Aches and stiffness are one of the most common things women mention in perimenopause, and one of the least talked about. Here's what's going on underneath, why the cold makes it worse, and what tends to help.

Why your joints ache more since perimenopause started

Oestrogen does a lot of quiet, unglamorous work around your body, and a fair bit of it happens in your joints.

It helps keep cartilage healthy, supports the thin lining that lubricates each joint, and influences the collagen in your tendons and ligaments. It also has a hand in how your body registers pain. When oestrogen starts fluctuating and falling, all of that shifts at once.

The result is joints that feel less oiled and more creaky. Tendons and ligaments lose some of their spring. Everyday movements that never needed thinking about suddenly need a moment.

Researchers have started grouping these changes together. A 2024 review in Climacteric proposed the term musculoskeletal syndrome of menopause to describe the cluster of joint pain, muscle loss, bone density change and tendon trouble that tends to show up together in midlife. The authors estimate that more than 70% of women will experience musculoskeletal symptoms through the transition, and around a quarter will find them severe.

That number surprised us, and it probably shouldn't have. It's a big slice of women dealing with something most of us were never warned about.

These aches often hit hardest in the morning and settle as the day goes on. Some women also notice they're simply more sensitive to pain than they used to be. If your shoulder has been the main offender, our piece on why frozen shoulder is so common between 40 and 60 is worth a read.

Menopause is rarely the only thing going on. Age, old injuries, a quiet few years, extra weight around the middle and conditions like arthritis all play a part too, and untangling them is a conversation worth having with your doctor rather than the internet.

What the cold actually does to stiff joints

Most women who ache in winter have been told at some point that it's in their head. The evidence says otherwise, though it's more measured than the folklore.

The largest study of its kind, Cloudy with a Chance of Pain, tracked daily pain reports from 2,658 people over 15 months using a smartphone app. It found real but modest links between pain and the weather, with humidity showing the strongest association, followed by low pressure and wind.

Damp days were the sore ones. Dry days were the easiest.

What the researchers couldn't do was explain the mechanism. Nobody has nailed down exactly why damp, low pressure air makes a joint grumble, and the honest position is that we still don't know.

The less mysterious part is behaviour. Cold weather makes all of us move less, sit longer, and hunch against the wind. Muscles around an already stiff joint tighten up, the morning walk gets skipped, and by August everything has quietly seized.

Winter stiffness isn't one problem. It's a hormonal shift and a seasonal slump arriving at the same time, which is also why the fixes work best in combination.

If the aches are turning up alongside hot flushes, night sweats and the general hormonal churn of this stage, that whole picture is what menopause joint pain often looks like, and it's the picture our Foundation blend was formulated around. Foundation may help relieve the symptoms of menopause and support healthy female hormonal balance during this time, using black cohosh, astragalus, white peony and licorice root.

It sits alongside the movement, warmth and food strategies below rather than replacing any of them. Always read the label and follow the directions for use. Adults only.

Movement is the thing that helps most

Motion is lotion. It sounds like a fridge magnet, but it holds up.

Joints are fed by movement. The lubricating fluid inside them circulates when you move, so the stiffer you feel, the more the instinct to rest works against you. Gentle daily movement beats an occasional big effort every time.

A few things that make winter movement more realistic:

• Warm up for longer than you would in summer. Five minutes of walking on the spot or arm circles before anything more demanding.
• Move indoors when the weather wins. Stairs, a hallway lap, a YouTube stretch class in the lounge room.
• Break it up. Three ten minute walks are easier to commit to than one thirty minute one, and your joints don't know the difference.
• Try water. A heated pool takes the load off sore knees and hips completely.
• Add resistance. Muscle acts like scaffolding around a joint, and building it back is one of the most useful things you can do in this decade. Our guide to strength training after 40 has a beginner routine you can start in your living room.

If mornings are your worst window, shift the routine. A warm shower before you stretch, rather than after, changes how the first hour feels.

Eating for calmer joints: omega-3s and where to find them

Omega-3 fats are the ones worth paying attention to here. They're the anti-inflammatory end of the fat spectrum, and most Australian women don't get much of them.

The research is promising rather than dazzling. A 2023 meta-analysis of nine trials found omega-3 supplementation eased joint pain and improved joint function compared with placebo, though the effect was modest, and later reviews have been more mixed.

Worth adding to your plate, in other words. Not worth expecting miracles from.

Food first is the sensible approach, and it's an easy one in winter when you're cooking anyway.

Everyday omega-3 sources and how to actually use them

Food	Practical serve	How to work it in
Salmon	1 fillet, around 150 g	Roasted with whatever vegetables are already in the oven
Sardines	1 tin, around 100 g	On toast with lemon and pepper, a genuinely good lunch
Mackerel	1 fillet or tin	Flaked through a warm potato and rocket salad
Walnuts	Small handful, around 30 g	Chopped over porridge or into a winter salad
Ground linseed (flaxseed)	1 to 2 tablespoons	Stirred into yoghurt, soup or a smoothie
Chia seeds	1 tablespoon	Soaked overnight with milk and cinnamon

Australian dietary guidance generally points to two or three serves of fish a week, with oily varieties doing the heavy lifting. If fish isn't your thing, the plant sources still count, they just work a little less efficiently in the body.

There's more detail in our piece on the role of omega-3s in menopause wellness if you want to go deeper.

Warmth strategies that earn their place

Heat won't change what your hormones are doing. It will change how the next hour feels, which on a cold Tuesday morning is the thing that matters.

1. Heat before movement, cold after. Warmth loosens stiff tissue and makes stretching easier. If a joint is swollen and angry rather than stiff, cold is usually the better call.
2. Keep a heat pack where you actually sit. At the desk, beside the couch. The one in the linen cupboard never gets used.
3. Layer the joints, not just the torso. Wrists, knees and ankles lose heat fast. Long socks, sleeves that cover the wrist, a blanket over the lap.
4. Warm the room before you get out of bed. A timer on the heater for fifteen minutes before your alarm changes the whole start of the day.
5. Shower first, stretch second. Five minutes under hot water does more prep work than any warm up routine.
6. Watch your hands. Gloves in the car, warm water when you're washing up, and a break from the keyboard every half hour.

Small things, but they stack.

This article is general information only and isn't a substitute for personal medical advice. If symptoms persist, talk to your health professional.