Why Hip Pain and Weakness Are So Common During Perimenopause

If you've entered your 40s and started to experience hip pain, tightness, or a frustrating sense of weakness during workouts or everyday activities, you're not alone. Many women are surprised to learn that these symptoms are not just in their head and may be closely linked to the hormonal shifts of perimenopause.

At Dynamic Performance and Therapy, we specialize in helping active individuals stay strong and pain-free. Let's dive into what the science says about why hip discomfort becomes more common during this transitional stage of life.

The Estrogen Link: More Than Just Hot Flashes

Estrogen does more than regulate your menstrual cycle. It also plays a key role in:

• Maintaining muscle protein synthesis

• Supporting tendon and ligament structure

• Modulating pain perception

As estrogen levels begin to fluctuate and decline during perimenopause, these systems can start to show signs of stress—especially around the hips and pelvis.

What the Research Says:

• A 2010 study by Lowe et al. found that women in early perimenopause showed reduced muscle power and coordination, especially in the lower body.

• Research published in Maturitas (2015) linked lateral hip pain and gluteal tendinopathy to hormonal changes and strength deficits in perimenopausal women.

  
  

Common Hip Issues in Perimenopause

Here are the most frequent hip-related complaints we see in our clinic:

1. Gluteal tendinopathy: Pain on the outside of the hip, often worse with side-lying or walking uphill.

2. Proximal hamstring tightness or pain: Especially with sitting or deadlifting.

3. Deep joint aching: Often tied to changes in bone density and joint stress.

4. Muscle imbalances: TFL and piriformis overactivity, with glute med/min inhibition.

   
   

The Nervous System Matters, Too

Perimenopause doesn't just change your muscles and joints—it also affects your nervous system. Research in Pain Reports (2021) shows that women during this life phase may experience increased central sensitization. In short, your brain and spinal cord may amplify pain signals more than they did before.

This means symptoms like burning, tightness, or fatigue around the hips may be real, even if imaging is "clean."

What You Can Do: 4 Action Steps

1. Strengthen the glutes with targeted exercises like hip airplanes, side planks with leg lifts, and loaded step-ups.

2. Balance the pelvis by retraining deep core control and breathing mechanics.

3. Respect load management. Avoid long periods of single-leg stance or high-volume plyometrics during symptomatic periods.

4. Work with a provider who understands this stage of life. A comprehensive plan should include both mechanical and hormonal considerations.

   
   

You Don't Have to Accept Hip Pain as Your "New Normal"

Understanding the hormonal and biomechanical drivers behind perimenopausal hip pain is the first step toward reclaiming control. At Dynamic Performance and Therapy, we create customized plans that address the root causes of pain and build long-term strength.

If you're dealing with these issues, know that you’re not broken—you just need a smarter plan.

Book a free movement consultation today and start feeling like yourself again or get started in learning more about peri-menopause and beyond by joining us Wednesday, May 21st at 5 pm for our event at Misty's Dance!