Menopause Hip Pain

If you’re in menopause and your hips have started to ache, it’s not a coincidence. There’s a link between estrogen loss and joint pain.

In this blog, I’ll explain how menopause can contribute to hip pain, what conditions are involved, and what you can do to manage the condition.

Does Menopause Cause Hip Pain?

I often hear my patients complain of joint pain, especially in the hip joint, during menopause. Naturally, many ask, “Is menopause to blame?”

The short answer is yes. 

But, menopause isn’t always the direct cause of hip pain, though it often plays a big part. Other factors can be involved too, but the changes your body goes through during this stage definitely contribute.

How Menopause Affects Hip Health?

As you go through menopause, one of the biggest changes is the drop in estrogen.

This has a significant impact on your joints, particularly your hips, which bear much of your body weight. Here’s how it happens:

Weak Bones and Cartilage

Estrogen protects your bones and preserves bone density. When its level falls, bone loss speeds up, sometimes by 20 percent. This leads to weakened bones, raising the risk of osteoporosis and fractures in the hip. 

In addition, estrogen also supports the health of your cartilage joints. Without it, the cartilage can wear down faster, which may lead to osteoarthritis.

Tendons and Muscle Degeneration

Estrogen supports collagen production, which keeps tendons strong and flexible. 

With less of it, tendons, like the gluteal or iliotibial, may become stiff, inflamed, heal slowly, causing pain.

Less Joint Lubrication

Estrogen helps lubricate joints. Its decline may lead to dryness and stiffness, causing hip discomfort.

Increased Inflammation

Estrogen also has anti-inflammatory properties. As its level drops, you may notice joint stiffness and discomfort, especially in weight-bearing areas like the hips.

Hip Conditions Caused by Menopause

Gluteal Tendinopathy

As estrogen levels fall during menopause, the tendons and muscles around your hips (gluteal tendons) weaken. These tendons connect the muscles in your buttocks to the hip bone.

When estrogen drops, collagen production goes down, too. This can make the tendons prone to injury and irritation, leading to gluteal tendinopathy. 

You may feel pain or tenderness on the outer hip during movement, exercise, or lying on that side.

Hip Bursitis

Hip bursitis is often caused due to swelling in the bursa. It’s a fluid-filled sac that acts like a cushion, reducing friction between bones and soft tissues.

During menopause, weaker tendons and muscles put more strain on the bursa. Over time, this may lead to irritation or swelling, which causes pain in the outer hip. 

It might feel especially sore when you walk, climb stairs, or lie on the affected side.

Osteoporosis (Stress Fractures & Aching)

After menopause, bones lose strength and density due to lower estrogen levels, which may lead to osteoporosis.

This may also increase the risk of fractures and pain, especially in weight-bearing joints, like the hips.

Referred Back Pain

Hip pain during menopause might originate from the lower back. Weight gain and decreased bone density may strain the spine, leading to pain radiating to the hips.

Hip Conditions Present During Menopause

Arthritis

More than half of women experience some form of joint pain during menopause. The two most common types I see are:

• Osteoarthritis: The hip joints slowly wear down over time.
• Rheumatoid arthritis: The immune system mistakenly attacks the joints, causing inflammation.

As estrogen drops, it speeds up cartilage breakdown and may weaken the immune system. 

This explains why joint pain often gets worse during menopause. In fact, women are more likely to develop rheumatoid arthritis after menopause.

Sacroiliac Joint Dysfunction

The sacroiliac joint (SI joint) connects your lower spine to your pelvis. When it’s irritated or misaligned, it causes pain in the hips or lower back. 

Hormonal changes during menopause affect joint stability, which may increase the chance of SI joint problems and hip pain.

Degenerative Disc Disease 

As we age, the discs in the spine naturally wear out, which leads to degenerative disc disease. With menopause, the loss of estrogen and progesterone can make this happen faster.

This makes the discs dry and stiff, leading to back pain that may spread to the hips.

Piriformis Syndrome

Piriformis syndrome occurs when a small muscle in the buttock (the piriformis) presses on the sciatic nerve.

It can cause sharp pain in the hips or down the leg. Hormonal changes during menopause may also affect muscle tone and flexibility, raising the risk of this kind of pain.

