Wednesday, November 29, 2023

Low Estrogen And Joint Pain

Joint Pain And Menopause: 11 Pain Stoppers

Hormones & Joint Pain: Are These Two Related

Feeling stiff or achy when you get up in the morning or after sitting for an extended period of time? Do you have sore knees? Tight hips? Achy fingers? Back pain? Joint pain is one of those symptoms that can make you feel old overnight, and unfortunately it strikes more than half of women during menopause. In fact, a study of more than 100,000 middle-aged female veterans found that going through menopause raised their risk of experiencing chronic pain by 85 percent. But you donât have to suffer and feel older than you are. There are a variety of ways to get relief from menopausal joint pain.

Menopause Joint Pain Osteoarthritis Or Osteoporosis

Menopause joint pain can affect joints all over your body and can also result in longstanding injuries becoming more painful.

According to Lee, menopause joint pain most commonly affects the following areas:

“As oestrogen continues to decrease, joints can become more inflamed and painful, resulting in an increased risk of osteoporosis and osteoarthritis developing,” she adds.

When it could be osteoarthritis

Osteoarthritis is more likely to occur in people over 50 years, around the same time that many women start menopause. While joint pain and stiffness around the time of menopause doesn’t always indicate osteoarthritis, it can be a symptom. Osteoarthritis joint pain is more likely to occur in the knees, hips, lower spine, fingers, and thumbs.

When it could be osteoporosis

Being over 40 and going through menopause increases your chances of rapid bone loss, which may lead to osteoporosis. Unlike menopause joint pain and osteoarthritis, you usually won’t feel pain unless you break a bone. Your doctor may wish to test you for osteoporosis if you are menopausal and have had a bone breakage from a minor injury.

Menopausal Joint Pain Relief Tips

If you are experiencing joint pain along with menopausal symptoms, there are a variety of methods and lifestyle changes that may reduce your pain and make managing your symptoms easier. Some of the simplest ways to ease your menopausal joint pain are:

Protein: Adding more protein into your diet can help you maintain muscle mass, which is vital to balance and bone support. Adults aged 60 and older should consume approximately 1.2 to 1.5 grams per kilogram of weight per day. For example, a 200-pound person over the age of 60 should aim to consume 108 grams of protein daily in order to maintain muscle mass and prevent joint pain.

Exercise: Regular exercise is a key component to any healthy lifestyle, no matter your age. Not only is it good for the health of your mind and heart, it can improve bone health too. Consistent exercise can help prevent your joints from becoming stiff and sore, though if this is a concern, be sure to stick to low-impact exercises such as swimming, biking, hiking, and yoga.

Diet: Increasing your protein intake isnt the only change you may need to make to your diet. Hot flashes can be prevented by eating smaller but more frequent meals that include fresh fruits and vegetables as well as foods full of calcium to increase bone health. Eating a healthy, balanced diet can provide your body with the vitamins and nutrients it needs to endure the changes of menopause with minimal adverse side effects.

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Joint Relief With Estrogen

Hormone therapy can be used to ease the many symptoms of menopause, including night sweats, hot flashes, and mood swings. New research indicates that hormone therapy, specifically estrogen, can also be used towards joint pain.

Estrogen therapy improves joint pain in post-menopausal women who have had a hysterectomy. Studies looking at the Women’s Health Initiative trial analyzed 10,000+ post-menopausal women. 77% of these women reported join pain and 40% experienced joint swelling. After just one year, frequency of joint pain was lower among women who received estrogen-only therapy, compared to women who were in the placebo group After three years, the subset of women who received estrogen continued to have joint pain less frequently than the placebo group.

The difference was seen only in women who received estrogen alone, vs. women with intact uteruses who took estrogen-progesterone combination therapy. Regardless, these findings give light to the many potential therapeutic values of estrogen. Post-menopausal women who are thinking about estrogen to alleviate their joint pain should consult their healthcare providers, and they should still follow the lowest dose of estrogen for the shortest amount of time needed to achieve the therapeutic goals desired. To understand more of the potential benefits of estrogen or estrogen-progesterone therapy, visit our menopause website here.

Hormone Imbalances And Pain

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Nearly 100 million Americans suffer from chronic pain, with more than 26 million between the ages of 20 and 64 reporting frequent low back pain . There can be many causes of pain including injury, infection, arthritis, nerve damage etc. However, for many people there is an underlying inflammatory component with any condition that not only adds to ongoing pain and suffering, but prevents healing and tissue repair. Inflammation can be thought of as the body saying, Somethings not right here, lets focus our efforts to fix it. Many people think about testing their hormones for ongoing symptoms such as low libido, hot flashes, or even fatigue, but chronic pain and inflammation can also be signs of imbalances in hormones including estrogen, progesterone, testosterone and cortisol. Lets break down the roles that hormones may play as they relate to pain, especially if those hormones are allowed to remain unbalanced.

