This might cross-over similar topics, but I’m interested in the specific experience of other women in perimenopause. I never had any joint problems through 20 years of cycling. Then 3 years ago (I’m now 45) I started to get knee pain, and for a time my hips were so stiff I had to reduce my riding by 1/3 volume and 1/2 intensity for most of a season. Had the doctor taken me seriously, as opposed to treating me like a medicine-seeking depressed woman, he should have been able to diagnose it as one of those symptoms of perimenopause. But I digress, and the knee pain is still there. It is particularly troublesome on those long sweet spot trainer sessions.
For other women at this stage, what were your experiences with joint soreness and what (including hormone replacement therapy) have you found that helps?
For context, I was on HRT for almost 2 years. Then quit because I gained weight and felt horrible. I did not get good advice from my doctor on this. I thought that HRT wasn’t supposed to interfere with your natural cycle, but mine returned after 23 months (15 of which I was on HRT). I quit 4 months later and it’s been regular ever since.
I’m also in perimenopause (49). I don’t have joint pain, but wanted to respond because it’s an interesting and important topic. I’m no expert, but I’m surprised HRT made you feel worse. Maybe the dose wasn’t correct for you? I’m on estrogen gel and cyclical progesterone which I’m taking in synch with my cycle. Would it be worth seeing a different doctor? Yours doesn’t sound great.
I’m the same as Overratedcarbon - 49, in peri, no joint pain, although I’ve noticed I get stiffer more easily (although that may just be because I’m now 49…) - but this is an important and interesting topic. I was just listening to a Feisty Menopause podcast yesterday about “should all women be on hormones”, and the comment was that if you’re in peri (not post), your hormones may be going kind of wild, and so adding additional hormones may actually make things worse. Her comment was that it may make the valleys slightly better, but the peaks will be much worse/higher - sort of like adding a whole layer of icing to a cake. Sometimes hormones aren’t the right thing. But sometimes they are. For me, they made an enormous difference for several of my symptoms (in particular the ones that were the worst to deal with) but I definitely still notice my hormones swinging around and still have other symptoms.
As for my stiffness, I have had to find different stretches periodically (super tight hip flexors showed up out of the blue - now I added in a twist stretch every night and that has resolved the issue and kept the problem at bay), and I have to pay attention to how I sleep. (I had a weird thing last year where my elbow was hurting. I finally figured out it was because I was sleeping with my head on my arm and my arm completely straight. Once I stopped sleeping like that my elbow stopped hurting. Go figure.) Not sure how to help the knee pain, but maybe that’s related to the hip stiffness - the IT band is connected at both ends…? But maybe it’s a different sort of knee pain…
Thank you @overratedcarbon and @dhellman for sharing your thoughts. I only want to know that this is real and that I don’t change my cycling habits in any significant way. It’s tricky to decide what is a manageable condition and what is part of the natural decline of aging. As mentioned in another thread by another user, training has been an important part of my identity and motivation in life. Getting out for a long ride is always a boost for my mental health (barring aches and pains that are making this tougher).
As for HRT, I meant that I felt bad about gaining 15 lbs in one year while on it. I got the sense that my doctor had never prescribed it before as she didn’t give me great direction on dosing other than “if tolerated”. She did not advise cycling the progesterone which is why I think I went so long without any bleeding. But it was upsetting to see it return. It’s not out of the question for me to reconsider HRT if I have the right information to be able to ask these questions. My doctor has referred me to a gynecologist for other reasons, but I expect it to be a minimum of 6 months (more like a year) to get the appointment. I could even be through menopause by the time the appointment comes up.
I’ll check out Feisty Menopause. This is another one that was recently recommended to ke. She has been pretty good.
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The Feisty Menopause podcast has a few specific episodes that I find useful. Many aren’t - they’re more discussions with athletic women about what they’ve accomplished even though they’re getting older. I got tired of many of those. But the episodes where she talks with people who are actually doing research in the area or who are super knowledgeable about hormones etc. are the ones I listen to, and more often than not they are informative and helpful. The one that was the best regarding estrogen was the one with the authors of the book Estrogen Matters:
The book was really worth reading IMO. Lots of super helpful stuff in there.
I definitely think your doctor had no clue when you were prescribed the hormones, which is terrible. You definitely should be cycling the progesterone. Personally, I opted for an OTC option available here in the states for both the estrogen and progesterone, mostly because I wanted to just try it out and see before I committed to a prescription, which seemed somehow more rigid to me. The OTC options are creams, so I have control over how much I apply. And I started low and increased until I felt “right”, and it’s a lot less than what even the box says.
As for the joint pain, I did a search on the Feisty Menopause website and found this episode:
I don’t think I listened to that episode, but it might be interesting for you.
Urgh. Mine didn’t have a clue about prescribing either, but I read all the clinical guidelines. She was way off with how she prescribed the progesterone the first time I saw her, and then when I went for a check-up she forgot that I should have it cyclically. So I had to say “but the guidelines say…”. At least she took it well.
@hmjgray I follow menopause_doctor on Instagram and just came across an interesting post: “Symptoms of low mood, memory problems, brain fog, fatigue, reduced motivation, muscle and joint pains, anxiety and reduced libido often improve when women who have low testosterone levels are prescribed testosterone.” That might be something worth looking into as well.
Thanks for this, too. It certainly all sounds familiar 
It’s valuable information to have when seeking advice from the doctor. My challenge will be to self advocate for any hormone treatment as it seems still to be unfortunately uncommon here.
- No joint pain. But estrogen is very anti inflammatory so if you dropped abruptly that could be a culprit. I see a manual physical therapist weekly and 100% give him credit for keeping me feeling awesome. I’d see if you could find one locally to go see and have them rule out a mechanical issue causing the pain.
I assume you’ve had a bike fit? And it isn’t something simple like that?