.
Women who know how menopause and joint pain connect can find relief faster. Joint pain might seem unavoidable during this transition, but the right management approach can reduce symptoms and keep you moving. Anyone with ongoing joint pain should talk to their doctor. They can create a customized plan that fits your needs and helps you feel better during this important time.
FAQs
Q1. What are some effective ways to manage joint pain during menopause? Low-impact exercises like walking, swimming, and yoga can help strengthen muscles and lubricate joints. Additionally, applying heat or ice to affected areas, staying hydrated, and maintaining a healthy weight can provide relief. For persistent pain, consult a healthcare provider about medical treatments or supplements.
Q2. Can hormone replacement therapy (HRT) help with menopausal joint pain? Yes, HRT can be effective for joint pain relief during menopause. It works by replacing diminished estrogen levels, which helps reduce inflammation and improve joint lining health. Some women experience complete resolution of joint pain after starting HRT. However, it's important to discuss the benefits and risks with a healthcare provider.
Q3. What supplements are recommended for menopause-related joint discomfort? Popular supplements for menopausal joint pain include omega-3 fatty acids, glucosamine and chondroitin, collagen, vitamin D, and turmeric (curcumin). These can help reduce inflammation, support cartilage health, and promote overall joint function. Always consult with a healthcare provider before starting any new supplement regimen.
Q4. How can stress reduction techniques help with menopausal joint pain? Stress management can significantly impact joint pain during menopause. Techniques like mindfulness meditation, deep breathing exercises, and cognitive behavioral therapy can help reduce cortisol levels, decrease muscle tension, and lower pain sensitivity. Regular relaxation practices can make physical symptoms more manageable.
Q5. When should I seek medical attention for joint pain during menopause? Consult a healthcare provider if joint pain interferes with daily activities, causes significant sleep disruption, or is accompanied by severe swelling or restricted movement. Additionally, if over-the-counter medications and lifestyle changes don't provide sufficient relief, a doctor can help determine if prescription treatments or further evaluation is necessary.
References
[1] - https://puresportsmed.com/blog/posts/managing-joint-pain-during-menopause
[2] - https://health.umms.org/2020/12/12/low-impact-exercises-for-joint-pain/
[3] - https://www.webmd.com/rheumatoid-arthritis/ra-menopause
[4] - https://www.positivepause.co.uk/menopause-blog/recognizing-joint-aches-inflammation-menopause
[5] - https://pmc.ncbi.nlm.nih.gov/articles/PMC6332715/
[6] - https://www.healthline.com/health/rheumatoid-arthritis/rheumatoid-arthritis-and-menopause
[7] - https://www.hollandandbarrett.com/the-health-hub/vitamins-and-supplements/supplements/omega/know-omega-3-ease-joints/
[8] - https://www.bupa.co.uk/newsroom/ourviews/joint-pains-menopause
[9] - https://www.mymenopausecentre.com/symptoms/muscle-aches-and-pain/
[10] - https://onlinemenopausecentre.com/menopause-joint-pain/
[11] - https://www.draliabadi.com/menopause/joint-pain-and-menopause/
[12] - https://lizearlewellbeing.com/health/the-menopause/omega-3-menopause/
[13] - https://thebettermenopause.com/blogs/the-better-gut-community/menopause-muscle-pain-aches-causes-treatment
[14] - https://www.physio-pedia.com/Menopause_Associated_Arthralgia
[15] - https://www.balance-menopause.com/menopause-library/rheumatoid-arthritis-and-menopause-what-you-need-to-know/
[16] - https://www.arthritis.org/health-wellness/healthy-living/family-relationships/family-planning/menopause-with-a-rheumatic-disease
[17] - https://versusarthritis.org/news/2021/october/hand-osteoarthritis-do-female-hormones-play-a-part/
[18] - https://www.menopause.org.au/images/stories/education/docs/nams/nams-practice-pearl-fibromyalgia.pdf
[19] - https://pubmed.ncbi.nlm.nih.gov/31612618/
[20] - https://www.webmd.com/menopause/features/menopause-chronic-pain-link
[21] - https://healthandher.com/blogs/expert-advice/easy-stretches-for-aching-joints
[22] - https://www.nhs.uk/conditions/menopause/things-you-can-do/
[23] - https://www.mymenopausecentre.com/bone-density-concerns/menopause-and-joint-pain/managing-joint-aches-and-pains-in-menopause-a-guide-to-bone-density-concerns/
[24] - https://www.bupa.co.uk/newsroom/ourviews/strength-training-menopause
[25] - https://www.newvictoria.co.uk/about-us/news-and-articles/menopause-and-joint-pain-causes-effects-and-relief-strategies
[26] - https://www.evernow.com/learn/menopause-joint-pain?srsltid=AfmBOoo0z0iRH60PXg7xk3ZYsXCkQQm7uB4kooxGtzaBcBBccESNdivt
[27] - https://novushealth.co.uk/2024/11/supporting-musculoskeletal-health-during-menopause/
[28] - https://www.medicalnewstoday.com/articles/menopause-and-joint-pain
[29] - https://www.mymenopausecentre.com/symptoms/joint-pain/
[30] - https://www.bupa.co.uk/health-information/muscles-bones-joints/over-the-counter-painkillers
[31] - https://www.nhs.uk/conditions/menopause/treatment/
[32] - https://thebettermenopause.com/blogs/the-better-gut-community/supplements-treatments-remedies-menopause-joint-pain
[33] - https://www.endocrine.org/patient-engagement/endocrine-library/menopause-and-bone-loss
[34] - https://pmc.ncbi.nlm.nih.gov/articles/PMC4046613/
[35] - https://www.theindependentpharmacy.co.uk/menopause-hrt/guides/best-supplements-for-menopause-joint-pain
[36] - https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/alternatives-to-hormone-replacement-therapy-hrt/herbal-remedies-and-complementary-medicines-for-menopause-symptoms/
