Sudden hot flashes, poor sleep, wonky irregular periods that lead to no periods, OK, we’re prepared for all of that. But sore feet? No one told us sore feet might be a result of menopause.

If you have sore feet, it may not be entirely due to reduced estrogen, but menopause can certainly play a role. Let’s talk about why your feet hurt and what you can do about it.

What causes foot pain in perimenopause and menopause?

Menopause, with its decline in estrogen, can cause more than pain in your lower back in menopause—and by that we mean your feet as well. 

Collagen loss is part of the problem. Less estrogen affects collagen production: “Collagen is basically the building block of our musculoskeletal system - bones, muscles, ligaments, tendons and skin. Less collagen synthesis means less elasticity of tendons and skin, constriction of blood vessels, decreased healing, increased risk of developing a soft tissue injury and joint pain.”

Osteopenia and osteoporosis may also play a role. A loss of estrogen after menopause may lead to lower bone density in the feet and consequently a higher risk of stress fractures in the foot.

Plantar fasciitis (heel pain that is worst in the morning) is also common among women in midlife as loss of estrogen affects the elasticity of the thick band of tissue that connects the heel bone to the toes.

Other changes not directly due to estrogen loss can also factor into foot pain: changes in posture due to other injuries or pregnancies, weight gain, compensation for muscle loss or poor balance can affect how we walk or stand and result in pain. Estrogen protects our soft tissues; the loss of it makes soft tissue more vulnerable to injury, inflammation, and pain.

Be aware that gout can happen to women in perimenopause and menopause. Gout pain is very different and usually sudden and severe, so if the pain comes on quickly, talk with a doctor. Gout can also get worse if left untreated, so don't wait to get help. Plantar fasciitis and collagen loss are generally slow and increase in severity over time. 

Fixes for foot pain in menopause

Low estrogen, osteoporosis, pregnancy posture – is there any way to fix those things? There are, and we strongly suggest talking with a doc or physical therapist about all of these, for your general well-being as well as for your feet.

Here are some things you can do:

1. Get more collagen. Your body makes collagen your whole life, but as we age, that production slows, particularly for women in perimenopause and menopause. Fortunately, you can replace some by eating right. Our menopause specialists suggest eating a combination of protein-rich foods and foods that contain vitamin C, zinc, and copper — your body creates collagen by combining amino acids, so you can help the process along by making sure all the ingredients are present. If bone broth isn’t your thing, there are menopause supplements available.
2. Manage weight. Reducing weight reduces the impact on your feet, but additionally, since many women gain weight quickly in perimenopause and menopause, that gain can cause women to modify their posture and gait, which can also lead to foot problems.
3. Get out of high heels. Or at the very least, be sure your heels are modified with inserts, foot beds or other cushions. Try to limit the standing and walking you do in heels by bringing along flats or athletic shoes for when you’re up and about.
4. Stretch, tape, and ice your feet. Once you have a diagnosis of what’s actually happening in your feet, some gentle stretches, kinesiology tape, and ice can help manage pain. If you have plantar fasciitis, chances are your feet hurt most in the morning. Some gentle stretches of calf and foot muscles, starting slowly to give your muscles time to warm up are a good idea. 
5. Lace your shoes properly. It sounds ridiculously simple, but for some women, simply lacing shoes differently to avoid pain points is really effective. Shoes come pre-laced from the shop, but like pretty much everything else, our feet are quite unique to us. Harvard Health gives examples for better lacing.
6. Supplements may help. Before opting for surgery or cortisone injections, you might try switching up your diet. Calcium, magnesium vitamins, and vitamin C could be helpful, among other nutritional supplements. CBD supplements for women have also been reported to relieve similar symptoms, and could be worth a shot.
7. Medical interventions. These can include wearing a boot to sleep in that keeps your foot in the proper position, steroid shots to reduce pain, shock-wave therapy to stimulate blood flow, a Tenex procedure to remove scar tissue, and generally as a last resort, surgery.
8. Don't go barefoot. Supportive shoes that cushion the foot and support your arches will help with foot pain, and there are slippers, sandals, and house shoes now being made with arch support, just for this purpose. 
9. Choose soft surfaces. If you're a runner or a walker, consider opting for softer surfaces. If you're a road runner, find a trail to get your miles in (just be careful of falling and/or twisting an ankle). It's a great way to mix up your training, spend some time in nature, and maybe give your feet a bit of a break.

If you’re an active woman in menopause, don’t let foot pain stop you from staying active, especially as doing less won’t necessarily make your feet hurt less, but it can have a lot of other negative affects on your body and psyche.

If your feet hurt more than usual, it's best to speak with your physician, and get a referral to a podiatrist or physical therapist who can help you identify what’s going on and get your feet back under you.