Menopause and arthritis

How menopause affects arthritis

When you have not had a period for 12 months in a row, this is known as menopause. With age, your ovaries lose their reproductive function, leading to your periods stopping. 

Menopause can be harder to recognise if you no longer have a womb, or if you use hormonal contraception, as you may not have periods. 

Menopause is a natural part of ageing for women. It tends to happen between the ages of 45 and 55, but it can occur earlier for some people. Menopause before the age of 45 is referred to as early menopause, and before the age of 40 it’s called premature menopause.  

During menopause, the levels of hormones called oestrogen and progesterone fall. These are 2 of the hormones that control your monthly cycle. 

Oestrogen is also important for bone strength. That’s why conditions like osteoporosis are more common after menopause. Oestrogen affects other parts of the body as well, which may explain why arthritis symptoms begin or get worse for some people during menopause. 

What are the symptoms of menopause? 

Menopause can cause symptoms that impact your daily life and your mood. These may include:  

• hot flushes – sudden feelings of heat, often in the face, neck and chest 
• night sweats 
• disturbed sleep 
• reduced sex drive  
• ‘brain fog’ – problems with memory and concentration 
• vaginal dryness – and pain, itching or discomfort during sex 
• headaches 
• dry, itchy skin and eyes 
• low mood or anxiety 
• palpitations, where you become aware of the feeling of your heart beating 
• joint stiffness, aches and pains 
• reduced muscle mass 
• frequent urinary tract infections (UTIs).

Perimenopause is the term used to describe the years just before menopause, when you may have some menopause symptoms – such as hot flushes – while still having periods. During perimenopause your periods may be less regular or more heavy than they used to be. 

Can menopause cause arthritis? 

Arthritis is a term that’s used to describe pain, swelling and stiffness in 1 or more joints. It can cause fatigue, along with other symptoms that may make you feel unwell, such as rashes and a fever. 

There are many causes of arthritis, and even more reasons you might have joint and muscle pain during menopause. It might be linked to hormone changes, arthritis or a different musculoskeletal condition. Some people have joint and muscle pain for the first time with menopause. It’s not always because of arthritis, but it might be.  

A GP will be able to examine your joints and ask you about your symptoms, suggest a diagnosis and offer treatments to help. Some women find joint pain caused by menopause is helped by HRT. Your GP may want to refer you to a rheumatologist.

Osteoarthritis and menopause 

Osteoarthritis is the most common form of arthritis. You’re more likely to develop it after menopause. It’s not clear why this is. We know that a drop in oestrogen levels can affect bone health. This may then lead to issues in the joints, which contribute to osteoarthritis. 

Rheumatoid arthritis and menopause 

Rheumatoid arthritis is a form of inflammatory arthritis. It’s an autoimmune condition. The immune system attacks the body's joints and tissues. 

Rheumatoid arthritis is more common in women than in men. The risk of developing it increases during and after menopause, particularly for women who’ve experienced premature or early menopause.  

It’s likely there’s a link between hormones and rheumatoid arthritis, though more research is needed to understand this fully. 

Will menopause make my arthritis worse? 

Menopause may make your arthritis symptoms worse. A recent study found that 8 out of 10 women with rheumatoid arthritis had symptoms that were worse during menopause.  

If you find your arthritis symptoms become harder to manage during menopause, mention it to your healthcare team. They can work with you to figure out if this is because of: 

• increased inflammation, which may require changes to your arthritis treatments to bring it under control 
• damage to the joints caused by arthritis in the past, which may need input from other team members such as physiotherapists 
• menopause itself. 

The side effects of some of the drugs used to treat arthritis can mimic menopause symptoms. It’s uncommon but methotrexate can make your vagina feel itchy or sore. And side effects of steroids can include hot flushes, disturbed sleep, disrupted periods and weight gain.  

Is it safe to use menopause treatments along with arthritis medication? 

Your doctor may suggest one or more treatments to help with the symptoms of perimenopause and menopause: 

• hormone replacement therapy (HRT)  
• oestrogen creams, ointments or pessaries to apply to the vulva/vagina 
• non-hormonal treatments 
• a form of cognitive behavioural therapy (CBT) that’s tailored to help with menopause.  

Oestrogen tablets (a form of HRT) increase your risk of blood clots. While this increased risk is small, you should avoid taking them if you know you have a higher risk of clotting. This applies to you if you’ve had a blood clot in the past, or if you have antiphospholipid antibodies in your blood, which are present in some people with autoimmune forms of arthritis. 

Oestrogen in the form of a patch, gel or spray does not appear to increase the risk of blood clots. It can be used safely by most women. If you have a womb, you’ll also need to take progesterone, which protects the womb from the effects of oestrogen.  

If your main symptoms of perimenopause and menopause are vulval or vaginal dryness and itching, you may not need HRT. Some women find non-hormonal treatment options improve their symptoms enough. If you need to use them as well, it’s safe to also use hormonal creams, ointments and pessaries containing oestrogen. This type of oestrogen treatment only works on the vulva and vagina, so will not help symptoms elsewhere in the body, such as hot flushes.  

It’s uncommon, but some menopause treatments can interact with drugs that are sometimes used to treat arthritis. This means they may cause side effects when they’re taken together, or one form of medication may cause the other to stop working as it should. 

Tell your doctor which medications you’re using to treat your arthritis, so that they can check that what they prescribe for menopause is safe.

