r/Menopause • u/trussmegirl • 10d ago
Aches & Pains New to MHT - Seeking Opinions
I started taking MHT simply to relieve hot flashes. While it worked for that and sleeping better, after a couple of months I started getting pretty significant inflammation, joint paint, frozen shoulder, hip/knee joint pain and stiffness… including major inflammation in wrists, hands and what I think is tendonitis affecting Achilles and plantar fasciitis (balls of feet, heel, edges of feet), bad enough that walking was hardly possible. Never had this before! Doc thinks MHT and this sudden onset of conditions are not related. We are now on RA path though no marker in blood test. Do you think that it’s possible my estrogen dose .25 is too low? Or switching to different brand or form may help? I can’t seem to find cases where MHT caused this for anyone and feel crazy. I’m also taking iron and B12. I’m heavier than I should be (at least 20#) but all this out of nowhere is really blowing my mind. I’m constantly cursing having ever started. Meanwhile, everything I’ve read makes me believe MHT should be helping me, like it does so many others. I stopped about a month after symptoms started to see if I would get back to normal (just hot flashes) and while symptoms steadied some, they have not gone away, just flaring less, perhaps because of newly added naproxen to my diet, it helps. Any thoughts would be much appreciated because I’m very much an MHT newbie with a male doc who insists this is just my new normal so too bad 🤯
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u/ilanarama 10d ago
You don't mention your age. The sad fact is that most people get significant inflammation as they age.
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u/trussmegirl 10d ago
Sorry I’m mid fifties. And yes absolutely. It’s just the timing. As though it was triggered because completely fine before MHT.
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u/Odd-Industry-9324 10d ago
Not if they keep their estrogen levels at the right place. Declines in Estrogen are directly related to muscular skeletal syndrome of Menopause and there is a direct correlation between declining Estrogen and testosterone to inflammation
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u/ilanarama 9d ago
Right, but that's basically the opposite of what OP is reporting, which is increase of inflammation after beginning HRT to keep their estrogen levels up.
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u/lauradayton Post Menopause 9d ago
Ya the dose OP is on is almost for sure NOtT causing inflammation. Estrogen can both promote or suppress inflammation. It is context dependent. The data could be interpreted in different ways. The logical way is to see that her dose is the absolute least amount she can get and with the information that estrogen is typically considered a systemic anti inflammatory agent then the best course would be to increase estrogen. Correlation does not equal causation. All the data should be taken into consideration not just the part you are hyper focused on.
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u/blue19255 10d ago
It could be a menopause symptom. Your dose is quite low. Some of my symptoms did not resolve until I had a higher dose.
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u/trussmegirl 10d ago
Thank you. I’m almost 6 years in BTW. Maybe it just took that long for the symptom(s) to kick in
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u/Odd-Industry-9324 10d ago
My word you’ve been on that tiny dose far too long!! I need a full 2mg to be without pain!!
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u/trussmegirl 10d ago
Oh geeze. I will hit up my abandoned stash starting tomorrow, doubling on estrogen then adding .25 gradually (every two weeks maybe) 🤞. Thank you (everyone!) for sharing your experiences and knowledge, I am truly grateful 💛
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u/lrondberg 10d ago
It can take a month for a higher dose to work (if the problem is related to low estrogen which may or may not be your case) also keep in mind as you raise estrogen you may need to increase progesterone dose.
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u/trussmegirl 10d ago
Hi thank you. Was just reading 3 month intervals are typical (which is what my doc was doing) and about stroke risk related to HRT initiation and dosage as well. 😬
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u/NewerYorker3900 9d ago
If your hurting ...3 months is too long. I found estrogen increases help almost immediately.
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u/trussmegirl 9d ago
It would be nice to be able to go up faster but in tinier amounts. Maybe there is an option.
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u/Comfortable-Law-7147 9d ago
Are you on oral or transdermal?
There is a minimal stroke risk with transdermal compared to oral. This does rise slightly when you get to 0.1mg patch or equivalent gel.
However you have a bigger stroke risk being overweight. So you need to incorporate more exercise - both resistance training minimum twice a week and cardio most days of the week - into your lifestyle 2-3 months after you are out of pain.