Changes to Gait Causing Hip Strain and Pain

During menopause, changes in muscle strength and flexibility may affect how you walk or stand. 

Sometimes, pain in one area causes the body to move differently, which puts extra strain on the hips.

Understanding the Difference

Aspect	Hip Pain Caused by Menopause	Hip Pain During Menopause
Cause	Directly tied to hormonal changes affecting muscles, tendons, and bones	Often due to pre-existing conditions (e.g, arthritis) worsened by menopause
Hormonal influence	Drop in estrogen weakens tissues and leads to pain	Hormones may influence severity but aren’t the main cause
Common conditions	– Osteoporosis – Gluteal tendinopathy – Bursitis – Pain referred from the back	– Arthritis – Degenerative disc disease – Sacroiliac joint dysfunction – Piriformis syndrome
Related symptoms	– Pain along with stiffness – Muscle weakness – Joint instability – Weight gain – Postural changes	– Pain with swelling – Stiffness – Referred pain

Identifying Hip Pain Related to Menopause

Symptoms

Hip pain during menopause can feel different for everyone. But here are some common signs I’ve seen in my patients that you should look out for:

• Pain around the hip joint that can spread to the groin, outer thigh, or buttocks
• A dull or sometimes sharp ache that doesn’t go away easily
• Discomfort when lying on the affected side, especially at night
• Trouble standing or walking for long periods
• Stiffness or reduced movement
• Tenderness when you press the outer hip
• Pain when sitting with crossed legs

These symptoms could also be due to gluteal tendinopathy, hip bursitis, or other menopause issues.

If you’re feeling unsure about why it’s happening, you’re not alone. I’m here to help you figure out what’s causing the pain and to guide you toward the right treatment plan.

However, if you notice these signs, please seek medical care right away:

• Sudden, severe hip pain
• Unable to put weight on your leg
• Fever or unexplained weight loss

These could be due to something like a fracture, and it’s important to get checked promptly.

Hip Pain at Night

One question I often hear is, “Why do my hips hurt at night while sleeping?” If you sleep on your side, it puts pressure around tissues in your hip, especially if they’re already inflamed. That pressure can lead to pain.

At night, your muscles naturally relax and blood flow slows down, so your joints may not get as much lubrication. This can make stiffness and discomfort more noticeable.

Menopause also affects your nervous system. Low estrogen levels may make you sensitive to pain. 

Plus, many women also experience sleep disturbances, which may contribute to inflammation. This lowers your pain tolerance at night and makes even mild discomfort feel more intense.

Differentiating from Other Causes

When a patient comes to me with hip pain during menopause, I take time to understand what’s really going on.

Here’s what I usually do:

1. First, we talk through your symptoms and any past injuries or conditions that might be playing a role.
2. I’ll gently examine your hips to check for tenderness, how you move, and how you walk.
3. Sometimes, we’ll need imaging, like an X-ray or MRI, to see if there are signs of arthritis or issues with the tendons.
4. I may also do some blood tests to rule out inflammation or infections.

Management and Treatment Options

Exercises and Physical therapy

One of the first things I often say is: movement is medicine. I know that may seem surprising, if your hip hurts, shouldn’t you rest it? Yes and no. 

Rest is important during a flare-up. But, staying active is one of the best ways to manage hip pain during menopause. 

Gentle movement helps:

• Strengthen your bones
• Ease joint stiffness
• Prevent muscle loss
• Improve lubrication in your joints
• Maintain flexibility and movement
• Support tendon health and recovery

Here are some exercises I recommend for my patients:

Low-impact Activities

Walking, swimming, and cycling are gentle on your hips and give your joints the movement they need.

Swimming is great because the water supports your body and reduces strain on your hips.

Strengthening Exercises 

Building up the muscles around your hips may ease pain and improve flexibility. A few exercises I often suggest are:

• Hip extensions 
• Side leg lifts
• Hip bridges
• Clamshells (using resistance bands)

These exercises may keep your muscles and bones strong, helping to manage hip pain.

Gentle Stretching

Stretching through yoga or Pilates helps with flexibility and posture, which takes pressure off your hips. Yoga may even support bone strength over time.

