Menopause-Related Joint Pain: Spotlight on Hip and Gluteal Tendinopathy
Last updated: October 15, 2025
My hip pain started as a dull ache that seemed to wander—sometimes in my left hip, sometimes my right, occasionally both. It persisted for two years before disappearing completely, only to return again recently. No amount of exercise or stretching seems to help, though I've learned to modify my behavior: I'm careful to distribute my weight evenly on both feet rather than shifting to one side, I take extra caution during workouts and gardening, and I rest when my body tells me to. If this sounds familiar, you're not alone.
Menopause is a transformative phase in a woman's life, bringing not just hormonal changes but also physical challenges that can be both confusing and frustrating. Among these challenges, joint pain—particularly in the hips and gluteal area—is a common but often misunderstood symptom. According to Cleveland Clinic, women who are over 40, especially those who have completed menopause, are more prone to hip pain and gluteal tendinopathy.
Let's delve into why hip pain occurs during menopause, its potential causes, and practical ways to address and alleviate this discomfort.
What Women Are Saying About Hip Pain During Menopause
"I couldn't sleep on my side anymore. Every time I rolled over at night, shooting pain would wake me up. I thought I needed a hip replacement at 52." — Carmen, age 54
"Climbing stairs became excruciating. What used to be effortless suddenly felt impossible. I'd have to pause halfway up, and people would stare." — Diane, age 51
"The pain moved around—sometimes my left hip, sometimes my right. My doctor kept sending me for tests, but no one connected it to menopause until I insisted on seeing a specialist." — Linda, age 49
These experiences highlight how debilitating and confusing hip pain during menopause can be, and how often it's misdiagnosed or dismissed.
Why Hip Pain During Menopause?
The onset of perimenopause or menopause is marked by a significant drop in estrogen levels. While we often associate estrogen with reproductive health, this hormone also plays a critical role in maintaining musculoskeletal health. Understanding how estrogen deficiency affects your body and brain helps explain why joint pain emerges or worsens during this transition.
Its decline can lead to several interconnected problems affecting your hips, joints, and overall mobility.
Gluteal Tendinopathy: A Primary Culprit
A key cause of menopause-related hip pain is gluteal tendinopathy, a condition where the tendons connecting the gluteal muscles to the top of the femur (upper leg bone) become strained or damaged. According to Cleveland Clinic, this tendon disorder causes the tendon tissue to break down or deteriorate, and it's a common cause of hip pain, especially in older women.
This area, called the greater trochanter, is a common site of discomfort, often referred to as greater trochanteric pain syndrome (GTPS) or trochanteric bursitis. Cleveland Clinic notes that as many as 1 in 3 people with lower back pain also develop hip pain from gluteal tendinopathy.
Osteoarthritis and Joint Deterioration
Estrogen deficiency also contributes to osteoarthritis, a condition where cartilage in the joints, including the hips, deteriorates, causing pain and stiffness. The systemic inflammation that increases during menopause further accelerates joint damage and contributes to the widespread aches many women experience.
The Estrogen-Collagen-Tendon Connection
Estrogen plays a vital role in the production of collagen, the structural protein critical for tendon strength and joint health. Research published in the journal Menopause and available through PMC demonstrates the connection between declining estrogen and musculoskeletal symptoms. With lower estrogen levels, collagen production declines, leaving tendons weaker and more susceptible to injury.
This same hormonal mechanism affects multiple body systems simultaneously—the same estrogen decline that causes hip pain can also trigger frozen shoulder, contribute to burning feet, and worsen restless legs. Understanding that these symptoms are part of the broader musculoskeletal syndrome of menopause can help you see the bigger picture.
What Causes Gluteal Tendinopathy?
The tendons in the hip undergo a natural wear-and-repair cycle. However, during menopause, this balance is disrupted. According to Mayo Clinic, tendinopathy can be caused by wear and tear on a tendon due to overuse or naturally over time as people age and their tendons become less flexible.
