Hip Pain and Menopause: Why Your Hips Hurt More Now

Hip pain and menopause often go together because falling estrogen affects tendons, joints and muscle. Estrogen helps keep tendons strong and joints comfortable, so as it drops, outer hip tendon pain, stiffness and night aches become more common. Regular strength training is one of the most helpful things you can do.

I’m a NASM certified trainer and corrective exercise specialist with over 20 years of coaching behind me, and new or worse hip aches in the late 40s and 50s are among the most common concerns women bring to me.

If your hips started hurting more around the same time your periods changed, you are not imagining it. Below, you’ll learn how menopause can affect your hips, the patterns that show up most, and the simple habits that help most women feel stronger and more comfortable.

How Menopause Affects Your Hips

Estrogen does far more than run your monthly cycle. Your tendons, ligaments, cartilage, muscles and bones all have estrogen receptors, which means they respond when estrogen levels change.

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During perimenopause, the years leading up to your last period, estrogen rises and falls unevenly. After menopause, it settles at a much lower level. Both phases can affect your hips in a few key ways.

• Tendons. Estrogen supports collagen, the protein that keeps tendons strong and springy. With less of it, tendons can become less able to handle load.
• Muscle. Muscle mass naturally declines with age, and the drop often speeds up around menopause. Weaker hip muscles leave tendons and joints to take more strain.
• Joints. Estrogen has a mild calming effect on inflammation. Lower levels can make joints feel stiffer, especially in the morning.
• Pain sensitivity. Hormone shifts, poor sleep and hot flashes can all turn up how strongly you feel pain.

My guide to perimenopause joint pain explains these whole-body changes in more detail.

Perimenopause vs Post Menopause Hip Pain

Perimenopause hip pain often comes and goes. Because estrogen swings up and down, many women notice good weeks and bad weeks, sometimes lining up with changes in their cycle, sleep or stress. Aches can seem to move around, from the hips to the knees to the shoulders.

Post menopause hip pain tends to feel steadier. Estrogen is now consistently lower, muscle loss continues if it is not trained, and tendons have had more time to lose some of their spring. This is also the stage when hip arthritis becomes more common.

The good news is that the same core plan helps in both stages. Building strength, staying active and managing load on the outer hip work whether your hormones are swinging or have settled.

Common Types of Hip Pain Around Menopause

Not all hip pain in midlife has the same cause. These are the patterns that show up most often.

These are common patterns, not a diagnosis. A doctor or physical therapist can confirm what is really going on.

Outer Hip Pain and Menopause

Pain on the side of the hip is one of the most common complaints women have around menopause. In many cases it comes from gluteal tendinopathy, an irritation of the tendons that attach your glute muscles to the bony point on the side of your hip.

It used to be called hip bursitis, but research now shows the tendons are usually the main issue. Women are far more likely to develop it than men, and it becomes much more common after 40, which lines up with the hormonal changes of perimenopause.

Current evidence favors strengthening and smart load management over stretching for this kind of pain. Deep outer hip and IT band stretches, crossing your legs and standing with your weight hanging into one hip can all press on the sore tendon.

My full guide to gluteal tendinopathy covers the condition in depth.

A question I hear a lot is whether to rest the hip completely until it calms down. Full rest usually backfires with tendon pain, because tendons get weaker without load. The goal is to reduce the things that press on the tendon while keeping the muscles working.

Glute Pain and Menopause

A dull, tired ache in the buttocks is also common in midlife. As muscle mass drops, the glutes may not handle long walks, stairs or busy days as well as they used to, and they can feel sore by evening.

The answer is usually more glute work, not less. Bridges, sit to stands and side-lying leg lifts help rebuild strength so the muscles can handle your day without complaining.

Menopause Hip Pain at Night

Night pain is one of the most frustrating parts of midlife hip trouble. Lying on your side presses directly on the outer hip tendons, and when your top leg drops across your body, those tendons get squeezed even more.

Hot flashes and night sweats can also wake you and make you more aware of aches you might otherwise sleep through. Poor sleep then makes pain feel worse the next day, which can become a frustrating cycle.

A few simple changes often help. Avoid lying on the painful side. When you sleep on the other side, place a pillow between your knees so your top leg stays level. Lying on your back with a pillow under your knees is another comfortable option.

My guide to hip pain at night covers more sleep position fixes.

