If your joints have started aching, your body feels stiffer than it used to, or you’re simply not as strong as you were, you’re noticing something real, and very common. Joint and muscle changes are one of the most widespread, and least talked about, parts of menopause.

What you might notice

Menopause can bring joint and muscle pain, joint stiffness and reduced flexibility, and a loss of muscle, together known as musculoskeletal symptoms. Women often describe them as a dull ache, stiffness, or aching joints, felt most frequently in the hips, knees, and fingers, and many also notice lower back pain, which has been found to increase around menopause. They’re strikingly common: more than 70% of women experience them, more often in perimenopause and with greater severity after menopause.

Why it happens

The decline in estrogen is closely linked to a decline in the health and function of muscles, joints, and connective tissues: the tendons, ligaments, cartilage, and fat tissue that hold the skeleton together. Estrogen has anti-inflammatory properties and helps keep muscle tissue healthy, so as it falls, these tissues can become drier, less elastic, and more prone to discomfort. Muscle becomes less able to recover from damage, muscle mass and strength gradually decline year over year, and the incidence of cartilage damage rises around the time of menopause, which may lead to the progression of osteoarthritis.

One telling detail: in about 40% of women, MRI scans show no abnormality in the joints. The ache is real even when the imaging looks normal.

Why it matters

These symptoms can meaningfully affect quality of life. A decrease in muscle strength can make everyday movements harder: rising from a chair, walking speed, climbing stairs, and recovering after a loss of balance. That can lead to doing less, which in turn affects overall health and mental well-being. Left unaddressed, these changes can be, in the words of the research, silent, devastating, and permanent, which is exactly why recognizing and acting on them matters.

What can make it worse

A few things raise the risk or the severity. A sedentary lifestyle and the higher body mass that can come with it are associated with more frequent, more severe aches and stiff joints, while repetitive joint stress or overexertion, and pre-existing joint problems, can worsen discomfort. Sleep disruption, anxiety, and low mood during the transition are also linked to pain: women who sleep poorly report more severe pain. And smoking can impair muscle mass and strength, increase muscle pain, and slow the healing of tendons.

The encouraging news is that these symptoms are manageable, through movement, nutrition, and medical options where needed, which is the focus of our companion guides.

This article is general information, not medical advice. Any decision about managing menopause symptoms should be made with your own healthcare provider.