Cleveland Clinic identifies that gluteal tendinopathy can occur from tendon overuse or underuse, with potential causes including:
Strain from Overuse
Intense activity without adequate recovery, such as excessive exercise or weight-bearing activities, can overload the tendons. The Mayo Clinic notes that repeating the same motions over and over puts stress on tendons, whether through jobs like gardening and house painting or sports activities.
Underuse and Sedentary Lifestyle
A lack of movement can weaken tendons, making them more prone to damage. This is particularly problematic during menopause when women may reduce activity due to other symptoms like fatigue or sleep disturbances.
Postural Habits
Cleveland Clinic identifies several posture-related causes:
- Standing with weight shifted to one leg
- Crossing legs while sitting
- Poor ergonomics
- Prolonged positions that compress tendons
These habits compress and strain the tendons over time, contributing to deterioration.
Direct Trauma
Falling onto the hip can exacerbate or initiate tendon damage.
Weight and Body Composition
Mayo Clinic lists being overweight as a contributing factor for gluteal tendinopathy. The weight gain many women experience during menopause can place additional stress on hip tendons and joints.
Hormone Changes
Mayo Clinic specifically identifies hormone changes as a cause of gluteal tendinopathy. The declining estrogen during menopause directly impacts tendon health and repair capacity.
Symptoms to Watch For
According to Cleveland Clinic, the most notable sign of gluteal tendinopathy is moderate to severe hip pain. Additional symptoms include:
Primary Symptoms
- Pain localized around the outer hip or buttocks
- Discomfort that extends down the outside of your leg to your knee or lower leg
- Lower back pain, groin pain, or gluteal pain
- Pain that often starts at the greater trochanter at the top of your thighbone
- Tenderness when pressing the side of the hip or when the area is touched
When Pain Worsens
Cleveland Clinic notes that pain may feel worse when you:
- Lie on the affected side (making sleep difficult)
- Walk, especially for longer distances
- Climb stairs or walk up inclines
- Stand after prolonged sitting
- Get up from a seated position
- Exercise or engage in physical activity
Associated Symptoms
Mayo Clinic describes tendinopathy symptoms as:
- Pain, often described as a dull ache, especially when moving the affected limb or joint
- Stiffness or weakness in the affected area
- Mild swelling
Many women also notice that hip pain affects their ability to sleep, contributes to daytime fatigue, and impacts overall quality of life.
Hip Pain vs Other Joint Pain in Menopause
While hip pain from gluteal tendinopathy is common, it's not the only type of joint pain women experience during menopause. Understanding the differences can help you communicate more effectively with your healthcare provider.
Hip and Gluteal Pain
- Located in outer hip, buttocks, or side of thigh
- Worsens with lying on the affected side
- Pain when climbing stairs or standing from sitting
- Often related to tendon issues
Knee Pain
- May occur alongside hip pain
- Often related to osteoarthritis or patellar tendinopathy
- Worsens with kneeling, squatting, or prolonged standing
- Can be caused by the same inflammatory processes
Shoulder Pain
- Frozen shoulder is extremely common in menopausal women
- Limited range of motion
- Similar hormonal mechanism (estrogen, collagen, inflammation)
- Often occurs around the same time as hip issues
Widespread Joint Pain
Some women experience the musculoskeletal syndrome of menopause, which includes:
- Multiple joints affected simultaneously
- Morning stiffness
- Generalized aches and pains
- Feeling like you've "aged overnight"
All of these symptoms share the common thread of declining estrogen, reduced collagen production, and increased systemic inflammation.
When to Track Your Symptoms
Keeping a symptom diary can help you identify patterns, track what helps or worsens pain, and provide valuable information to your healthcare provider.
