World Menopause Day: Joint Pain, Sleep and Midlife

Pictured above: the NightCool Scoop Neck Nightshirt in Navy.

Sunday, October 18, is World Menopause Day, in the middle of Menopause Awareness Month (Awareness Days). The International Menopause Society founded the day in 2009 and chooses its theme (IMS). For 2026 it is Chronic Pain in Midlife, and the White Paper authors have been appointed (IMS President, April 2026). The paper was not on the IMS page when we checked on October 7, so we do not describe it here.

This is the night side of that theme, for women whose joints ache and who also sleep hot. Pain, sleep and heat run in a loop. We will map it, then mark each place you can break it.

Is joint pain a symptom of menopause?

Yes, joint pain is a common symptom of menopause and perimenopause. The Menopause Society lists joint aches and pains among the changes that may come around menopause, alongside sleep problems and mood changes (The Menopause Society).

A 2026 review of 93,021 women found muscle or joint pain in 40% of women before the transition, 57% in perimenopause and 59% after menopause (Kruse et al., 2026). An earlier meta-analysis put musculoskeletal pain at 71% of perimenopausal women (Lu et al., 2020). Both found the studies vary a lot, so read the figures as a range.

Break point: Naming it. Many women put new aches down to age. Linking them to the menopause transition changes the conversation with your doctor.

What is the musculoskeletal syndrome of menopause?

It is a term introduced in 2024 for the joint, muscle and bone changes linked to the loss of estrogen in midlife: joint pain (arthralgia), loss of muscle mass, loss of bone density and progression of osteoarthritis. The review that named it estimates that more than 70% of women experience musculoskeletal symptoms through the transition and 25% are disabled by them (Wright et al., Climacteric, 2024).

The pain can move around or settle in certain joints, such as the shoulder, and many clinicians do not use the term yet (Harvard Health).

Why do joints and muscles ache in perimenopause?

Perimenopause joint pain tracks the fall in estrogen. Its receptors sit in joints, ligaments, tendons and bones, so when estrogen drops the whole musculoskeletal system feels it (Harvard Health). Estrogen helps keep cartilage, ligaments and muscles in balance (The Menopause Society).

• Menopause muscle aches and stiffness. In a large US study of women aged 40 to 55, muscle stiffness affected 54% during menopause (The Menopause Society).
• Earlier, more abrupt loss. Women with premature surgical menopause were more likely to report musculoskeletal discomfort later on.
• Not only hormones. Osteoarthritis, thyroid problems, autoimmune conditions and some medicines, such as statins, can cause aches too (Harvard Health).

Why is joint pain worse at night and stiff in the morning?

Joint pain often worsens at night because you hold still for hours: sleep position and alignment cause most of it, and joints swell when you stop moving, Cleveland Clinic's physiatrist explains (Cleveland Clinic). Movement loosens them again, so the first steps of the morning are the stiffest (Cleveland Clinic).

Night also turns the volume up. "Your body is quieter at night," a Cleveland Clinic physical therapist says, "so you're more likely to hear the thing in your body screaming the loudest" (Cleveland Clinic). Some conditions flare at night or with certain positions (Sleep Foundation). Find your pattern:

How do poor sleep and pain feed each other?

They feed each other both ways, and sleep may push harder. Long-term studies show poor sleep predicts new chronic pain and flare-ups, and sleep problems predict pain more strongly than pain predicts sleep problems (Finan, Goodin and Smith, J Pain, 2013).

Cleveland Clinic cites research that 50% to 90% of people with chronic joint pain do not sleep well. Menopause adds its own load: as many as 46% of women have sleep difficulties in the years before menopause (Sleep Foundation). Here is the loop:

1. 1Estrogen falls. Joints, tendons and muscles lose some of its support.
2. 2Joints ache. Lying still at night, they stiffen and get louder.
3. 3Sleep breaks. Pain, a hot flash or a damp sheet wakes you.
4. 4Pain feels sharper. A short night lowers your tolerance the next day.

One more link: after menopause, sleep apnea was associated with worse joint pain, and The Menopause Society's medical director said joint pain may be a reason to consider apnea. Snoring, fatigue or morning headaches are worth raising; see menopause sleep disorders.

Break point: Sleep is the link with the most handles. Cognitive behavioral therapy for insomnia (CBT-I) has been shown to help insomnia in people with chronic pain (Sleep Foundation).

What changes when you also sleep hot?