But if your pain is related to tendon issues or bursitis, be careful. Deep squats, lunges, or high-impact exercise could make things worse.

When that’s the case, I often refer my patients to a physical therapist. They guide you through movements that are safe and right for your body.

Medications

I recommend my patients to start with these simple, yet effective options:

• Acetaminophen (Tylenol) for mild pain relief
• Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or naproxen, may reduce pain and swelling

Topical creams may also provide relief with fewer side effects. But make sure not to use them long-term without medical advice.

If these don’t offer relief, I might consider other treatments like corticosteroid injections or even hormone therapy (HRT).

To HRT or not to HRT?

Many of my patients ask if HRT can help with joint pain, and it might.

HRT may ease joint pain in areas like the hips, knees, and hands, during early menopause. It may also improve bone strength and reduce discomfort. 

HRT might be worth considering if:

• Your joint pain is moderate to severe and hasn’t improved with other treatments
• You’re also dealing with hot flashes or night sweats
• You’re under 60 and within 10 years of starting menopause
• You’re at high risk of osteoporosis or already showing signs of bone loss

But HRT isn’t suitable for everyone. I’ve seen possible risks such as:

• A slight increase in the breast cancer risk
• Blood clots or stroke, though rare
• Side effects like bloating, breast tenderness, mood changes, or nausea

I always suggest a personalized approach, considering your health and needs.

Supplements

These supplements may support your bones and joints:

Supplement	Possible Function
Calcium and Vitamin D	Support bone health
Vitamin K2	Improves bone density
Collagen supplements	Ease joint discomfort
Omega-3 Fatty Acids	Reduce swelling and protect cartilage
Glucosamine and Chondroitin	Reduce osteoarthritis symptoms
Turmeric (Curcumin)	Has anti-inflammatory properties that may relieve joint pain

But it’s important to seek medical guidance before starting anything new. 

I also recommend my patients avoid unregulated supplements that are often marketed as “menopause cures.” Using doctor-recommended supplements is one of the best and safest ways to get the maximum benefit.

Alternative Therapies

These alternative therapies may manage hip pain during menopause:

• Massage may reduce muscle tension and pain
• Biofeedback helps you control body functions to reduce pain
• Acupuncture may reduce chronic pain, though more research is needed
• Cognitive Behavioral Therapy (CBT) helps you cope with pain by addressing the mental and emotional aspects.

Make sure to get medical guidance to find out what works best for you. 

Treating Menopausal Hip Bursitis

Hip bursitis is common during menopause, caused due to inflammation around the hip joint. Low estrogen levels may make you prone to it.

Common symptoms include:

• Pain on the outer side of the hip
• Pain after standing or walking for an extended period
• Pain that worsens with movement or at night

Here’s what I recommend my patients to follow to manage this pain:

Step 1: At-home Care

• Rest and avoid activities that worsen the pain, like walking for long periods.
• Apply an ice pack to the painful area for 15–20 minutes to reduce swelling.
• Over-the-counter options like ibuprofen or paracetamol may ease pain.

Step 2: Physical Therapy

This is one of the most effective treatments. I refer my patients to a physical therapist who can guide them through:

• Gentle stretching to improve hip flexibility.
• Strengthening exercises for the gluteal muscles, which provide better support to your hip
• Posture & movement correction to address habits that may contribute to pain.

Step 3: Injections (If needed)

If the pain doesn’t improve with other treatments, injections may be an option:

• Corticosteroid injections may offer fast pain relief by reducing inflammation.
• Platelet-rich plasma (PRP) uses your own blood components and may support healing.

Menopausal Hormone Therapy (MHT)

For some cases, MHT may help with hip pain. When MHT is combined with exercise it may reduce pain and improve movement. 

With the right combination of rest, exercise, and sometimes medication, I’ve seen that hip bursitis can be managed effectively.

Finding Relief is Possible

Menopause can bring unexpected changes, including hip pain that affects how you move, sleep, and feel. But you’re not alone, and you don’t have to push through it in silence.

There are safe, effective ways to manage this pain, and I’m here to help you find the path that works best for you.