Joint pain

• It is estimated that 50% of women experience menopausal arthralgia.
• There are many factors that can contribute to this, which should be explored, including high BMI and poor posture. However, joint pains can also be a result of hormone changes.
• The BMS says oestrogen deficiency has been reported to negatively affect connective tissue metabolism in joints, bone matrix, skin, intervertebral discs and other tissues.
• NICE says muscle and joint pains have been linked to a decrease in oestrogen levels.

Because arthralgia is common in the menopause transition, it does not routinely require further investigation unless:

• There are other concerning signs or symptoms that may warrant urgent referral (red flags).
• There are other signs that might suggest an alternative diagnosis such as degenerative osteoarthritis, PMR, inflammatory arthritis, reactive arthritis or fibromyalgia. For information on arthralgia and differential diagnoses, see NICE CKS guidance.
• Symptoms are persistent or severe despite hormone replacement.