07/01/2026
Women's Health β Knee Osteoarthritis (KOA)
Women in their mid-to-late 40s (usually ages 45 and above) begin the natural stages of perimenopause, a transitional phase surrounding menopause that marks a decline in ovarian function. This phase lasts 1 year after the final menstrual period and involves myriad physical and psychological changes. Because of the symptom overlap, some women going through perimenopause are incorrectly diagnosed with fibromyalgia.
Estrogen plays a crucial role in health and quality of life. Fluctuating estrogen levels often trigger a range of symptoms of perimenopausal syndrome, with many women finding that their joints suddenly become stiff and painful, making it harder to build and maintain muscle during this phase of their lives.
In recent years, studies have found that changes in perimenopausal estrogen levels are closely associated with pain in knee osteoarthritis (KOA) (Zhao et al., 2025). This is due to estrogen's protective effect on joints and cartilage and its anti-inflammatory properties; therefore, when estrogen levels decrease, reduced cartilage integrity and increased inflammation can increase the risk of knee osteoarthritis (KOA) in women.
Even though every woman's experience of menopause transition is unique, data have shown that knee osteoarthritis (KOA) is becoming increasingly common in women during perimenopause; therefore, diagnosis and individualizing treatment options are vital. Many non-pharmacological protocols may help alleviate symptoms of knee osteoarthritis (KOA), including physical therapy, physical therapy modalities, Platelet-Rich Plasma (PRP), traditional Chinese medicine, low-impact exercise, and diet.
The bottom line:
It is advised to consult your doctor as soon as joint pain becomes persistent or interferes with your daily activities. Declining estrogen during perimenopause accelerates cartilage breakdown and inflammation; therefore, it is critical to seek a professional evaluation if knee pain continues so symptoms can be managed and further joint damage can be prevented.
Source:
Zhao H, Yu F, Wu W. The Mechanism by Which Estrogen Level Affects Knee Osteoarthritis Pain in Perimenopause and Non-Pharmacological Measures. Int J Mol Sci. 2025 Mar 7;26(6):2391. doi: 10.3390/ijms26062391. PMID: 40141035; PMCID: PMC11942494.