You get two alarms instead of one. Lower estrogen narrows the range of temperatures that feel comfortable, so sweating starts at a lower core temperature (Sleep Foundation). A hot flash typically lasts one to five minutes and can bring clammy skin and chills (Cleveland Clinic).

Cleveland Clinic's hot flash advice is practical: dress in layers, keep the house cool with fans or air conditioning, and keep cool compresses handy. More in sleeping hot in perimenopause, even when the room is cold.

Break point: The sweat wake. A light layer that wicks sweat away from the skin will not stop a hot flash. It changes where the sweat goes: off the skin and into a fabric that stays breathable.

What is the best sleeping position for joint pain?

For most joint pain, the best sleeping position is on your side with a pillow between your knees, off any sore shoulder. That is Cleveland Clinic's physiatrist's starting point, and the Sleep Foundation suggests it for hip and lower back pain (Sleep Foundation). Sources differ on back sleeping: Cleveland Clinic suggests avoiding lying flat, while the Sleep Foundation ranks a supported back position second for lower back pain (Sleep Foundation).

Keep a knee pillow snug, not thick (Sleep Foundation). Stomach sleeping is the position most likely to leave you sore in the morning (Sleep Foundation). For back pain, MedlinePlus suggests curling up with a pillow between the legs (MedlinePlus). More in which sleep position is best for you.

How should you set up your bedroom for sore joints and hot nights?

Keep the room cool, dark and quiet, and stage everything before you lie down. The Sleep Foundation puts the best bedroom temperature at about 65 degrees Fahrenheit, in a 65 to 68 range (Sleep Foundation), and for menopause suggests a fan and a glass of ice water nearby.

• Pillows in place before lights out: knees, sore arm.
• Layers on the bed: a top cover you can push off in one move.
• A stretch before bed: low back, front of the hips, hamstrings (Cleveland Clinic).
• Skip alcohol as a sleep aid: it might make you drowsy, but it will not give you restful sleep (Cleveland Clinic).

How do you get up at night with sore joints?

If pain keeps you awake, the Sleep Foundation's advice is to leave the bed and go to another room until you feel sleepy. For the trip, the National Institute on Aging suggests night lights near the bed, a bathroom light left on, a phone by the bed and a clear floor (NIA).

Break point: The hallway. Lights and a clear floor before bed, and a dry layer on the nightstand in case you wake up damp.

What should you wear to bed when your joints ache and you run hot?

Something easy to get on and off that does not trap heat. Sleepwear does not treat joint pain, night sweats or hot flashes, so this is practical design:

• Nothing over the head. The NightCool Snap Front Nightshirt opens all the way down the front, so it goes on and comes off without lifting it over your head. Cleveland Clinic lists difficulty raising the arm among rotator cuff symptoms.
• No waistband. A nightshirt or nightgown has no elastic at the waist.
• Sleeves for the night. The Long Scoop Neck Nightgown with 3/4 Sleeves stops clear of the wrist; the Long Sleeve Scoop Neck Nightshirt covers the whole arm. More in does sleeve length matter?
• A fabric that moves sweat. Every NightCool piece is made with a fabric that wicks sweat away from the skin and stays breathable through the night.

Try it on a stiff morning first. NightCool comes with our 30-Night Cool Sleep Trial: sleep in it, wash it, and if it is not right, start a return within 30 days of delivery. See the trial terms.

When should you see a doctor about joint pain?

See a doctor if pain interferes with daily life, and right away for a hot, swollen joint (Cleveland Clinic). Signs of joint inflammation include swelling, warmth, tenderness and redness (MedlinePlus). Harvard Health adds: seek help if symptoms disrupt movement or sleep, or stiffness gets worse.

One line matters for this audience: Cleveland Clinic lists night sweats alongside joint pain as a reason to see your doctor, with fevers, chills, weight loss and a history of cancer. Menopause causes night sweats too, so mention both rather than assuming one explains the other. Tick anything that applies:

What treatments can you ask your doctor about?