Challenges in Diagnosis
One significant hurdle for menopausal women experiencing joint pain is misdiagnosis. General practitioners often overlook hormonal shifts as a contributing factor to symptoms like joint pain, headaches, and insomnia. This oversight can lead to:
- Unnecessary tests (e.g., CAT scans, MRIs)
- Medications that only mask symptoms rather than address the root cause
- Referrals to multiple specialists for conditions that could be managed through hormonal and lifestyle interventions
- Frustrating delays in getting appropriate treatment
- Increased healthcare costs
Cleveland Clinic emphasizes that many conditions can cause hip pain, and a correct diagnosis is critical to proper treatment and faster recovery. You may need imaging tests like MRI or ultrasound to look for tendon injuries or inflammation.
Understanding the link between menopause and musculoskeletal health is essential to avoid these frustrating and often costly missteps. Working with a menopause specialist who understands these connections can save you time, money, and unnecessary suffering.
Managing Menopause-Related Hip Pain
According to Cleveland Clinic, about half of people with gluteal tendinopathy will get better without treatment—but symptom relief may take up to a year. That's a long time to live with hip pain, especially when 7 out of 10 people with the condition see significant improvements with eight weeks of physical therapy exercises.
Physical Therapy: The Gold Standard
Cleveland Clinic states that physical therapy exercises can ease symptoms and help you manage the condition. Unlike tendinitis, tendinopathy rarely gets better with rest alone—you need targeted exercises to regain mobility.
A physical therapist can design a personalized program to:
- Strengthen hip muscles and glutes
- Improve posture and movement patterns
- Increase flexibility without overloading tendons
- Address biomechanical issues contributing to pain
- Teach you which activities to modify or avoid
Lifestyle Adjustments
Exercise Regularly (with modifications):
Engage in low-impact activities like swimming, walking, or yoga to strengthen muscles without overloading tendons. Mayo Clinic recommends mixing high-impact exercise with low-impact options and easing up if activities cause pain.
Strength Training with Caution: Focus on exercises targeting the glutes and core to support hip stability. However, avoid exercises that trigger pain, and build strength gradually.
Stretching: Incorporate gentle stretches for the hip flexors and glutes to maintain flexibility, but avoid aggressive stretching that might further strain tendons.
What to Avoid:
- Standing with weight shifted to one leg
- Crossing legs while sitting
- Sleeping on the affected side
- Sudden increases in training intensity
- Activities that cause sharp pain
Mind Your Posture
Cleveland Clinic recommends avoiding prolonged positions that compress tendons. Use ergonomic furniture to support proper alignment, and be conscious of how you stand and sit throughout the day.
Practical tips:
- Distribute weight evenly on both feet when standing
- Use a cushion when sitting to reduce pressure on hips
- Take breaks from sitting every 30-60 minutes
- Sleep on your unaffected side with a pillow between your knees
Healthy Weight Management
Maintaining a healthy weight reduces unnecessary strain on the tendons and joints. The weight gain that often accompanies menopause can worsen hip pain, so addressing this through diet and appropriate exercise is important.
Anti-Inflammatory Diet
Supporting your body with anti-inflammatory foods can help reduce overall inflammation and support tendon healing. Focus on:
- Omega-3 fatty acids (fatty fish, walnuts, flax seeds)
- Colorful fruits and vegetables high in antioxidants
- Lean proteins for tissue repair
- Adequate hydration (try our 30-day hydration challenge)
- Limit processed foods, sugar, and inflammatory fats
Addressing Hormonal Imbalance
Discuss hormone replacement therapy (HRT) or other treatments with a healthcare provider to address estrogen deficiency and its impact on tendon health. Since declining estrogen is a root cause of reduced collagen production and weakened tendons, addressing the hormonal imbalance may improve symptoms.
Learn more about your options in our HRT 101 Guide, and use our HRT Price Checker Tool to compare costs. Check which menopause medications are FSA eligible to help manage treatment expenses.
Pain Management
Over-the-counter options: Cleveland Clinic notes you may benefit from nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to temporarily reduce pain and inflammation.
Corticosteroid injections: For severe pain, your provider might recommend injections, though Mayo Clinic notes that corticosteroids can increase risk of tendinopathy, so these should be used cautiously.
