Hormones & Pain: Why People Who Menstruate Experience Pain Differently

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Hormones are like the mood swings of your body’s pain system—one minute they’re helping you out, and the next, they’re turning up the dial on your discomfort. For people who menstruate, hormonal fluctuations throughout the menstrual cycle, menopause, and other life stages can seriously mess with how pain is experienced and how quickly we recover. Let’s explore how that works, and maybe add a little humor to the mix because, well, why not?

MENSTRUAL CYCLE: HORMONAL PEAKS & VALLEYS

For anyone who menstruates, the hormonal rollercoaster of the menstrual cycle is a familiar ride—except it’s not the fun kind. Estrogen and progesterone are the headliners, and depending on where you are in the cycle, they can either be helping you power through your day or throwing wrenches into your plans.

  • Follicular Phase (Day 1–14): Estrogen is your bestie here, rising steadily as your body preps for ovulation. Estrogen’s got that pain-relief magic that boosts your endorphins (your body’s natural painkillers), so this phase can actually feel like a relief from any aches and pains you were dealing with earlier. Hey, some good news at last! Your body’s also recovering more quickly during this phase. If only the rest of the month could be this kind to you, right?
  • Ovulation (Around Day 14): As if having a period wasn’t already fun enough, you get a little hormonal chaos right around ovulation. Estrogen peaks just before you release an egg, and while you might feel great in some ways, this is also when your body’s sensitivity to pain might rise. Not only that, but the physical stress of ovulation, combined with fluid retention, can make those random aches and pains feel like they’re coming from a whole other dimension.
  • Luteal Phase (Day 14–28): Enter progesterone, which rises after ovulation. But instead of being your knight in shining armor, it has a tendency to turn the volume up on pain sensitivity. Progesterone’s anti-inflammatory properties are nice, but it also makes you more vulnerable to pain. This phase is notorious for PMS symptoms, including cramps, headaches, and joint pain. Oh, and if you’re bloated? That doesn’t help either. It’s basically the universe’s way of saying, “You thought the first two weeks were tough? Hold my beer.”

MENOPAUSE: THE END OF AN ERA (AND HORMONES)

Menopause is the grand finale of the menstrual cycle—a little too final for comfort, to be honest. With it comes the reduction of estrogen and progesterone, which can really throw off your body’s relationship with pain:

  • Decreased Estrogen and Pain Perception: Estrogen isn’t just about regulating the cycle; it also helps moderate pain through its effect on neurotransmitters. When estrogen dips during menopause, many people report an increase in joint pain, muscle aches, and discomfort. Basically, it’s like your body’s pain dial goes up, but no one asked for it. If you have a chronic condition like arthritis or fibromyalgia, menopause can make it feel a lot worse.
  • Hot Flashes and Pain Sensitivity: Hot flashes? More like your body’s version of an inconvenient fire drill. These sudden bursts of heat and stress on your system can make you feel extra sensitive to pain, and when your sleep is disrupted by these flashes, the recovery process from any injury or inflammation slows down. Just what you needed, right?
  • Bone Density Loss: Estrogen has an important role in maintaining bone health. When levels drop, bones can become more fragile, leading to joint pain, fractures, or a greater susceptibility to injury. So, not only are you dealing with inflammation and general discomfort, but now your body might be playing defense on multiple fronts.

HORMONE TREATMENTS & TRANSGENDER HEALTH

For those undergoing hormone treatments as part of a gender-affirming process, hormonal changes can also have a significant impact on how pain is perceived and managed. People undergoing testosterone therapy, for example, may experience changes in muscle mass, bone density, and overall pain sensitivity. Similarly, those on estrogen blockers or undergoing hormone replacement therapy (HRT) might find their pain perception altered as their hormones shift. Everyone’s experience is unique, but it’s crucial for healthcare providers to take these factors into account when considering pain management strategies and recovery times.

BREASTFEEDING & ESTROGEN DEFICIENCY

Here’s something that’s not talked about nearly enough: breastfeeding can result in estrogen deficiency. And, as if recovering from childbirth wasn’t already challenging enough, this hormonal dip can leave tissues, which are already healing from delivery, more sensitive. This means everyday activities like picking up your baby, carrying groceries, or even just sitting down can cause pain and inflammation. The lack of estrogen affects your muscles, ligaments, and joints, making those everyday motions feel like you’ve been running a marathon without your consent. So, if you’re breastfeeding and dealing with this, you can talk to your medical provider about whether a topical estrogen cream could help. And take it easy on yourself—your body’s working overtime in more ways than one. 

WHY IT MATTERS FOR TREATMENT & RECOVERY

It’s crucial to understand how hormones impact pain—because if you’re not in the right hormonal phase, your body might not be as receptive to treatments as you’d hope. Pain management should be personalized to fit each phase of the cycle, menopause, or even hormone treatment stages. Here’s how it plays out:

  • Tailoring Treatment to the Cycle: Treatments like physical therapy, chiropractic care, and massage therapy may work better during certain times of the cycle (hello, follicular phase!). During the luteal phase, you may need more attention to pain relief, while during menopause or hormonal treatments, a shift in strategy may be required for the most effective results.
  • Managing Chronic Pain: People who menstruate are more likely to experience chronic pain conditions, including fibromyalgia and migraines. Understanding hormonal impacts can help guide a more effective pain management plan and prevent flare-ups. Trust me, no one needs more of those.
  • Inflammation and Recovery: Estrogen is your inflammation-fighting sidekick, so when it’s low, recovery can be slower, and your pain can linger longer. Whether it’s recovering from surgery, childbirth, or just the grind of life, hormonal fluctuations are going to impact how well you bounce back.

DON’T LET HORMONES KEEP YOU DOWN

So, there you have it: hormones can make your body act like it’s on a rollercoaster ride with no seatbelt. From menstruation to menopause and everything in between, understanding how these hormonal fluctuations impact pain is key to managing it better. Whether you’re navigating the ups and downs of your cycle, dealing with the effects of hormone treatments, or handling the added challenges of breastfeeding and estrogen deficiency, it’s all about finding the right balance for your body.

And don’t forget—be kind to yourself. It’s not just about surviving your period or menopause, it’s about thriving, even when your hormones are doing their best to mess with your peace. You’ve got this!