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[elle]

Hi, this is my first time posting so apologies if I'm missing anything!

 I'm hoping to find anyone who can relate, suggest, advise etc about the following.

I've spent the last 2.5 years trying to find out the cause of musculoskeletal pain that came on during perimenopause. After numerous tests and treatments including MRI's, bloods, Xrays, ultrasounds, physio and HRT as well as currently being put on opiates, I think hormonal imbalances due to menopause has led to ligament laxity. I've always been hypermobile and since perimenopause my bones and joints have become really loose This has led to daily and constant mild-mid-severe pain and impacted hugely on all aspects of my life

I had thought because the pain started during perimenopause that the laxity might be down to hormone deficiency so I started HRT patches in the hope of redressing the balance, however this seems to have made my ligaments more lax resulting in more pain. During my first pregnancy I developed Split Pubis Symphisis which I still suffer from so I wonder if too much relaxin is perhaps playing a role. Treatments that I've had so far don't address the hormonal aspect. I'm wondering if anyone has had this experience and if they have seen anyone who has managed to help.

Thanks so much in advance

[CLKD]

Hi.  As oestrogen levels drop muscles may become lax = aches and pains.  As well as the body may become dry: inside and out; deep in the ears, eyes, skin, vagina, between the toes etc..

Why have you been prescribed Opiates?  Is this by your GP who should have referred you to a dedicated menopause clinic if this hasn't already been discussed.

   let us know how you get on.  Some find that keeping a mood/food/symptom diary of use. 

[elle]

Thanks so much for the response.

My GP hasn't referred me to the menopause clinic, I asked and she said she was the one to talk to about menopause and could prescribe HRT.  I'm hoping if the patches don't work that she will refer me.if not I can see another GP.  I'm desperate to speak to someone there. I was referred to the chronic pain clinic and prescribed Tramadol then dihydrocodeine by a consultant there, I'm grateful for what they do but I'm still in a lot of pain every day and the side effects are pretty full on. It was only after a lot of investigations, researching and 2 years of pain that I went back to my GP and said I think this might be related to menopause. I mentioned it to GPs, physios, rheumatologist and pain clinic and the answer was the same, that there wasn't that much research done in the area of hormones and musculoskeletal conditions. I had to dig my feet in.

Oh gosh yes about the diaries, I have charts for everything. I find hard data for me is a lot more reliable than memory esp where emotion and pain can interfere!

Thanks again

[CLKD]

Firstly - has this GP been on a menopause 'course' with i.e. Dr Newson?   Apparently 1 of ours has but is keeping it quiet  .  My friend sees this particular GP and updated me as I was concerned that she wasn't getting the correct advice.  So mayB ask the Practice manager whether any GPs have specific menopause knowledge.

In the mean time, ring the private menopause clinics to see what the fee scales might be.  1 shouldn't have to go privately but paying for proper advice i.e. about laxity, gives another pathway in order to challenge your GP.

When did U last have X-rays?  That might be another way to go, another basis from which to work.

[Penguin]

I had this in pregnancy, symphosis pubis disorder (SPD). You're right in that it is too much relaxin and I've been told the impact of that can continue long afterwards. I was on crutches from  20 weeks  it was awful. It was only around hips and pelvis for me though, do you get it elsewhere? My pelvis is still unstable and I see an osteopath regularly to put my hip back in place as getting out of place due to loose ligaments means it affects my shoulders now too. The only things that help me are regularly osteopathy to make sure I am fully aligned (with SPD you likely won't be) and very regular yoga. I also have to avoid external hip rotations in yoga. You have my sympathies, it can be very painful.

[CLKD]

Is this due to a shift in hormones during pregnancy?  A friend was in a wheelchair for 8 months following the birth of her child. 

[elle]

Thank you for the response, that's much appreciated

I did ask my GP who I would speak to re menopause and she said "me". Perhaps she didn't refer me to the clinic because she hadn't prescribed HRT patches at that point. My plan is to go back and ask to be referred again

Re private clinics, my budget is limited so I'm hoping to get as far as possible along the NHS route. Would you know if there is a list somewhere as I haven't had much luck with google? I did ask one private hospital if they could direct me towards the right person/dept and they said Gynecology. I'm in Edinburgh

My xrays, mris and scans have all been within the last year but they all came back normal. It appears that ligament laxity isn't something that shows up on scans, other than perhaps an open or standing MRI machine. I'm wondering whether hormones level might indicate laxity. GP said there are no blood tests to test for relaxin or laxity.

