Perimenopause hip pain on the outside of the hip, worse when you lie on your side at night, is most often gluteal tendinopathy, not arthritis. I went through the primary research: why falling estrogen may weaken hip tendons, the 30-second standing test that points to the diagnosis, why the LEAP trial found education plus exercise beat a cortisone injection, and what a 2022 trial found about HRT. Plus the sleep and sitting changes that took pressure off the tendon.