Joint Pain, Bone Loss & Menopause: What Every Woman Deserves to Know

When we talk about menopause, hot flashes and mood swings usually steal the spotlight. But two of the most frustrating and life-altering symptoms women experience during the menopause transition are often overlooked: joint pain and bone loss.

If your knees ache when you get out of bed…If your hips or shoulders feel stiff or inflamed…If your body just doesn't feel like it used to…

You're not alone. And you're not imagining it.

Estrogen: The Missing Link in Joint and Bone Health

Estrogen isn’t just about your cycle—it’s a powerful hormone that helps maintain the health of your entire musculoskeletal system, including your bones, joints, ligaments, and muscles. There are estrogen receptors throughout your body, which is why women often experience new or worsening pain, stiffness, and weakness in midlife as estrogen levels decline.

And it’s not just about how you feel. It’s also about what’s happening under the surface.

During the menopause transition, women can lose up to 20% of their bone density. Add in joint discomfort and muscle loss, and the risk of osteoporosis, fractures, and chronic pain climbs sharply.

• 70% of all hip fractures occur in women

• 30% of women who suffer a hip fracture die within a year

• And far too many women are dismissed, misdiagnosed, or told this is “just aging”

  
  

My Own Experience: It Wasn't Just Age

Before I started estrogen, I honestly thought I was just getting older—and quickly. I was stretching my hips before bed and again in the middle of the night. My back hurt when I exercised. My shoulders were so uncomfortable I ended up in physical therapy. I had to modify pushups because my shoulder pain and tightness made them too painful.

Now, one year after starting HRT, most of that is gone. I feel strong again. My joints are comfortable. I move better, lift heavier, and recover faster. I can’t believe how much better—and if I’m being honest, how much younger—I feel.

And I see this every day in my patients, too. When we support the body with the hormones it needs, it responds beautifully.

HRT: A Powerful Option for Bone & Joint Health

Estrogen is FDA-approved to treat osteoporosis, and it does more than just protect your bones—it often improves joint pain, muscle soreness, stiffness, and recovery.

When started during perimenopause or early menopause, HRT can:

• Preserve bone density and prevent fractures

• Improve mobility and muscle strength

• Reduce joint inflammation and pain

• Help you stay active and independent

  
  

And if estrogen alone isn’t enough, testosterone can be a valuable addition for many women, improving bone density, muscle tone, energy, and physical resilience.

When HRT Isn't Enough—or Not an Option

If you’re still struggling with joint pain despite HRT, or if hormone therapy isn’t the right fit for you, we can absolutely dig deeper. Sometimes I’ll recommend a DEXA scan to assess bone density or run additional testing to uncover other contributors to pain.

One of my favorite tools for chronic pain and inflammation is low-dose naltrexone (LDN). It’s gentle, unique, and especially helpful for the right types of pain when other treatments fall short.

There are also other osteoporosis medications like Prolia and Fosamax, and while I’m happy to discuss them, they’re not my go-to if estrogen and lifestyle modifications are an option.

Lifestyle Is Non-Negotiable

Hormones help—but they’re not the whole story. Every woman benefits from:

✅ Weight-bearing and resistance training

✅ Mobility work and stretching

✅ Vitamin D and K2 to help calcium go where it belongs

✅ Calcium-rich foods or supplements (1000–1200 mg/day)

✅ Balance and strength training to reduce fall risk

Let’s Get You Moving Again

In my clinic, I talk to every woman about her bones and joints—because these are the things that determine how well we move, how strong we feel, and how vibrant we stay in midlife and beyond.

My goal—for every patient and for myself—is this:To be able to get down on the floor and play with your grandkids at 80, heck at 90… and get back up on your own.

That kind of vitality doesn’t happen by chance. It takes estrogen, movement, strength training, and a personalized plan—and I’d love to help you build yours.

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Portions of this blog were inspired by the FDA’s Expert Panel on Hormone Replacement Therapy for Women. For more on the musculoskeletal benefits of estrogen, I also recommend following the work of orthopedic surgeon and active aging expert Dr. Vonda Wright.