Other interventions: Heat or ice therapy, massage, or acupuncture may provide relief for some women.
When Surgery May Be Needed
According to Cleveland Clinic, some people may need surgery to mend a torn tendon. However, this is typically considered only after conservative treatments have been tried for an extended period.
Managing Sleep Disruption
Hip pain often interferes with sleep, creating a vicious cycle where poor sleep worsens pain and inflammation. If hip pain is affecting your rest, read our guide on sleep disturbances during menopause for additional strategies.
Explore sleep support products that other women have found helpful, including supportive pillows and pain relief options.
When Hip Pain Signals Something Serious
While gluteal tendinopathy and menopausal joint pain are common, certain symptoms warrant immediate medical attention:
Red Flags
Cleveland Clinic recommends calling your healthcare provider if you experience:
- Severe pain that interferes with daily activities
- Hip pain that doesn't improve with rest and self-care
- Pain accompanied by fever (could indicate infection)
- Sudden inability to bear weight on the affected leg
- Visible deformity or severe swelling
- Pain that worsens progressively over weeks
Conditions to Rule Out
Your healthcare provider should evaluate for:
- Fractures or stress fractures (especially if you have osteoporosis risk)
- Hip labral tears
- Bursitis
- Arthritis (osteoarthritis or inflammatory arthritis)
- Referred pain from lower back issues
- Circulatory problems
- Infections
The Importance of Proper Diagnosis
Cleveland Clinic emphasizes that many conditions can cause hip pain, and a correct diagnosis is critical. You may need imaging tests to pinpoint the precise cause. This tendon problem rarely gets better without treatment, and rest alone doesn't help.
Advocating for Yourself
Navigating menopause-related health concerns requires self-advocacy. If you feel your symptoms are being overlooked or misdiagnosed, consider:
- Seeking a second opinion
- Consulting a menopause specialist familiar with women's health during menopause
- Asking specifically about the hormonal connection to your symptoms
- Keeping detailed records in a symptom diary
- Requesting imaging tests if conservative treatment isn't working
- Being persistent about finding answers
A multidisciplinary approach that considers hormonal, physical, and lifestyle factors often yields the best outcomes. Don't accept dismissive responses like "it's just part of aging" or "learn to live with it" without exploring all treatment options.
The Connection to Other Menopause Symptoms
Hip pain doesn't occur in isolation. The same hormonal changes causing joint issues are also responsible for:
- Systemic inflammation throughout the body
- Frozen shoulder and shoulder pain
- Widespread musculoskeletal aches
- Burning feet and circulation changes
- Restless legs syndrome
- Raynaud's syndrome
- Sleep disturbances
- Anxiety and mood changes
Understanding these connections helps you see that addressing the root cause—hormonal changes and inflammation—can improve multiple symptoms simultaneously.
Frequently Asked Questions
Why does menopause cause hip pain?
Menopause causes hip pain primarily through declining estrogen levels, which affect collagen production and tendon strength. Estrogen is critical for maintaining healthy tendons, and when levels drop, tendons become weaker and more prone to injury and deterioration. This commonly leads to gluteal tendinopathy, where the tendons connecting gluteal muscles to the hip bone break down. Additionally, estrogen decline increases systemic inflammation throughout the body, contributing to joint pain and osteoarthritis.
Can perimenopause cause hip pain?
Yes, perimenopause can definitely cause hip pain. The hormonal fluctuations during perimenopause—when estrogen levels are rising and falling unpredictably—can trigger tendon problems, joint inflammation, and pain. Many women first notice hip discomfort during perimenopause, which may worsen as they transition into full menopause. Women over 40, especially those approaching or in menopause, are more prone to gluteal tendinopathy and hip pain.
What is gluteal tendinopathy?
Gluteal tendinopathy is a condition where the tendons connecting the gluteal muscles (buttocks muscles) to the top of the thighbone (greater trochanter) become damaged or deteriorate. It causes moderate to severe hip pain on the outer hip and buttocks that worsens with activities like lying on the affected side, climbing stairs, or walking. It's particularly common in menopausal women due to declining estrogen's effects on tendon health and collagen production.
