25/08/2025
➡️For women over the age of 50, 1 in 4 women are thought to struggle with gluteal tendinopathy. A drop in oestrogen levels, which is associated with menopause, is considered to a big factor in affecting collagen tensile strength and synthesis. 💪🏽
According to a study by Cowan et al (2021) "Menopausal hormone therapy with any exercise plus education was associated with greater improvements in pain and dysfunction as compared with placebo cream in a subgroup of participants (BMI
Can HRT help patients with Gluteal Tendinopathy?
Gluteal Tendinopathy (GT) is thought to affect 1 in 4 women over the age of 50. Changes in oestrogen levels that are associated with the menopause are thought to be a key factor and may influence collagen synthesis and tensile strength.
Hormone Replacement Therapy (HRT) has the potential to help address these hormone changes but hasn’t been studied as a treatment in tendinopathy until recently. Cowan et al. (2021) found the addition of Menopausal Hormone Therapy improved outcomes for patients with GT but only in a subgroup of participants with a BMI of less than 25.
More research is needed but it’s worth discussing with your patients, especially if they are considering HRT for other health benefits. For peri-menopausal patients who present with tendon pain it can help to slow down the progress of rehab and return to activity to allow more time for adaptation. For runners a gradual return to training is needed, especially with provocative sessions like hill running and faster workouts. Other factors like general health, previous injury, obesity and mental wellbeing should also be considered.
Key Reference:
Cowan RM, Ganderton CL, Cook J, Semciw AI, Long DM, Pizzari T. Does Menopausal Hormone Therapy, Exercise, or Both Improve Pain and Function in Postmenopausal Women With Greater Trochanteric Pain Syndrome? A 2 × 2 Factorial Randomized Clinical Trial. Am J Sports Med. 2022 Feb;50(2):515-525. doi: 10.1177/03635465211061142. Epub 2021 Dec 13. PMID: 34898293.
