Women's Health Community

Dear TinaAB; Oh my gosh, a 13 hour day on top of chronic fatigue and muscle pain--that would just about kill me. How have you been able to sustain the pace?

We cannot give you an exact answer about the weight gain but some data suggests that both aging and menopause may be contributing factors. It is well known that our metabolisms slow down at least 2% per decade (more for some people). Many women have observed both weigh increases and a change in weight distribution (more abdominal fat) after menopause. Honestly, in both my professional, and personal, experience the only antidote is to really increase the intensity of cardio exercise and add resistance training. Both of these are likely to be difficult given your present fatigue and muscle symptoms. Thus your initial choice may be to do more of a work up on those symptoms.

Your combination of symptoms (fatigue plus muscle/joint pain makes me wonder about some type of autoimmune disorder. Here is more information about this:

http://women.webmd.com/features/life-with-autoimmune-disease

Another condition which has these same symptoms is fibromyalgia. Here is more information about fibromyalgia:

http://www.webmd.com/fibromyalgia/guide/fibromyalgia-symptoms-typeshttp://www.webmd.com/fibromyalgia/guide/fibromyalgia-symptoms-types

Both of these conditions are assessed by a rheumatologist MD. They would be in the best position to know what blood tests to order.

If other readers have had a similar experience (and/or any fixes) I would ask you to share that with TinaAB and the rest of us.

In Support,
Jane

Since my hysterectomy, I get joint pain in my knees when my estrogen gets low. This makes sense since joint pains generally start around middle age. But it seems that high estrogen can cause joint pains too because some women with endometriosis complain of joint pain.

As far as weight gain and fatigue, those seem fairly common at least based on the women I've connected with since my hysto. I don't have nearly the energy I did before that surgery. I used to go non-stop and never run out of steam. I sure can't imagine a 13 hour work day! I feel for you! I'm not working full-time and can't imagine going back to a full-time job.

I haven't gained weight but don't eat nearly as much because I'm hardly ever hungry. But I did develop a big belly; it's like my whole midsection is scrunched and flabby and it's disgusting.

I'm curious how the hormone cream is working out. Are you able to sleep through the night? That was one of the worst symptoms of low estrogen for me. Horrible depression was the other. But there were many others. All I can say is estrogen is my new best friend!

Sometimes it's hard to find the HRT that works best. If the cream isn't working, you may need to try something else.

I did a PubMed search and this study shows a link between joint pain and low estrogen. This study specifically addresses joint pain (arthralgia) caused by aromatase inhibitors which reduce estrogen.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2140182/
"The prevalence of joint pain in the knees, hands, feet, and other joints increases with age in women, reaching a maximum in the group 50 to 59 years of age, implicating hormonal changes . The prevalence of osteoarthritis increases around menopause , and rheumatoid arthritis has its highest incidence and prevalence in the decade following menopause, perhaps triggered by estrogen deprivation.... Postmenopausal status is also an independent predictor of increased musculoskeletal pain, with estrogen deprivation contributing to arthralgia during menopause and aromatase inhibition exacerbating painful symptoms by further estrogen reduction."

This study http://arthritis-research.com/content/12/5/R182 of mice in the Netherlands concluded that "These data demonstrate the significance of oestrogen for articular cartilage and subchondral bone and the maintenance of healthy joints. Depending on the site in the joint, oestrogen depletion may directly increase cartilage damage and subchondral bone loss or increase susceptibility for an additional trigger. The current data support an etiological role for altered oestrogen signalling in osteoarthritis and thereby substantiates the link between estradiol and the development of osteoarthritis. The current data strongly add to the concept of the involvement of bone, specifically the subchondral bone plate, in osteoarthritis."

In naturally menopausal women, I suspect when joint pain develops it's more gradual than when it occurs after oophorectomy. Also, since menopausal ovaries continue to produce some testosterone (as well as estrogen) this may provide some further joint and muscle protection.

Hopefully, getting your estrogen "right" will give you some relief. It's also possible that testosterone will help but that may be in your hormone cream - you didn't say. But then again, it may take some tweaking of dosages.

Meno brain caused me to forget to mention the following that was stated in the first article about a link between low estrogen and aromatase inhibitors -
"Also, arthralgia is a known side-effect of some medications, including angiotensin converting-enzyme inhibitors, proton pump inhibitors, quinolones, and tibolones."

So if you're on any of these drugs to treat such things as high BP, acid reflux/GERD, or various infections including UTI's then that could be at least part of the cause of your joint pain.

Thanks so much for your quick reply. I will make an appointment with a rheumatologist first thing tomorrow morning. I appreciate your guidance very much. It gives me hope.

Thank you for taking the time to reply to my submission. I also appreciate you looking up this additional information for me. I haven't had many typical symptoms since my hysterectomy. The only thing affecting my sleep is stress; if it wasn't for that, I think I'd sleep fairly well. I have the occasional hot flash, but they come and go quickly. The most troubling symptom I've had (besides the fatigue and pain) is a complete loss of libido. It makes me very sad. I finally got married for the first time, less than four years ago. I love my husband dearly, but the combination of fatigue, pain and zero desire makes things difficult. I've only been using the hormone cream for two months, now. It is supposed to help, but so far I haven't noticed a single difference. This is really no way to live. I truly appreciate your reply. It gives me hope.

I get it - no libido here either since hysto. I miss that too and just want those feelings of being a sexual person back.