Does estrogen help joint pain?
Yes, estrogen plays a crucial role in joint and tendon health. It stimulates collagen production, which is essential for strong tendons and healthy cartilage. Estrogen also has anti-inflammatory properties that help reduce joint inflammation. When estrogen levels decline during menopause, collagen production decreases, tendons weaken, and inflammation increases—all contributing to joint pain. Hormone replacement therapy may help some women reduce joint pain by addressing the underlying estrogen deficiency.
How long does menopause joint pain last?
The duration of menopause-related joint pain varies significantly among women. Some experience relief as hormone levels stabilize after menopause, while others have persistent symptoms that require ongoing management. For gluteal tendinopathy specifically, about half of people improve without treatment within a year, but 70% see significant improvement with eight weeks of physical therapy. With proper management including hormone therapy, physical therapy, lifestyle modifications, and anti-inflammatory strategies, most women can reduce symptoms substantially.
What helps hip pain during menopause?
Hip pain during menopause responds best to a multi-faceted approach: physical therapy exercises (the most effective treatment), addressing hormonal imbalance through HRT when appropriate, maintaining proper posture and avoiding positions that strain tendons, anti-inflammatory diet and adequate hydration, appropriate exercise that strengthens without overloading tendons, healthy weight management, and pain relief through NSAIDs or other interventions as needed. Unlike simple tendinitis, tendinopathy rarely improves with rest alone—targeted treatment is essential.
Can hormone therapy prevent tendinopathy?
While research is ongoing, hormone therapy may help prevent or reduce severity of tendinopathy by maintaining estrogen levels that support collagen production and tendon health. Since estrogen decline is a recognized cause of gluteal tendinopathy, replacing estrogen through HRT may provide protective benefits. However, HRT isn't appropriate for everyone, and the decision should be made with a healthcare provider considering individual health history, risk factors, and symptoms. For more information, consult our HRT 101 Guide and discuss options with a menopause specialist.
Conclusion
While menopause can bring challenges like hip pain and joint discomfort, understanding its impact on your body is empowering. By recognizing the connection between hormonal changes and musculoskeletal health, you can take proactive steps to manage symptoms, improve mobility, and enhance your quality of life.
The key takeaways are:
- Hip pain during menopause is common and directly related to declining estrogen
- Gluteal tendinopathy is a specific condition affecting many menopausal women
- Physical therapy is highly effective—70% see significant improvement in 8 weeks
- Addressing hormonal imbalance through HRT may help some women
- Lifestyle modifications including proper posture, exercise, and diet are essential
- Proper diagnosis is critical—don't accept dismissive responses
- Hip pain is part of the broader musculoskeletal syndrome of menopause
Remember, you're not alone—millions of women share similar experiences. According to Cleveland Clinic, women over 40, especially those who have completed menopause, are significantly more prone to these issues. Armed with knowledge, support from healthcare providers who understand menopausal health, and evidence-based treatment strategies, you can navigate this transition with confidence and vitality.
If you're experiencing persistent or severe hip pain, don't wait a year hoping it will resolve on its own. Seek evaluation from a menopause specialist or physical therapist who can help you start effective treatment now.
For more information about menopause symptoms and personalized answers to your questions, visit our Q&A about menopause.
Symptom Relief
Managing menopause symptoms can feel overwhelming, especially when effective solutions seem hard to find. From hip and joint pain to other physical challenges, these shifts can impact daily life and overall well-being. Explore our Symptom Relief page to discover products that other women have found helpful in managing their symptoms of perimenopause and menopause, including options for joint support, pain relief, and sleep support.
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Explore More
Want to dive deeper into menopause and its symptoms? Visit our Resources page, where you’ll find a collection of studies, articles, and books from trusted experts. Whether you're looking for the latest research or practical insights, these resources can help you better understand your body and make informed decisions about your menopause journey.