If your knees started aching in your early 40s or late 40s — and nothing had actually changed in your activity level — you're not imagining it. The pain is real, and the cause is often overlooked by doctors: estrogen loss. Why perimenopause causes knee pain Estrogen does a lot more than regulate your menstrual cycle. It actively protects your joints — lubricating cartilage, reducing inflammation, and maintaining the soft tissue around your knees. When estrogen levels drop in perimenopause (typically beginning in your early 40s), that protective effect diminishes....
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