Menopausal Hormone Therapy, Injections and Key Clinical Tips

Reduced estrogen and progesterone affect connective tissue and are linked to tendon pathology. A systematic review suggested hormone supplementation may reduce tendon abnormality in postmenopausal women, which led to the GLoBE Hip trial: a two-by-two factorial randomized trial of 132 postmenopausal women comparing targeted tendon loading with sham exercise, and transdermal hormone cream with placebo, all with education, over 12 weeks. All groups improved on the VISA-G. Hormone therapy was better than placebo when BMI was below 25, possibly because of metabolic factors or the delivery method. The targeted program trended toward faster improvement than the sham program, though not significantly. Rachel outlines the history of hormone therapy safety evidence and recommends referral to a medical practitioner where it may suit the patient. Corticosteroid injections give short-term benefit at best, with high recurrence, and the HIPPO trial found PRP no better than placebo. Her key tips: education first, targeted loading with kinetic chain strength, awareness of coexisting hip conditions and no routine imaging.