Menopause

Yes, both Achilles tendinitis and frozen shoulder (adhesive capsulitis) can potentially be related to menopause. This connection stems from the hormonal changes during menopause, particularly the decline in estrogen levels, which can affect tendons, muscles, and joints.

• Tendon Health: Estrogen plays a role in maintaining the health and elasticity of tendons. As estrogen levels drop during menopause, tendons may become less flexible and more prone to injury. This can lead to conditions like Achilles tendinitis, where the tendon at the back of the heel becomes inflamed and painful.
• Decreased Collagen Production: Estrogen also supports collagen production, a protein that provides strength and flexibility to tendons. With lower estrogen, collagen production decreases, making tendons like the Achilles more susceptible to tears or overuse injuries.

• Hormonal Impact on Joints: Frozen shoulder is characterized by pain and stiffness in the shoulder joint, often developing slowly over time. While the exact cause is not always clear, hormonal changes during menopause are believed to contribute to joint stiffness and increased risk of conditions like frozen shoulder.
• Estrogen’s Role in Joint Health: Estrogen has anti-inflammatory properties and helps maintain joint lubrication. Its decline during menopause can lead to joint stiffness, inflammation, and decreased mobility, which may trigger or worsen frozen shoulder.
• Tendon and Muscle Tightening: As estrogen levels drop, tendons and muscles may tighten, leading to restricted movement, which is a hallmark of frozen shoulder.

• Increased Risk of Tendinitis: Along with Achilles tendinitis, menopausal women may be more prone to tendinitis in other areas, like the elbows, wrists, and shoulders.
• Joint Pain: Many women experience generalized joint pain or stiffness during and after menopause due to the reduced anti-inflammatory effects of estrogen.

Addressing these issues might involve hormone replacement therapy (HRT), physical therapy, anti-inflammatory medications, and specific exercises to maintain tendon and joint flexibility.

Hormonal treatment for peri-menopause and menopause, often referred to as hormone replacement therapy (HRT), can provide relief from menopausal symptoms but also carries potential risks. Here’s a balanced overview of the benefits and risks based on scientific research:

Symptom Relief:

• Hot Flashes and Night Sweats: HRT is highly effective in reducing hot flashes and night sweats. Studies indicate that about 75-90% of women experience significant relief from these symptoms with HRT .
• Vaginal Symptoms: HRT helps alleviate vaginal dryness, irritation, and discomfort during intercourse, improving sexual health and quality of life .

Bone Health:

• Osteoporosis Prevention: Estrogen plays a key role in maintaining bone density. HRT can help prevent osteoporosis and reduce the risk of fractures in postmenopausal women . Research indicates that HRT can decrease bone loss significantly during the early years after menopause .

Cardiovascular Health:

• Potential Cardiovascular Benefits: Some studies suggest that starting HRT around the time of menopause may reduce the risk of heart disease, although results are mixed. The Women's Health Initiative (WHI) indicated that younger women (under 60) may benefit more from HRT than older women .

Improved Quality of Life:

• HRT can enhance overall well-being, mood, and cognitive function in some women, particularly those experiencing severe menopausal symptoms .

Breast Cancer:

• Research has shown a slight increase in breast cancer risk associated with long-term use of combined estrogen-progestin therapy, particularly after 3-5 years of use. The risk appears to be lower with estrogen-only therapy in women who have had a hysterectomy 

Cardiovascular Risks:

• HRT may increase the risk of blood clots, stroke, and heart attack, particularly in older women or those with pre-existing cardiovascular conditions. The WHI reported an increased risk of thromboembolic events in women taking HRT .

Endometrial Cancer:

• Women with an intact uterus who take estrogen-only HRT are at increased risk of endometrial hyperplasia and cancer. The addition of progestin can mitigate this risk .

Gallbladder Disease:

• There is evidence that HRT may increase the risk of gallbladder disease and the need for gallbladder surgery, particularly in women taking estrogen .

• Personalized Approach: The decision to use HRT should be individualized, considering a woman's health history, symptom severity, and personal risk factors. It’s essential to weigh the benefits against the risks.
• Timing and Duration: Starting HRT close to the onset of menopause (typically around age 50) may provide more benefits with fewer risks. Long-term use should be carefully considered, and regular evaluations with a healthcare provider are recommended .
• Non-Hormonal Alternatives: For women who cannot or choose not to take HRT, there are non-hormonal options for managing symptoms, including lifestyle changes, non-hormonal medications, and alternative therapies.

Hormonal treatment for peri-menopause and menopause offers significant benefits, particularly for symptom relief and bone health, but it is not without risks. The decision to use HRT should be made collaboratively with a healthcare provider, taking into account individual health profiles and preferences. Ongoing research continues to refine our understanding of the optimal use of HRT in menopausal management.

4 Hendes Sundhed offers mental health services, including counseling and medication management for conditions such as anxiety, depression, and bipolar disorder.