top of page

Hot Off the Press: How Testosterone Could Impact Your Joint Health…What Every Midlife Woman Needs to Know

A brand-new study just dropped in Osteoarthritis and Cartilage (literally published just two weeks ago!) and it’s giving us even more reasons to rethink how we view hormones, especially testosterone, in midlife women.¹


Here’s the scoop:


Researchers followed 8,600 adults aged 45+ and found something pretty fascinating:

In women, higher levels of testosterone…especially free testosterone…were linked to:


  • Less knee osteoarthritis

  • Less chronic knee pain


And here’s the plot twist:


These protective effects were only seen in women, not men. In fact, in men, higher testosterone was actually linked to worse hand OA.¹

And before you say "maybe it was just age or weight,” nope…researchers adjusted for age, BMI, menopause status, and other lifestyle factors and the results still held.¹

doctor viewing x-ray of knee osteoarthritis

This finding is particularly relevant for women transitioning through perimenopause and menopause, stages characterized by declining levels of estrogen and testosterone. While estrogen's role in joint health has been extensively studied, this research emphasizes the importance of testosterone in maintaining joint integrity.




Why It Matters in Perimenopause and Menopause


Testosterone naturally declines in women during the menopause transition, just like estrogen. While estrogen tends to hog the spotlight, this study is a strong reminder: testosterone matters too.²⁻³


Testosterone plays a key role in:


  • Pain Regulation

  • Joint Integrity & Bone Density

  • Muscle Mass

  • Mobility


Testosterone isn’t just about libido or building muscle. When testosterone drops? 


Less testosterone = Higher risk of joint breakdown. More pain. Less mobility. A slower bounce back.


So if you’re feeling achy or stiff, or not moving like you used to…it might not just be “getting older.” It could be your hormones waving a white flag.




The Burden of Osteoarthritis in Women


Women…especially during and after their menopause transition…are nearly twice as likely as men to develop OA in the knees and hands.⁴ That risk ramps up during the hormonal shifts of midlife, underscoring the significant impact of hormonal changes on joint health.



The Role of Testosterone in Women's Joint Health


Understanding the hormonal influences on joint health is essential for proactive management of OA, especially during the menopausal transition. While hormone replacement therapies can be beneficial for some, non-hormonal strategies offer alternative or complementary options. It's crucial to consult with your healthcare providers to tailor an approach that aligns with your individual health needs and preferences. Ask your trusted provider if testosterone is right for you. If they are unwilling to discuss this...it might be time to find a new provider.


The Menopause Society provides a directory service to find Certified Practitioners who wish to provide healthcare for women through perimenopause and beyond In your area.


Or you can get get expert care & personalized prescriptions for menopause symptoms from online providers such as



Non-Hormonal Strategies to Manage Osteoarthritis


For women in perimenopause and menopause, managing osteoarthritis without hormones is crucial. Here are a few evidence-based approaches:


  1. Regular Cardio: Engaging in low-impact activities like walking, swimming or cycling, as well as increasing your overall daily movement, can improve joint mobility and function and reduce pain.⁵ ​


  1. Strength Training: Tailored exercises can strengthen muscles around joints, enhancing stability and function.⁶ ​


  1. Healthy Weight Maintenance: Maintaining a healthy weight reduces stress on joints, particularly the knees and hips.⁵


  1. Anti-Inflammatory Nutrition: Incorporating anti-inflammatory foods, such as omega-3-rich fish, fruits, vegetables, anti-oxidants and fiber may alleviate symptoms.⁷ ​



The Bottom Line:


This research adds another layer of powerful evidence showing why midlife women need to be proactive about their hormone health...not just for hot flashes or mood swings...but for preserving the ability to move, stay active, and stay independent and pain-free for the decades to come. 


Stay tuned... I’ll be talking more about how to support your hormones naturally...and when it might be time to have a bigger conversation with your healthcare provider. Your knees (and hands) will thank you. 


For now, I Introduce you to this month’s challenge: The Goblet Squat. It’s one of the most functional, joint-friendly strength moves out there—and it’s your May power move for mobility, muscle, and menopausal momentum.


Read about the challenge here.




Join the challenge here.





References


  1. Szilagyi IA, Schiphof D, Chaker L, et al. Associations between testosterone and knee and hand osteoarthritis among males and females from the general population. Osteoarthritis Cartilage. Published online April 2025. doi:10.1016/j.joca.2025.03.006

  2. Traish AM. Testosterone therapy in women: a review of efficacy and safety. Cleve Clin J Med. 2021;88(1):35-44. doi:10.3949/ccjm.88a.ccc051

  3. Davison SL, Bell R, Donath S, Montalto JG, Davis SR. Androgen levels in adult females: changes with age, menopause, and oophorectomy. J Clin Endocrinol Metab. 2005;90(7):3847-3853. doi:10.1210/jc.2004-1563

  4. Chen Z, Yu J, Smith C, et al. Global burden of osteoarthritis in women: a systematic analysis from 1990 to 2021. BMJ Glob Health. 2024;10(3):e017198. doi:10.1136/bmjgh-2023-017198

  5. Fransen M, McConnell S. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2015;(1):CD004376. doi:10.1002/14651858.CD004376.pub3

  6. Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. Lancet. 2019;393(10182):1745-1759. doi:10.1016/S0140-6736(19)30417-9

  7. Mobasheri A, Batt M. An update on the pathophysiology of osteoarthritis. Ann Phys Rehabil Med. 2016;59(5-6):333-339. doi:10.1016/j.rehab.2016.07.004



 
 
 

Comments

bottom of page