Are complementary treatments safe during menopause? 

Complementary treatments such as herbal remedies are not recommended for menopause symptoms. That’s because we do not know how safe or helpful they are. They may also interact with your arthritis treatments. 

Ask your GP or pharmacist for advice if you’re thinking about using a complementary treatment for menopause symptoms or to help manage your arthritis.  

If you decide to try an alternative therapy, make sure the person you use is fully insured and has a set code of ethics. 

How can I look after myself during menopause? 

Both menopause and arthritis can make daily life more difficult. But with the right treatments and support, it’s possible to live well with arthritis during menopause.  

Keep moving

Keeping active can help you stay mobile if you have arthritis. It also helps your body to release feel-good hormones called endorphins, which boost your mood. 

Because muscle mass drops in menopause, it’s even more important to keep moving, to help strengthen your muscles. Weight-bearing exercise is also essential for bone health.  

If you're new to exercise, start slowly and build up. Any exercise is better than none.  

Sleep better

Poor sleep can make pain harder to deal with, and it can affect your mood. But getting a good night’s sleep is not easy – menopause and arthritis can disturb your sleep. 

Here are some tips to help you sleep better if you’re in pain: 

• Do some gentle stretches to relax your mind and your muscles just before bed. 
• Practise mindfulness. 
• Have a warm bath or shower to ease stiff, painful joints. 
• Take pain relief medication around half an hour before you get into bed. 

Sleep issues become more common during menopause. This means you’re more likely to experience 

• sleep apnoea 
• snoring 
• struggling to get to sleep or waking up a lot in the night (insomnia) 
• restless legs syndrome (RLS) 
• night sweats. 

Your GP can help. They may suggest things to try yourself, such as sleeping under thin layers at night. They might offer you HRT. Or they could offer to refer you for CBTi, which is CBT for sleep problems.  

They may also offer you a blood test to rule out underlying health issues that can cause sleep problems and would need to be addressed, such as thyroid problems or low iron. Low iron is more likely to be a problem in people with some forms of inflammatory arthritis. And it can be a side effect of some drugs used to treat arthritis, such as methotrexate. 

Manage your mental health

Many women experience mood swings, brain fog and anxiety during menopause. The added challenge of arthritis can make it harder to cope with these changes in mood.  

It’s not selfish to take time for yourself. It’s part of managing your arthritis during menopause. You may want to try some of these tips for looking after your mental wellbeing: 

• Yoga and tai chi, and mindfulness techniques, can be a great way to unwind.  
• Writing down your thoughts can help you process and reframe your them. 
• Spend time in nature.  
• Talk to a friend, family member or loved one about how you’re feeling. You may also find it helpful to join a local support group. 

If you’re finding it difficult to cope with menopause symptoms and arthritis, mention it to your GP or healthcare team. They will be able to suggest extra support, such as talking therapy. They can also talk to you about how HRT or antidepressants might help with your mental wellbeing. 

If you’re unsure how to start the conversation, it might be helpful to list your symptoms. If you suspect you’re perimenopausal, you could think about tracking your periods. 

If you’re in crisis, you can call Samaritans on 116 123, 24 hours a day. 

Have a healthy diet

By choosing to eat a healthy, balanced diet, you can lower your risk of certain health issues that are more likely to affect you during and after menopause, such as heart disease and osteoporosis. 

Eating plenty of fruits and vegetables, and avoiding foods and drinks that are high in saturated fat, salt and sugar, is important for heart health.  

One way to reduce your risk of osteoporosis is to eat plenty of calcium. Try for a mix of: 

• dairy, and dairy alternatives 
• leafy greens 
• legumes 
• nuts and seeds 
• fish with edible bones, such as tinned sardines 
• cereal or fruit juice that’s labelled ‘fortified’. 

Some people with arthritis may be advised to take high doses of vitamin D, or to take a calcium supplement too. Ask your healthcare team what they advise. 

Ask for support at work

Arthritis and menopause can make work difficult. If you feel you can, talk to HR or a manager about your menopause and arthritis symptoms.  
They may agree to: 

• provide a fan or move your desk close to the window if you have hot flushes 
• offer equipment like cushioned pads or footrests if you have joint pain 
• let you work from home when your symptoms are flaring up or if you’re having very heavy periods 
• offer a quiet place to work and allow extra breaks if you have headaches and fatigue 
• educate your team about menopause symptoms in a sensitive way. 

Research

Research has explored the impact of gender and menopause on arthritis. Arthritis UK-funded research has explored the links between sex hormones, menopause and arthritis This includes studies looking at whether HRT could help relieve hand osteoarthritis pain, and how changes in hormone levels may affect joint health. 

What are researchers looking at now? 

• A team of researchers called SOLVE (the Stratification of Osteoarthritis to Promote Living Well and Treatment Effectiveness Consortium) is exploring how menopause and other factors might impact on how osteoarthritis develops and affects people differently.  
• The MSK Epidemiology Consortium is helping us understand the impact of menopause on people with arthritis, with a view to developing guidance for menopause-related pain. 

Sources

• National Institute for Health and Care Excellence 2026b Menopause: identification and management. NICE guideline NG23. 
• National Institute for Health and Care Excellence, 2022 Osteoarthritis in over 16s: diagnosis and management. NICE guideline NG226.

Last review: October 2026 

Next review: October 2029