Ask what is driving the pain first. Harvard Health suggests bringing four things: when symptoms began relative to perimenopause, whether the pain is local or widespread, your other menopause symptoms, and your medicines. The options the sources describe, to weigh with your clinician:

• Hormone therapy. Harvard Health says it can help some women. In the Women's Health Initiative trial, estrogen alone lowered how often women had joint pain at one year (76.3% vs 79.2% on placebo), a modest, lasting effect, while joint swelling was slightly more common (42.1% vs 39.7%) (Chlebowski et al., Menopause, 2013).
• Movement. Low-impact exercise, gentle stretching and strength training; check with your provider first.
• Heat or ice, topical treatments, physical therapy (Cleveland Clinic).
• Pain medicine. Over-the-counter options are not right for everyone, for example with stomach ulcers or kidney or liver disease (Cleveland Clinic).
• Sleep treatment. CBT-I for insomnia, and an apnea check if you snore.

Myth or fact: menopause and joint pain

Tap a card for the verdict.

The short version

• Joint and muscle pain is common in perimenopause and after, and it has a name: the musculoskeletal syndrome of menopause.
• Night makes it louder, mornings make it stiff, and poor sleep makes it sharper.
• Side sleeping with a pillow between the knees, off any sore shoulder, is the usual starting point.
• Keep the room near 65 degrees, the covers light and the route to the bathroom lit.
• Hot, swollen joint, fever, weight loss, numbness or injury: call your doctor.

Shop the Snap Front Nightshirt Shop NightCool

Your questions, answered

Read next

Sources

1. International Menopause Society. World Menopause Day (page read October 7, 2026).
2. International Menopause Society. President's Message, Prof. Rossella Nappi, April 2026.
3. Awareness Days. World Menopause Awareness Day 2026. Updated September 28, 2026.
4. Awareness Days. Menopause Awareness Month 2026. Updated September 28, 2026.
5. Wright VJ, Schwartzman JD, Itinoche R, Wittstein J. The musculoskeletal syndrome of menopause. Climacteric. 2024;27(5):466-472. PMID 39077777.
6. Kruse C, et al. Musculoskeletal manifestations of perimenopause: a systematic review and meta-analysis of 93,021 women. JB JS Open Access. 2026;11(1). PMID 41523660.
7. Lu CB, et al. Musculoskeletal pain during the menopausal transition: a systematic review and meta-analysis. Neural Plasticity. 2020. PMID 33299396.
8. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-52. PMID 24290442.
9. Chlebowski RT, et al. Estrogen alone and joint symptoms in the Women's Health Initiative randomized trial. Menopause. 2013;20(6):600-8. PMID 23511705.
10. Harvard Health Publishing. Musculoskeletal syndrome of menopause: when menopause makes you ache all over. June 5, 2026.
11. The Menopause Society. Menopause topics: symptoms.
12. The Menopause Society (NAMS). Sleep apnea may lead to increased joint pain in postmenopausal women. Press release, March 2, 2022.
13. The Menopause Society. Premature menopause linked to increased musculoskeletal pain and likelihood of sarcopenia. Press release, May 1, 2024.
14. Cleveland Clinic. Joint pain. Medically reviewed, last updated November 10, 2023.
15. Cleveland Clinic Health Essentials. How to keep sore hips, knees and shoulders from ruining your sleep. With Geraldine Dapul, MD. January 13, 2022.
16. Cleveland Clinic Health Essentials. How to relieve rotator cuff pain at night. With Kelly Kinsey, MSPT, AT. December 15, 2021.
17. Cleveland Clinic. Hot flashes. Medically reviewed, last updated October 21, 2024.
18. MedlinePlus Medical Encyclopedia. Joint pain. Review date January 14, 2026.
19. MedlinePlus Medical Encyclopedia. Low back pain, acute. Review date June 27, 2026.
20. Sleep Foundation. Pain and sleep. Medically reviewed by Anis Rehman, MD. Updated July 16, 2025.
21. Sleep Foundation. Why does my body hurt when I wake up? Medically reviewed by Lulu Guo, MD. Updated September 3, 2026.
22. Sleep Foundation. How to sleep with lower back pain. Updated July 30, 2025.
23. Sleep Foundation. Benefits of sleeping with a pillow between your knees. Updated May 1, 2025.
24. Sleep Foundation. What is the best sleeping position? Updated July 25, 2025.
25. Sleep Foundation. Menopause and sleep. Updated July 15, 2026.
26. Sleep Foundation. The best temperature for sleep. Updated July 11, 2025.
27. National Institute on Aging. Preventing falls at home: room by room.

This article is general information about sleep and sleepwear, not medical advice. Joint pain has many causes. If pain disrupts your sleep or daily life, or you notice any of the warning signs above, talk to your doctor or care team.