Why perimenopause affects your hips and what helps
Nicola Tik
Hip discomfort during perimenopause is more common than many people realise, and it often appears without any obvious injury or change in activity. Part of the reason it can feel confusing is that hip pain does not always present where people expect it. Understanding what is happening in the hip during this hormonal transition, and where the discomfort tends to show up, makes it easier to recognise and manage.
Oestrogen, the hormone that regulates many of the body's systems beyond reproduction, plays a direct role in maintaining the health of the cartilage, connective tissue, and synovial fluid of the hip joint. The hip is a deep ball and socket joint that absorbs significant force with every step, and it relies on these structures to distribute load effectively and protect the joint surfaces during everyday movement.
During perimenopause, fluctuating oestrogen affects the quality and resilience of the hip's cartilage and connective tissue in ways that make the joint more reactive and less tolerant of load than it would be during periods of hormonal stability. The cartilage cushioning the joint becomes less well maintained, the ligaments supporting the hip become less consistent in their resilience, and the synovial fluid lubricating the joint becomes less reliable. The result is a hip that responds more readily to activity, sustained positions, and changes in load than it did previously.
One of the reasons hip pain during perimenopause can feel confusing is that it does not always present in the place people expect. Many people assume hip pain should be felt on the outer side of the hip, but hormonally driven hip discomfort during perimenopause most commonly shows up in the groin, the deep buttock, and the outer hip and thigh area. It can also refer down into the thigh, which sometimes leads people to attribute it to a lower back or knee problem rather than the hip itself.
Pain in the groin with weight-bearing activity, aching deep in the buttock after prolonged sitting, and outer hip tenderness that is worse after walking or climbing stairs are all common presentations of hip involvement during perimenopause. Recognising these patterns as potentially hip-related makes it easier to manage them appropriately rather than attributing the discomfort to an unrelated cause.
Hip symptoms during perimenopause share the same variability that affects other joints during this transition. The hip may feel entirely manageable on some days and significantly uncomfortable on others, without any obvious change in what has been done. Activities that were previously comfortable, walking longer distances, climbing stairs, or sitting for extended periods, may begin to produce stiffness or aching that was not previously present.
This variability is a direct consequence of fluctuating oestrogen rather than structural damage, and understanding it as such makes it easier to adjust activity and expectations without becoming overly cautious about movement. Reducing activity significantly in response to hip pain during perimenopause tends to weaken the surrounding muscles and reduce joint lubrication, which makes the hip more vulnerable rather than less over time.
Consistent gentle movement is one of the most effective tools for managing hip pain during perimenopause. It maintains joint lubrication, keeps the surrounding muscles engaged, and moderates the pain sensitivity that fluctuating oestrogen produces. The hip responds particularly well to movement that takes it through a varied range, because the joint is designed to move in multiple directions and benefits from that variety in a way that more constrained joints do not.
On days when the hip is more reactive, walking on flat surfaces, gentle cycling, and swimming all maintain movement through the joint without the impact load that stairs or uneven terrain involve. Gentle hip circles, slow side-stepping movements, and careful hip flexor stretches within a comfortable range all help ease the stiffness and maintain the mobility of the joint on more difficult days.
Warmth applied to the hip and outer thigh before activity eases the stiffness and joint sensitivity that builds during rest and makes movement more comfortable, particularly first thing in the morning or after prolonged sitting.
If you have a few minutes, VIDA has short videos you can follow at your own pace, which can help maintain hip mobility and ease the tension in the surrounding muscles during this period.
The muscles of the glutes, hip flexors, and outer hip play a central role in protecting the hip joint by absorbing load and stabilising the joint during movement. During perimenopause, when the cartilage and connective tissue of the hip are more reactive, maintaining strong and well-functioning surrounding muscles becomes particularly important as a way of reducing the demand placed directly on the joint structures.
Strength-based movement that engages the glutes, hip flexors, and the muscles of the thigh supports the hip by distributing load more broadly and improving the joint's tolerance of everyday activity. Bodyweight exercises, resistance bands, walking on varied terrain, and any activity that involves the hips and legs working against some form of load all contribute to maintaining the muscular support the hip relies on during this hormonal transition. Building this gradually is important, because the hip during perimenopause is more reactive to sudden increases in demand than it would be at other hormonal stages.
Because hip symptoms during perimenopause are variable, adjusting activity based on how the joint is responding on a given day tends to work better than applying a fixed approach regardless of symptoms. On days when the hip is more reactive, reducing impact, breaking up longer periods of walking or standing with rest, and avoiding sustained positions that compress the hip at a fixed angle all help manage reactivity without stopping activity altogether.
Avoiding prolonged sitting in low or deep seats that force the hip into a more compressed position reduces the discomfort that builds during sustained sitting on more reactive days. Supportive footwear that cushions impact through the hip during walking also makes a meaningful difference to how the joint manages sustained activity on more difficult days.
Your VIDA pain check-in is a good way to track how hip symptoms are shifting over time and to notice patterns in when the joint tends to be more or less reactive.