Hip pain over 40? It’s not what you think.
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If you've been dealing with mysterious hip pain, muscle weakness, or even mobility issues and you're a woman entering or post-menopause you’re not alone. Many of us are. And the reason is different than you think. Menopause changes not just our sex hormones but it also affects our whole body.
Our HPA axis—the hypothalamus, pituitary, and adrenal glands—work together in a delicate balance to regulate hormone production. During menopause, as our sex hormones fluctuate and trigger common symptoms like hot flashes, brain fog, and weight gain, the resulting stress can disrupt this balance. Because each of these organs relies on the others to produce key hormones, the adrenals often bear the greatest strain, which can lead to elevated cortisol levels.
Yes, the same stress hormone we hear about constantly may be doing far more damage than we realized, especially to midlife women. Here’s what recent studies are revealing and why this matters more than ever.
How High Cortisol Wreaks Havoc on Your Hips
Cortisol is your body’s primary stress hormone, released by your adrenal glands in response to physical or emotional stress. While it’s essential in small amounts, chronically elevated cortisol is toxic especially to your muscles and bones.
Recent findings show that high cortisol levels can break down muscle tissue leading to muscle weakness, joint instability, and pain in the hips. For women in perimenopause and postmenopause when estrogen, progesterone, and testosterone are also declining this can mean compounding damage to the musculoskeletal system. And unfortunately, it doesn’t stop there.
Cortisol and Bone Breakdown
Cortisol doesn’t just attack muscle it’s also devastating for your bones.
It slows down bone formation
It accelerates bone loss
It increases the risk of osteoporosis and hip fractures
In more extreme cases, prolonged exposure to high cortisol can even lead to a condition called Avascular Necrosis (AVN). This is where the blood supply to the hip bone is cut off, causing the bone tissue to die, resulting in intense pain and usually requiring surgical intervention, like a hip replacement.
Other Signs Your Cortisol Is Too High
Hip pain might be the symptom that gets your attention but it’s rarely the only sign. High cortisol often shows up in a host of other ways, including:
Weight gain (especially around the belly and face)
Brain fog and memory problems
Insomnia and early waking
Morning nausea or low appetite
Cravings for salty or sugary foods at night
Low libido ("dead bedroom syndrome")
Anxiety, depression, or rage
Headaches or migraines
Crushing fatigue or overstimulation
According to research from the University of California, doctors fail to identify high cortisol in 83% of cases. That means countless women are suffering in silence, medicated for symptoms like anxiety, depression, or chronic pain without ever addressing the underlying driver: stress and hormonal imbalance.
If this resonates with you, don’t ignore it.
Track your symptoms: Write down what you're experiencing and when.
Ask your doctor about cortisol testing: Specifically salivary or Dutch hormone testing, which can be more accurate than a one-time blood test.
Support your stress response: Through lifestyle shifts like better sleep, gentle movement, adaptogenic herbs, breathwork, and nervous system regulation.
Seek out practitioners who understand hormonal health: Especially those who specialize in perimenopause, menopause, or functional medicine.
Your hip pain isn’t just “part of getting older.” It’s not in your head and it’s not something you just have to live with.
Tracy Farrell is an expert in gut health, thyroid, and endocrine issues. She has more than 20 years of experience in healthcare starting on the administrative side and then as a Functional Diagnostic Nutrition Practitioner and Integrative Health Coach for the last five years at Natural Endocrine Solutions. She has certifications in Small Intestine Bacterial and Fungal Overgrowth (SIBO & SIFO) and has coordinated wellness programs for clients with autoimmune disorders and thyroid issues such as Hashimoto’s and Graves’ disease. Most recently she received a Bone Density Certification from Functional Diagnostic Nutrition.