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Why Strength Training Helps Most

As a corrective exercise specialist, this is the message I repeat most to women in this stage of life: muscle is your best friend. Strength training helps tendons become more resilient, keeps muscles strong enough to protect the joints, and supports bone density at the same time.

Tendons respond best to steady, progressive loading. That means starting gentle and adding a little more effort over weeks, not jumping into a hard workout or avoiding the hip completely.

Here is a simple starting routine. Do it two or three days a week.

1. Glute bridge. Lie on your back with knees bent. Press through your heels and lift your hips until your body forms a straight line. Hold 2 seconds. Do 2 sets of 10 to 12.
2. Isometric side push. Lie on your back with a belt looped around your thighs just above the knees. Press gently outward into the belt and hold 30 seconds at a moderate effort. Do 4 to 5 holds.
3. Sit to stand. From a sturdy chair, stand up without using your hands and sit back down slowly. Do 2 sets of 8 to 10.
4. Side-lying leg lift. Lie on your pain-free side with a pillow between your knees, then lift the top leg slightly back and up. Do 2 sets of 8 to 12. Skip it if it presses on a sore hip.
5. Step-ups. Step up onto a low, stable step, leading with one leg, and step down slowly. Do 2 sets of 8 per side, holding a rail if needed.

Mild discomfort, around 3 out of 10, that settles within 24 hours is usually fine with tendon pain. If pain rises sharply or lingers into the next day, ease back. My hip strengthening exercises guide shows a full beginner plan.

Everyday Habits That Help

Strength is the foundation, but daily habits decide how your hips feel between workouts.

• Stand evenly. Keep weight on both feet instead of hanging into one hip.
• Uncross your legs. Sit with both feet flat and knees about hip width apart.
• Keep walking. Regular, comfortable walks on flat ground keep hips moving. Build distance slowly.
• Warm up before activity. A few minutes of easy walking or gentle hip circles helps stiff joints.
• Protect your sleep. Good sleep lowers pain sensitivity, so a cooler bedroom and a steady bedtime can help your hips too.

If morning stiffness is your main complaint, my guide to joint stiffness after menopause has more ideas.

Talking to Your Doctor About Menopause

Hip pain is worth mentioning at a menopause checkup, especially if it is new, getting worse or affecting your sleep. Your doctor can check whether hormones, bone health or another condition is playing a part and talk with you about treatment options. Bring a short note of where it hurts, when it started and what makes it better or worse.

When to See a Doctor or Physical Therapist

Most midlife hip pain is manageable with strength and smart habits. But see a doctor or physical therapist promptly if you notice:

• Numbness or tingling in your leg or foot
• Leg weakness, or a hip that gives way
• Pain after a fall, even a minor one, since bone density can drop after menopause
• Fever with joint pain, or a hip that is hot and swollen
• Pain that wakes you at night, no matter how you lie
• Loss of bladder or bowel control, which needs emergency care
• Pain that is no better after 2 to 3 weeks of gentle care

Your This-Week Plan

1. Day 1: Note where your hip hurts and when, and stop crossing your legs.
2. Day 2: Start sleeping with a pillow between your knees and avoid lying on the sore side.
3. Days 3 and 5: Do the strength routine at a gentle effort, 1 to 2 sets each.
4. Days 4 and 6: Take a comfortable 15 to 20 minute walk on flat ground.
5. Day 7: Review how your hip feels and book a checkup if it is worse.

Quick Questions

This guide is part of my hip and lower body pain guide, where you’ll find help for outer hip pain, gluteal tendinopathy, glute pain and hip pain at night, plus clear advice on when to see a doctor.

The Bottom Line

Hip pain and menopause are closely linked, mostly because lower estrogen leaves tendons and muscles less able to handle load. Outer hip tendon pain, stiffness and night aches are common, and you are not alone in noticing them.

The best response is steady strength work, smarter sitting and sleeping positions, and regular walks. Give it a few weeks of consistency, and talk to your doctor if pain is new, getting worse or keeping you up.

This article is for general education and isn’t medical advice. Talk to your doctor about menopause symptoms, bone health and treatment options, and see a doctor or physical therapist for ongoing hip pain. Get medical help promptly for numbness, leg weakness, pain after a fall, fever with joint pain, pain that wakes you at night, or any loss of bladder or bowel control.