Estradiol:Estrogen deficiency, or having lower than optimal estrogen levels, has been repeatedly linked to osteoarthritis as estrogens influence the way joint tissues help with bone production and re-building, promoting muscle growth as well as decreasing muscle breakdown. Estradiol has been shown to protect joints from weakening, protect against osteoarthritis, and reduce the likelihood of joint replacement.



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Estrogen And Joint Pain Controversies

The medical community is not in full agreement that low levels of estrogen contributes to or worsens osteoarthritis conditions in menopausal or post-menopausal women. In 2010 one paper discussed this controversy:

is experienced by more then half of the women around the time of menopause. The causes of joint pain in postmenopausal women can be difficult to determine as the period of menopause coincides with rising incidence of chronic rheumatic conditions such as osteoarthritis. Nevertheless, prevalence of arthralgia does appear to increase in women with menopausal transition and is thought to result from reduction in levels. . . Hormone replacement therapy has been shown to have some benefit in alleviating arthralgia associated with menopausal transition, and can be considered in women who report distressing vasomotor symptoms. Simple analgesia, weight loss and physical exercise should be encouraged particularly in women with underlying osteoarthritis. Finally, other factors commonly associated with chronic pain and menopausal transition such as fatigue, poor sleep, sexual dysfunction and depression need to be addressed.

Exercise For Menopause Joint Pain

If you experience menopause joint pain, you may be tempted to limit your movements. It may feel counter-intuitive at first, but the experts recommend staying as physically active as possible.

Lee says: “Move! Motion is lotion, and if this is managed and progressed slowly it can be an effective tool for pain management.”

Why: “Unfortunately, weight gain is also a common side effect of menopause, and increased weight can have a detrimental effect on joint and muscle pain due to increased load. Therefore, weight management is a key part of managing joint pain.”

What: “There are lots of forms of exercise that can help with pain as well as other menopause symptoms. An effective ‘menopause friendly’ programme should consist of endurance, strength/resistance, and balance exercises.”

Clare says: “It is best to be as active as possible and most of all enjoy your sports.”

Why: “Weight-bearing exercises will strengthen your musculoskeletal system which will help to alleviate joint aches and pains, protect brittle bones, and may prevent osteoporosis.”


Why: “When the female body is pushed too hard, it goes into adrenal stress and this creates havoc in the incredibly engineered yet delicate hormonal balance.”

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How Can Hormone Replacement Therapy Help With Osteoarthritis

Physicians have access to a growing variety of FDA-approved bioidentical hormones, which are identical on a molecular level to those found naturally in the body. Women who have had a hysterectomy are treated with estrogen alone. On the other hand, women with a uterus need progesterone as part of their therapy.

The effectiveness of HRT on osteoarthritis may depend on when treatment is begun. For example, women who are experiencing early symptoms of joint pain and inflammation who are considered to be at a higher risk of developing OA may benefit from a lower dose treatment .

Pinkerton points out that not all women may feel better on HRT. Side effects may include fluid retention, breast tenderness or swelling, headaches, or mood changes. Hormone therapy has the best benefit/risk profile when started close to menopause, under age 60, or within 10 years of menopause, she says.

Starting hormone replacement therapy after age 60, or more than 10 years from menopause, carries an increased chance of developing heart disease or stroke. Hormone therapy is not recommended for anyone already at risk of developing these conditions, because those risks will outweigh the benefits for most women, adds Pinkerton.

Why Is Tmj Disorder So Prevalent Among Women

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Not only is there a clear dominance of TMJ in women, but also the severity of the problem is often at a level virtually never seen in men. This scenario is frequently seen in the case of teenage girls, suggesting that the problems we are confronted with could be hormonal. Some research has unveiled a link between TMJ and estrogen, which could shed light on the dominance of TMJ in women.

Take the example of Mary, a 17-year-old female who came to my practice. Marys problems started when she was 12 years old with the onset of non-painful TM joint noises that did not interfere with eating or jaw function. Over time, pain emerged and her bite began to change, altering her profile and appearance. Before long her pain was so debilitating and her bite so altered, that there was no choice but to seek surgical treatment. Both TM joints had dissolved away and her jaw profile and bite had to be reestablished.

How could this happen with no history of trauma and no apparent underlying medical disease? The role of hormones, estrogen in particular, has been identified. Research has shown that Estrogen:

  • Impacts the bodys natural pain fighters
  • Increases inflammation in the Temporomandibular Joints
  • Compromises the strength and adaptive ability of all ligaments

Though the treatment that Mary had received has restored function, jaw stability, and reduced her pain, there is still much to learn about gender specific jaw problems.

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Loss Of Oestrogen And Testosterone:

Joints have oestrogen receptors which are affected by the loss of oestrogen in menopause, and pain in joints can affect womens ability to exercise, leading to muscle loss and weight gain. Oestrogen protects joints and reduces inflammation, but when estrogen levels drop, inflammation can increase, the risk of osteoporosis and osteoarthritis can go up and make it painful to move freely.

As testosterone falls in women along with oestrogen and progesterone, some women also find it harder to maintain muscle strength, and again, testosterone replacement at normal female levels can help.

