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Gluteal Tendinopathy in Perimenopausal Women.

Gluteal tendinopathy is a common cause of buttock pain

Causes, challenges, and the possible role of Hormone Replacement Therapy

Gluteal tendinopathy, a condition causing pain and discomfort in the buttock and thigh region, is more common than you might think. And while it can affect people of all ages and genders, peri-menopausal women often face specific factors and challenges related to this condition. In this blog post, we'll delve into the world of gluteal tendinopathy, explore why it is more prevalent in peri-menopausal women, and discuss the potential role of hormone replacement therapy in managing this condition.

Understanding gluteal tendinopathy ?

Gluteal tendinopathy is a condition that primarily affects the tendons in the buttocks, particularly the gluteus medius and gluteus minimus tendons. These deeper muscles sit underneath the big gluteaus maximus muscle extending across the buttock to attach to the outer hip. These tendons play a crucial role in stabilizing the hip joint and facilitating movements like walking, running, and climbing stairs. All tendons need load ( pull ) placed through them but it's a delicate balance - too much load or repetitive load and it can overwhelm the tendon making it unhappy. When these tendons become injured or irritated, it can result in pain and decreased functionality in the hip and buttock region.

Occurence in peri-menopausal women

Peri-menopause, the transitional phase before menopause, is marked by hormonal fluctuations, including a decrease in oestrogen levels. These hormonal changes can contribute to the development of gluteal tendinopathy in several ways:

  1. Reduced Tendon Strength: Estrogen plays a role in maintaining the strength and integrity of tendons. As oestrogen levels begin to decline during peri-menopause, tendons can become weaker, less able to cope with the load put through them and become more susceptible to injury.

  2. Muscle Imbalance: Hormonal changes can also lead to muscle imbalances, where certain muscle groups become weaker or tighter, especially those with a higher proportion of red muscle fibres ( power fibres ) . In peri-menopausal women, weakened hip abductor muscles can put extra strain on the gluteal tendons during activities, increasing the risk of tendinopathy.

  3. Changes in Activity Levels: Some women may experience changes in their physical activity levels during peri-menopause, which can affect tendon health. Reduced activity or changes in exercise routines can impact the strength and flexibility of the gluteal tendons.

Challenges for Peri-Menopausal Women.

Joint and tendon pain is common in peri-menopausal women

Peri-menopausal women facing gluteal tendinopathy encounter unique challenges:

  1. Delayed Diagnosis: Tendinopathy symptoms may be attributed to other common peri-menopausal symptoms like joint pain or muscle stiffness, leading to a delay in diagnosis and treatment.

  2. Menopausal Symptoms: Pain from gluteal tendinopathy can exacerbate existing peri-menopausal symptoms like hot flashes and sleep disturbances, making this period even more challenging.

  3. Impact on Quality of Life: Reduced mobility and persistent pain can affect the overall quality of life, hindering daily activities and causing emotional distress.

Hormone Replacement Therapy (HRT) and Gluteal Tendinopathy

Hormone replacement therapy (HRT) can be prescribed to alleviate menopausal symptoms by replacing the declining oestrogen levels. However, its influence on gluteal tendinopathy remains a topic of research and hot debate.

While HRT can help maintain overall tendon health by supporting collagen production, it may not directly prevent or treat gluteal tendinopathy. The condition is often multifactorial, influenced by factors beyond just hormonal changes.

When considering HRT, it's essential to discuss the potential risks and benefits with your GP. They can help assess whether HRT is suitable for you, considering your overall health, menopausal symptoms, and the presence of gluteal tendinopathy. My own personal view is that it is worth at least considering a trial of HRT. It's not like a diabetic or cardiac medication - you don't have to take it. If you try it and it doesn't suit you then simply stop taking it, hey, at least you tried.

Managing Gluteal Tendinopathy

If you suspect you have gluteal tendinopathy or have been diagnosed with it, here are some strategies to manage the condition:

  1. Physiotherapy: A physiotherapist or sports therapist can develop a tailored exercise program to strengthen the affected muscles, improve flexibility, and address any muscle imbalances.

  2. Pain Management: Over-the-counter pain relievers or anti-inflammatory medications may provide short-term relief, allowing a window of opportunity to complete rehab.. Your healthcare provider can guide you on their appropriate use.

  3. Lifestyle Modifications: Adjusting your activities to reduce stress on the gluteal tendons, such as avoiding prolonged sitting or activities that exacerbate pain, can be helpful. Again your therapist can advise you on the best exercises for YOUR particular set of symptoms.

  4. HRT Consideration: If you are peri-menopausal and considering HRT, consult with your healthcare provider to discuss its potential impact on your specific case of gluteal tendinopathy.


Gluteal tendinopathy is a common but often underdiagnosed condition that can significantly impact the lives of peri-menopausal women. Understanding the factors contributing to its occurrence, the unique challenges faced by this demographic, and the potential role of hormone replacement therapy is crucial.

If you suspect you have gluteal tendinopathy or are experiencing pain in your hip and buttock region, don't hesitate to reach out to your healthcare provider. With proper diagnosis and management, you can regain your mobility and improve your overall quality of life during the peri-menopausal transition and beyond.

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