I feel what I need is my hormones adjusted to stop my ligament laxity which is causing pain. An anti-relaxin drug! 

[elle]

Hello Penguin

I'm sorry to hear you're having to deal with SPD. Yes, too much of the hormone relaxin which loosens all the ligaments. Mine has never gone completely away and with menopause my thinking is that relaxin is playing a big role again in my other pains. As well as my hip pain (20 years now) my ribs slip regularly often causing excruciating pain and my ankles are in pain all the time. I'm glad to hear you get some relief from osteopathy. I was in a corset most of my pregnancy to try and hold me together and had to crawl to get around! It's made me think some people are more susceptible to relaxin than others. Are you flexible/hypermobile/double jointed? I used to be 5.4" and I'm now 5", my MRI showed scoliosis and my height loss is due to my ligaments not being able to hold my skeleton in place. I feel like my insides are crumpling away! I hope you continue to get relief from osteopathy

[elle]

Is this due to a shift in hormones during pregnancy?  A friend was in a wheelchair for 8 months following the birth of her child.

Sorry, still working out how to reply! Yes, the hormone relaxin loosens the ligaments around the pubic bones for childbirth but some women get excessive amounts. I feel for your friend, I hope she has made a full recovery. I was put in a corset and had to crawl around. I'm suspecting relaxin is playing a part in my MSK pain.

[CLKD]

 . ...... it took about 18 months B4 she began to feel well.

Do U have a plan?

[elle]

. ...... it took about 18 months B4 she began to feel well.

Do U have a plan?

I have every sympathy with your friend, it's very difficult mentally and physically.

I think re plans- go back to GP and ask again for a referral to the menopause clinic

If I can't get anywhere then I would have to look at what I can afford privately. I don't have private health insurance and worry I would only be able to afford so far along the line.

I'm assuming that online hormone tests don't give a full picture given variability, but I don't know if  that means ones offered either by NHS or private hospitals would also be unreliable. Relaxin caused me so many problems during pregnancy with ligament laxity, I'd really like to know if this is contributing to my current issues.

In the meantime the plan is to keep researching, I'm very open to any suggestions here though.

[CLKD]

It can be so tiring though 

Would a referral to a Gynae be any use?  Where R your records lodged, mayB go back to that Hospital?

I would ring the surgery and ask if there is a GP/Nurse Practitioner with menopause knowledge [I may have said already  ] and ask which GP is likely refer you to an NHS Clnininc.  It might be worth looking at Louise Newson's website too.

[elle]

I'm a bit lost to be honest with who to see if I were to go privately. The hospital i contacted said if I had "menopause concerns" then I should see a gynecologist. I've written to ask them if private consultants at the hospital can/will refer to an NHS clinic or consultant

Thanks for the link recommendation I'll take a good look at the website, I'm sure it will be helpful

[Pixie]

I have ehlers danlos syndrome type 3 (hypermobility). Progesterone is known to loosen ligaments more even more so when taken on its own.

I've found that I can only take hrt through the skin. Oral progesterone gives me immense pain and the oestrogen isn't enough to counteract it.
So far I'm doing good on everol sequi and actually feel better on the progesterone part which is bizarre. God help me if I ever need to increase the oestrogen because I'll be stuck.

[elle]

I have ehlers danlos syndrome type 3 (hypermobility). Progesterone is known to loosen ligaments more even more so when taken on its own.

I've found that I can only take hrt through the skin. Oral progesterone gives me immense pain and the oestrogen isn't enough to counteract it.
So far I'm doing good on everol sequi and actually feel better on the progesterone part which is bizarre. God help me if I ever need to increase the oestrogen because I'll be stuck.

Hi Pixie, thanks for the input, yes, I've come across EDS as I've been trying to work out my own hypermobility journey. That's really useful to know thanks.My GP has me on Evorel Conti but I've just come off them because I'm struggling so much with the ligament laxity on them. Could I ask if you tried the  Evorel Conti before the sequi?

 Did you find a GP/consultant who understood the relationship between hypermobility and hormones in relation to menopause?

I'm really glad you've found something that helps, or at least stops you feeling too much pain.