Factors That Set Off The Chronic Inflammation Process Include:

1. Joint pain and hormonal imbalance

Many women first report joint pain when they are in perimenopause or menopause. Midlife hormone shifts, especially fluctuating estrogen levels, can have a deep impact on your joints. Since estrogen has an anti-inflammatory effect in the body, as it declines naturally it can increase the symptoms of chronic inflammation, including joint pain. If you have joint pain and PMS, or symptoms of perimenopause or menopause, find out more about restoring balance to your reproductive hormones.

2. Joint pain and adrenal stress

Cortisol, the hormone released in response to stress, works as an inflammatory agent, which is usually okay if youre experiencing a relatively short episode of stress. But when you have sustained stress the kind many of us are experiencing it can cause inflammation to spread and/or become chronic. If you have joint pain and high stress, find out more about restoring balance to adrenal hormones.

3. Joint pain and earlier injuries

Previous joint injuries can be ground zero for chronic inflammation, especially if the injury never healed well. Joint pain and stiffness in the area years later can occur due to chronic inflammation. Sometimes, bone spurs may develop in joints where a tiny bone fracture is healing or where tendonitis has been a recurring problemthink repetitive motion injuries like carpal tunnel or tennis elbow. These spurs can cause sharp pain when they press against soft tissues or nerves.

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There Is No General Consensus On The Effects Of Vitamin D On Osteoarthritis Some Results Seem Promising

As the above research points out, vitamin D does have a place in helping a patient with knee osteoarthritis. Vitamin D supplements are readily available and food rich in vitamin D is plentiful. These include salmon, herring, and sardines, for non-fish lovers spinach and kale. Of course, sunshine helps a lot too.

A study in the Orthopaedic Journal of Sports Medicine concludes on what vitamin D may do: Some studies have investigated the effect of vitamin D on osteoarthritis progression and pain management however, while there is no general consensus on the effects of vitamin D on osteoarthritis, some results seem promising. Vitamin D supplementation may be a safe method to treat and prevent osteoarthritis, but future research is required to define the specific pathway and ultimate efficacy.

Is Your Joint Pain Caused By Osteoarthritis

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Joint pain in women in perimenopause or menopause is frequently diagnosed as osteoarthritis. Conventional practitioners tend to offer two treatment paths: prescribing increasingly stronger drugs for pain, or waiting until the problem gets bad enough that surgery is required. For most of us, neither approach is acceptable.

While many women first notice this issue during midlife when reproductive hormones fluctuate naturally, joint pain is not an inevitable sign of aging its more likely a signal that something is triggering inflammation that affects the joint. It could be an injury directly affecting the painful joint, or it could be a system-wide inflammation thats manifesting as joint pain. Either way, you have an excellent opportunity to find joint pain relief if you address that inflammation.

Even if your joints are seriously deteriorated from lifelong wear and tear meaning, cartilage, tendons, or ligaments are damaged or missing, or you have bone degeneration or bone spurs there are natural steps you can take to quiet down inflammation. But it is important to take action sooner rather than later.

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Medical Interventions For Menopause Joint Pain

You may also use over-the-counter medicines to help reduce inflammation and painful joints. These include common painkillers and anti-inflammatory gels and medication. Your pharmacist will be able to advise.

It should also be noted that hormone replacement therapy is widely accepted as the most effective method for managing the symptoms of menopause. By restoring the oestrogen levels you lose during menopause, there is strong evidence that HRT can ease menopause joint pain alongside a whole host of other symptoms.

What Does Estrogen Do

This hormone is responsible for many bodily functions. It supports regulation of metabolism, insulin sensitivity, glucose metabolism, and even body weight. Estrogen is necessary for sexual development during puberty, breast changes during puberty and pregnancy, cholesterol metabolism, and bone metabolism. It also helps the lining of the uterus grow as needed during menstruation and early stages of pregnancy.

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Knee Osteoarthritis It Started With A Meniscus Tear

Some women who contact our office will tell us that they were very active and had no knee pain or knee pain symptoms such as swelling. They were happy going about their business and sports and then one day they turned to the left or right with one of their legs planted and the next thing they knew they were getting an MRI because their doctor suggested some type of meniscus tear had occurred. This is not really a meniscus tear from nowhere. It is the result of degenerative changes in the womans knee.

A study in 2008 looked at this phenomenon of a meniscus tear in healthy postmenopausal women. Published in the journal Osteoarthritis Cartilage the researchers examined Fifty-seven post-menopausal women with no knee pain or knee problems. Then they followed these women for two years to see if they developed new or worsening meniscus tears and if cartilage loss had something to do with bone loss at the tibial plateau. The tibial plateau is that part of your shin bone that the femur of thigh bone meets at the knee. Remember these women had no knee pain and were asymptomatic, but did show some knee damage on an MRI.

Two years after the baseline MRI:

  • Forty-six percent of women had a meniscal tear in either the medial and/or lateral compartment.
  • Women who had a tear were older and had more lateral cartilage defects .

So what does this all mean to you?

In other words, many factors can lead a seemly non-problematic knee to become problematic out of the blue.

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