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Other Hip Treatments
Hip Pain in Menopause: Causes and Treatment in London
Hip pain that arrives or worsens around perimenopause and menopause is common and under-recognised. Falling oestrogen affects tendons, muscle, bone and the way you feel pain, so bursitis, tendon pain and stiffness often surface together in your late forties and fifties. Most of it responds to the right loading, strength work and, where needed, targeted injections, without surgery. The first step is working out what is hormonal, what is mechanical and what is both.
Can menopause cause hip pain?
Yes, and it is one of the most overlooked causes of hip pain in women in their late forties and fifties. Oestrogen does far more than regulate the menstrual cycle. It helps maintain the collagen in your tendons, the strength of your bone, the volume of your muscle and even the sensitivity of the nervous system that processes pain. As oestrogen falls through perimenopause and menopause, all of those shift at once. Tendons become more easily irritated, bursitis flares, muscle is harder to hold on to, and aches that would once have passed now linger. Many women are told this is simply ageing. It is more specific than that, and that specificity is exactly what makes it treatable.
The hip problems that cluster around menopause
Three patterns show up again and again. The first is outer hip pain, gluteal tendinopathy and trochanteric bursitis, felt on the side of the hip and often worse when lying on it at night. The second is a general loss of tendon and muscle resilience, so the hip tires and aches with activity it used to tolerate without complaint. The third is the early acceleration of osteoarthritis in a joint that was already wearing, as bone and cartilage lose some of their hormonal protection. These frequently overlap, which is why a single label rarely captures what is actually going on.
Why menopausal hip pain gets missed
Because it sits in the gap between two specialists. The gynaecologist manages the hormones and the orthopaedic surgeon manages the joint, and the hip pain falls down the middle. This is the two-sided failure I built my practice to correct. Some women are offered surgery for a hip that did not need it, when the real driver was tendon pain and deconditioning that the hormonal change had unmasked. Others are told it is all menopause and to wait it out, while a genuinely arthritic hip quietly worsens. Neither is good enough. The work is to look at the whole picture, hormonal and mechanical together, and act on what is truly there.
At a Glance
How I assess menopausal hip pain
I start by separating the strands. A careful history and examination, and where it is needed a scan, tell me whether I am dealing with tendon pain, bursitis, early arthritis or a combination, and how much of the picture is hormonal. Where hormone replacement is relevant I will say so and work alongside your GP or menopause specialist rather than around them, because the joint and the hormones are part of the same story. This is not a hip to be looked at in isolation, and I do not treat it as one.
How hip pain in menopause is treated
Treatment is built for the individual, not the diagnosis. The foundation is strength and loading work, because well-loaded tendon and muscle are the single most effective protection against the changes menopause brings, and because the same work protects bone. Where a tendon or bursa is inflamed and will not settle, an ultrasound-guided injection can calm it enough for the rehabilitation to take hold. Where arthritis is the driver, the pathway follows the joint. Two women of the same age with the same scan will often leave with different plans, because their bodies, their histories and the lives they are fitting recovery around are different. That is the point of doing it properly.
Frequently Asked Questions
Yes. Falling oestrogen affects tendons, bone, muscle and pain sensitivity, so tendon pain, bursitis and stiffness commonly surface or worsen around perimenopause and menopause. It is one of the most overlooked causes of hip pain in women in their late forties and fifties.
Night pain on the side of the hip is usually gluteal tendinopathy or trochanteric bursitis, which becomes more common as oestrogen falls. Lying on the affected side compresses the irritated tendon and bursa, which is why it wakes you.
For some women it can, because oestrogen supports tendon, bone and muscle. Whether HRT is right for you is a decision for you and your GP or menopause specialist. I focus on the mechanical side and work alongside them rather than duplicating their role.
Not always. It is often tendon pain or bursitis unmasked by hormonal change rather than joint wear, though menopause can also accelerate existing arthritis. Telling these apart is the whole point of a proper assessment, because the treatment differs.
Strength and loading work is the foundation, as it protects tendon, muscle and bone. Where a tendon or bursa is inflamed, an ultrasound-guided injection can help. Where arthritis is the driver, treatment follows the joint. The plan is tailored to you.
See someone who will look at both the hormonal and the mechanical picture rather than only one. You can book an assessment with Dr Arj Imbuldeniya on 0207 859 4016 or at admin@ortholongevity.co.uk.
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