Abstract:

Knee osteoarthritis (KOA) is one of the most prevalent musculoskeletal disorders in postmenopausal women, leading to significant pain, disability, and reduction in quality of life [1]. Menopause, characterised by a decline in estrogen and other sex hormones, has been identified as a key factor influencing the onset and progression of KOA [2]. Estrogen deficiency contributes to altered cartilage metabolism, inflammation, and changes in pain perception, leading to increased vulnerability to the development of KOA and knee pain.
Objective: This review explores recent evidence (2018–2025) regarding the relationship between menopause and knee pain in KOA, examining hormonal, metabolic, biomechanical, and psychosocial mechanisms. We also highlight the implications for physiotherapy management in postmenopausal women.
Methods: A focused search was performed in PubMed and Google Scholar for studies between 2018 and 2025 using combinations of terms including “menopause,” “knee pain,” “osteoarthritis,” “estrogen deficiency,” and “postmenopausal women.” Randomised controlled trials, cohort studies, and systematic reviews were included.
Results: Postmenopausal women demonstrate higher prevalence and severity of knee pain and structural OA changes compared to premenopausal women [4]. Estrogen deficiency impairs cartilage repair, increases synovial inflammation, and influences central pain modulation [5,6]. Hormone replacement therapy (HRT) and physical activity interventions have shown potential benefits in reducing KOA pain and improving function [7,8].
Conclusion: Menopause-related hormonal changes contribute significantly to knee pain in female patients with KOA through multi-system mechanisms. Comprehensive physiotherapy approaches incorporating exercise, weight management, education, and potentially adjunctive hormonal therapy may optimise outcomes in this population.

Keywords:

menopause, postmenopausal women, knee pain, osteoarthritis, estrogen deficiency, hormone replacement therapy, physiotherapy.

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Methods