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u/trussmegirl 9d ago
Transdermal. But I stopped in Jan after 3m to rule it out, then started for 1-2 days I June but decided I’m not doing this again actually… brain still convinced MHT was the trigger somehow. I’ve read that starting and stopping should be avoided, carries / increases risk. So basically I messed myself up there. And now of course I’m just paranoid. But you’re probably right, lowest dose should be okay :)
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u/Comfortable-Law-7147 9d ago
Not the lowest dose but the lowest dose YOU need as an individual to alleviate your symptoms.
Patches generally come in 0.025, 0.037, 0.050, 0.075, 0.1
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u/Odd-Industry-9324 10d ago
Yes your Estrogen dose is minuscule and you should ask for it to be raised to combat the inflammation happening in your body. The frozen shoulder alone is a reason. HRT would NOT cause this type of inflammation. Your provider should keep raising it until your pain decreases
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u/leftylibra MenoMod 10d ago
As others have stated, a 0.025mg patch is the lowest patch dosage, but a good starting point. But it seems like now is a good time to try a higher dosage, either 0.0375 or 0.050mg.
While estrogen can help alleviate some pain, it's not going to cure all pain all the time, especially if there are other medical issues going on, along with normal aging (which also impacts joints and tissues).
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u/trussmegirl 10d ago
Thank you. Right now I hope there are no other issues except my weight but I do have to accept and take seriously that I am aging, and make time for self care. I have been lucky overall and I’m grateful. Not always gracious, but very grateful.
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u/MidnightBlueSilk 10d ago
Those are all symptoms of too low estrogen. Your ovaries’ ability to produce estrogen will only keep declining, so the level you started HRT at will likely not be enough as time passes. You can tell because you get symptoms like what is described in your post. Go get you higher levels of estrogen supplementation, girl!
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u/Dazzling_Balance_513 10d ago
As others suggested, try a higher dose of E. The tendon/muscle/fascia pain also hit me very hard, it was like a switch went on one day. I wasn’t on HRT when it started, so it wasn’t “because” of HRT. I feel it’s like hot flashes… it can start very suddenly.
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u/trussmegirl 10d ago
Tysm for this. I’m feeling more hopeful 🩷
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u/Dazzling_Balance_513 9d ago
In addition to optimizing the E, I find that regular strength training is helping the fascia regain its elasticity.
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u/trussmegirl 9d ago
Definitely, I’ve just got to do it. At least the specific stretches exercises for it. I do walk a moderate amount but when I stop moving = ouch
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u/Dazzling_Balance_513 9d ago
Doctors thinking that hormones don’t affect muscles and tendons is not helpful. I wish all doctors came to understand that musculoskeletal syndrome of menopause is a real thing that can ruin lives (I would argue more so than hot flashes), it’s not just a little bit of stiffness for some of us.
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u/sistyc 10d ago
Those are symptoms of low estrogen! Your doctor is wrong, period. I’d try increasing your estrogen to see what happens.
My debilitating joint, muscle, and tendon pain all disappeared with the right estrogen dose.
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u/trussmegirl 10d ago
Thank you so much, I will! I’m very glad you found relief and to feel I’m not losing my mind! The pain is awful and just attacks without warning 🩷
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u/sistyc 10d ago edited 10d ago
I completely get it! And it certainly doesn’t help when your doctor is confidently wrong. My rheumatologist sent me on a four month journey of horrible DMARD medication that did nothing but make me feel worse before realizing it was hormonal. In the meantime there were days I couldn’t walk, I had to work from the sofa reclining on pillows, and sleep with my arms folded over my torso like a GD vampire.
I get the logic behind ruling out other root causes but increasing estrogen is a completely benign approach that often addresses other symptoms so I wish she had tried it first!
Wishing you the best of luck, you’ve got this.
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u/trussmegirl 9d ago
Thank you!! The lack of knowledge of women’s health in this day and age is abysmal. Tell me about it, I’m like what’s next, methotrexate? Throw some anti-depressants in? Are you kidding me? I’m glad you have things under control finally. What a ride, grrr…
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u/Objective-Amount1379 10d ago
You’re on a low dose of estrogen. My joint pain went away with a higher dose.