Does anyone have knowledge/ experience correlating oestrogen levels with PMR? Can it be a trigger, and exacerbate symptoms?
I have read that inflammation increases during menopause.
Is it worth having my hormones tested? I'm about 2 years into menopause.
Changes in oestrogens can cause symptoms similar to PMR - but in that case it tends not to respond well to pred but does respond well with oestrogen replacement HRT,
The link between increased pain from existing chronic health conditions , like PMR, Arthritis and Fibromyalgia during the Menopause , or when the hormone levels in the body swing during Perimenopause and Menstruation, are only beginning to be studied but are acknowledged by Medical Professionals.A recent study by a clinical psychologist of 200,000 female military veterans case histories proved that increased symptoms of Chronic Pain occurred during Menopause for whichever long term health and pain symptoms they had.
With most chronic health issues ( including gastric , inflammatory or cardiac ones) women consistently report that their symptoms get worse during certain times of the month, in line with the oestrous cycle or have got worse or can flare up whilst they suffer the hormone triggered symptoms of the Menopause.
I myself was put on contraception injections to help control symptoms of chronic pain. I had Adenomyosis (neurological version of Endometriosis when uterine cells have attached to the nerves) and migraines that happened during the month , and were particularly bad during ovulation, injections were not just to help control Menstruation itself. I finally required an early hysterectomy, including ovary removal to prevent the increase in pain , inflammation and other symptoms that happened as my hormones changed each month. I was put on to the HRT alternative, Livial , and my hormones did not have an impact on my quality of life anymore ( even if other issues have). When I had GCA I didn't suffer the monthly swing up in pain that I have heard others do after they suffer menopause symptoms because I had been on the replacement therapy for years before developing GCA.
As Pro said, if anyone feels that they can link the flares they are having to their Menstrual or Menopause cycle it is worth going to discuss trialling the use of a single hormone contraceptive, HRT, or a HRT alternative like Livial to control those hormone symptoms and eliminate one of the triggers for chronic pain from PMR , Oestoarthritis, Arthritis, Fibromyalgia, Chronic Migraine or other illnesses that involve the joints and pain.
Oestrogen changes and hormone imbalance also makes the nerves more sensitive to pain and pain messages , so sometimes the increased pain or feeling of a flare that can happen with inflammatory conditions , isn't entirely caused by inflammation but is also higher nerve sensitivity causing a bigger pain response. It can be a reason that it can take longer to bring pain under control during a flare of PMR triggered by hormones if we only increase Pred on its own and don't take other Self Care steps to improve the symptoms or use a way to reduce the nerve pain as well.
People whom also suffer conditions that can also involve Neurological Pain are often recommended to begin Garbapentin, Pregabalin or other nerve medication and those whom take Neurological medications already for other conditions are also advised to use a Sick Day Rule during Menstruation or periods of active Menopause symptoms and have a small increase in the dose of medication to help reduce the effect of the increased sensitivity to pain that occurs in the nerves because of oestrogens.
You could try keeping a diary before starting a hormone medication to track when your Menopause symptoms occur and how soon afterwards you feel your PMR or other Chronic Pain symptoms change.
Knowing when your Menopause or Menstrual Cycle symptoms occur by keeping a diary is a really helpful thing for all women to do whom have any type of Chronic Illness.
It can help you to plan your month better so that you have more rest at certain symptomatic times during the day and you can plan Stress Free days at the point when your hormones are causing the most issues.
It is one thing that doctors with more interest in Self Care techniques advise to all Chronic Pain patients.
Learn to say 'No' and slow down or have days off on the days in the month that your illness is most affected by hormones .
There are four other tips that are generally advised to help manage how your hormones effect your pain along with Hormone medications and Pacing Yourself.
1. Practise relaxation and breathing techniques every day , and particularly when hormone symptoms occur to reduce the effect of those symptoms on your pain and other illnesses.
2. Keep Active , but gently so.
One piece of advice which I was given by a Chronic Pain and Fatigue Specialist was to stay active throughout the day even if the Fatigue makes you feel like a lead weight. They advise that everyone tries to do minimum3000 steps a day to keep healthy, not the mystical 10,000.
This number of steps as Pain Management should be broken up over the day , doing some steps every hour rather than in one big exercise activity.
The steps you do during daily activities count so on a good day you won't need to make the effort to do these steps at all.
It's on a bad day or when you are heavy with Fatigue that you need to remind yourself to have a little stroll and stretch each hour to help control pain and hormone levels.
3. Create a good Bedtime routine,
You may not be able to sleep , especially on high steroid doses or if you have night sweats and night symptoms but it is good to get rest both mentally and physically in a comfortable bedroom with a steady but cool temperature.
Body rest is more important than hours of sleep to reduce body pain.
Try to wind down slowly over a number of hours in the evening and switch off all devices , including the phone at least an hour before bed.
4. Keep Hydrated and keep at a steady temperature.
Water intake helps improve hormone balance , nerve messaging and inflammation so regular fluids can reduce hormone symptoms and help you recover quicker from pain caused by them.
Wearing layers and keeping at a steady 'Goldilocks' temperature, not too hot , not too cold improves your control of hormone symptoms like hot flushes, chills and sweating , if you can control these quicker through breathing, drinking and adding or removing clothing it is less likely to cause you tension and trigger pain that could cause a flare in your PMR or other Chronic Pain conditions.
Hope this helps , Bee
PS : To the Men , you can also have hormone triggered flares in Pain as you get older and levels of Estrogens and Testosterone swing up and down in your systems too. The Male Menopause isn't a myth.
~Fascinating reading with so much to absorb - thank you Bleary ~
Thank you for your most comprehensive answer!!
So worth pursuing HRT. I heard this evening that the hormone blood tests are not so reliable, as the hormones fluctuate so much, and that they work more on symptomatic treatment.
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PMR Blood levels
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