The hot flushes, mood swings, and sleep disruptions are widely discussed in relation to menopause, but there's another symptom that you may not be aware of: sudden joint and muscle pain.

If you've felt a twinge as you climb stairs, or noticed your hands feeling stiff in the morning, you're not alone. Research published in the journal Neural Plasticity shows that increased inflammation, weakened muscle and bone strength, and heightened pain sensitivity are all common during perimenopause, menopause, and post-menopause. Add to this the increased risk of osteoporosis as oestrogen levels drop, and it's clear our musculoskeletal system needs extra support during this life stage.

And while you can't stop these inevitable hormonal changes, you can support your body along the way.

The gut-bone connection

Dr Lucy Williamson, a registered nutritionist and gut health expert, believes many people are missing a crucial piece of the puzzle when it comes to managing menopausal joint pain.

"There's growing understanding that strength training, adequate sleep and stress management have a vital part to play here. But what about food?" she asks. "I would say that taking care of your gut microbiome is the single most important thing you can do to help protect your body from this, and so many of the typical symptoms of menopause."

The connection between our gut and our bones might not seem obvious at first, but our gut microbiome – the trillions of bacteria living in our digestive system – plays a powerful role in everything from inflammation to hormone production.

Maintaining a healthy weight during menopause involves finding what works for your body. Bones are strengthened by the weight they carry (which is why strength training helps), and nourishing your body with the right foods plays a crucial role too.

Here's where gut health comes in: your gut microbiome actually supports your natural production of GLP-1, a hormone that helps regulate appetite and metabolism. By nurturing your gut with prebiotic, fibre-rich plants and probiotic foods (such as kimchi, yoghurt, or cheese eaten little and often), you encourage your body to produce this helpful hormone naturally. These fibre-rich foods also help you feel fuller by keeping blood sugar levels stable.

💡
Research suggests a link between disordered eating and perimenopause and menopause. If reading about weight, food, or body changes feels distressing or triggering, talk to your GP or contact BEAT for support.

Calcium: the bone-building essential

Getting enough calcium is important during menopause, and you should aim for two to three servings of calcium-rich foods daily:

  • Dairy sources are particularly effective because the protein they contain (casein) helps your body absorb calcium more easily. Think milk, hard cheeses like cheddar and edam, and yoghurt.
  • Plant-based options include fortified plant drinks, tofu, and calcium-fortified plant yoghurts. If you're eating leafy greens like kale, watercress, and spring greens, pair them with vitamin C-rich foods to boost calcium absorption.
  • Surprising sources include cereals and grains, especially when soaked overnight (try overnight oats), sourdough bread (the slow fermentation may improve calcium absorption), mushrooms, sesame seeds, tahini, and tinned sardines.

Vitamin D and protein

Getting enough vitamin D through food becomes essential in the winter months when many of us get less exposure to sunlight. Fish and mushrooms are your best dietary sources, but Dr Williamson recommends topping up with at least 10 micrograms of vitamin D as a supplement throughout winter.

To maintain healthy bones, muscles, and collagen, you need all the essential amino acids – what nutritionists call "complete" protein sources. Include fish, dairy, meat, eggs, chia seeds, quinoa, soya, and nuts regularly. A Mediterranean-style diet, rich in colourful plants, healthy oils, fish, and some meat, typically provides adequate protein. 

Menopausal joint pain can feel disheartening, especially when it impacts your ability to do things you love. But by nourishing your gut microbiome and ensuring you're getting enough calcium, vitamin D, and protein, you're giving your body the tools it needs to stay strong and resilient during this transition.