I work with an Integrative OB/GYN practice out of Irvine, California. It was during a ROUGH mental/emotional time in my life in which hormone imbalances in addition to past traumas and my mom’s death and her journey with cancer and Alzheimer’s. I needed brain support and hormone support. I listened to Dr. Felice Gersh speak on a colleague of mine’s podcast regarding estrogen and brain health, and then I found out she was the doctor of my beloved mentor’s. It was a done deal for me, and every year I fly across the country to work with the best in the field.
I feel the best I’ve ever, ever felt. Through changing my diet, discovering food sensitivities that drive gut imbalance and inflammation, supplementing as needed, supporting my structural health and getting stronger in the gym, supporting my detoxification through minimizing toxins, sauna, and epsom salt baths, and taking care of my brain through prayer, meditation and neurofeedback work, my body is the healthiest it has ever been.
But…I’m struggling with my shoulders. They hurt, often not at the same time, and not consistently with specific motions. I know what to do to take care of my body, my joints, my structural health: full body mobility on the foam roll, keeping my deep core stabilizers, (yes, plural, there are “core stabilizers” for most of our joints and body parts), making sure I am in healthy, efficient alignment when strength training, and self-treating the structures that need help. I’ve managed to keep myself of of back and knee pain, and still do most of the activities I love through this structural approach.
But this is different…there’s more to it.
We hear a lot about changes in our tissues, our fascia, as we age. We lose hydration, and microfibers lose their elasticity. As we experience a decline in hormone production, this also affects our fascia, I believe with regard to loss of elasticity, which makes sense since we wrinkle (but I need to dive deeper into understand the mechanisms of what occur and pull up the research) There are many studies of how women are more prone to ACL injuries during certain times of their cycle, again indicating the influence of hormones on the tissues, but I need to know more.
On the topic of research, the tides are turning on the research of estrogen and hormone replacement therapy. Estrogen has been demonized due to a couple of poorly designed research studies. Estrogen is so important for so many structures and processes in the body.
As I needed to feel better 3 years ago and need to keep my body and brain as healthy as possible given my genetics, I was on board for exploring Hormone Replacement Therapy.
However, it’s not as simple as being prescribed hormones based on lab values. Inflammatory levels, detoxification health, stress levels and management ALL must be considered, addressed and supported in the process.
Back to my shoulders…
Lots of talk on social media about estrogen and womens’ shoulder issues. There absolutely are relationships there with regard to changes in hormone levels AND how hormones are metabolized in the liver. Liver is often a contributor to shoulder issues via its fascial connections and influence on tendons, and metabolization of hormones. (will deep dive into the literature to see who else is exploring these relationships or send me what you find!)
I’ve been on estradiol and progesterone for 3 years…my shoulders are struggling
I brought this up to my doctor. As we looked at my labs, together, she noted my DHEA, which is a precursor to testosterone production, as well as my testosterone was on the lower side of normal. She recommended we try to increase both to see if we can increase estrogen in my tissues/fascia as some testosterone will metabolize into estrogen. We also changed the delivery system of my progesterone. (Progesterone has been a lifesaver for me, particularly with regard to subclinical depression and mood stability. I was identified with low progesterone when I was pregnant and needed progesterone injections to maintain my baby, yet no one discussed ,that maybe my body needs consistent help in the progesterone department.)
I was a little nervous to try, as I really was feeling great hormonally, mood, weight, strength…except for my shoulders. But I was open to try.
I made sure I documented what I started and when, and how I was feeling. I continued to document what I noticed over the days.
I recognized increased breast swelling as I cycled in the progesterone which was now in intervaginal form, was oral prior. I had experienced this when I tried topical progesterone. I don’t like this feeling, and clearly, I am struggling somewhere in the pathway to metabolize this form. I was hoping it was something my body needed time to adjust to, but this has been consistent over 3 months.
I have been on the fence of testosterone. I have noticed an increase in strength at the gym. But in my second month, I am very aware of my increase in appetite. I am hungry, and I can’t stop thinking about food and eating. This little body, and slow metabolism CANNOT handle an appetite as such.
And, I’m becoming irritable and a bit ragey. That is the DHEA for me. I experienced this in the past as well. I am hypersenstive in my receptors.
As my labs came back, my testosterone has increased significantly, DHEA is over the top, and I don’t know how, but I cannot find old progesterone labs in which to compare my current levels.
All of this to say, YOU ALSO need to be the detective in your health!
It’s the scientific method…gather the evidence, form a hypothesis, see what you’re going to measure, test the hypothesis, assess the results, pivot as the results guide you.
Your body is unique in its genetic makeup, structural, cellular, and nervous system health. You have your unique goals, needs, wants, and desires for your body and your life. If you don’t pay attention to the signals/barometer of your body, you’ll never know how well or not well an intervention works for you. We are NOT taught to pay attention to the messages of our bodies. In fact, we’re taught to ignore them, or in most medical practices, they are silenced by a medication. When in fact, these messages are signs that something is out of balance.
It takes a true partnership of a provider who will work with you, and honor your body’s responses to intervention, and pivot when something wasn’t the right fit.
I am grateful for my doctor and the partnership we have.
I am still wrestling with shoulder pain. And, I don’t like how I feel on DHEA and testosterone, I have discontinued the DHEA, and will decrease the dose of testosterone until the prescription ends. I don’t like to “muddy the water” and make multiple changes when I am testing out something on my body. I have brought collagen back into my diet for soft tissue/fascial support. And I am focusing even more on shoulder girdle stability and position in the gym, prior and during my lifting. I am trying to not sleep with my arm over head! I have been lax with regard to my eating…sugar, gluten, dairy, eggs, have creeped back in, driving inflammation. Very likely another piece of the puzzle of my tissue irritability. So, I’ll clean house in my eating for 4-6 weeks. As I write this, intuitively, I think diet is likely the biggest player for me right now (which absolutely will affect how well my liver is functioning.)
I’ll keep you posted. Stay curious. Be a detective of your body. Get to know the messages it sends you.
J