Pain with HRT is common, but you don’t have to live with it

wellness

Dec 5

It is very common to experience joint pain, pelvic pain and headaches while transitioning through HRT. The reason is quite scientific, but the solutions to relieving this pain are easy and accessible!

So why is it that an estimated 72% of trans people undergoing HRT experience pelvic and joint pain?

Testosterone and Estrogen, the hormones responsible for reproductive anatomy, play a huge role in how we as humans experience pain and how often it occurs. Testosterone has a tendency to dull down pain inside of the body while estrogen has been shown to have a dulling effect as well as an intensifying effect, depending on the source of pain.

The increase in joint pain and headaches during this time is related to how each individual's body handles the added hormones. The hormones in either situation, change the perception of pain and the pain tolerance of the person from what they may have previously become accustomed to.

A person who is taking estrogen (or estradiol), will experience a new intensifying effect of pain that may have already been present at a much more manageable level. They may also experience painful breast tissue, bowel changes and pelvic floor sensitivity because all of those tissues are affected by estrogen.

A person who is taking testosterone, will find that as their estrogen level drops in relation to the T, headaches become more frequent because the common migraine is linked to lowered estrogen levels.

Both estrogen and testosterone play a role in cartilage and bone health. This link is what is responsible for much of the joint pain experienced during transition. Estrogen also plays a significant role in arthritic changes, most commonly first seen in the pelvis and leg joints during a menopause or menopause-like hormone setting.

All of this is to say that - joint pain is common and expected with the transition, but you do not just have to live with it!
There are 5 simple, effective and accessible things you can do to find relief from the aches and pains associated with HRT.

Hydration & Diet

It is crucial to include proper nutrition during transition for so many reasons and I would be crazy to not include it as the first line of relief. Your body relies on hydration to keep your joints properly cushioned and easily movable. You should be taking in half your body weight in oz of water per day. It is particularly important during times of significant health changes like transitioning because your cells need water and minerals to repair and adapt.

Nutrition will depend heavily on what the goal of transition is and the aesthetic you are after. The protein/carb balance of your diet will heavily depend on if you are looking to increase lean muscle mass or de-bulk. In either case, getting a lot of value from the foods you are eating is important. Adding lots of colorful fruits and veggies is a must to add vitamins and minerals into your body that are crucial from joint and cell repair.

Finding a source of minerals like supplements or trace mineral drops will help provide your body with everything it needs to incorporate all of the changes in the most effective way possible.

Boswellia & Curcumin

These two herbs are powerhouses for inflammation and pain. They are irreplaceable (cue Beyonce) in your journey to having a pain-free transition.

Boswellia is a traditional herb used for its anti-inflammatory properties and would be most helpful for people experiencing pelvic pain or arthritis symptoms. If you are waking up with pain or ending your day with pain, this herb is a great investment.

Curcumin is the active part of turmeric, the well known yellow kitchen spice. Curcumin is also used for its anti-inflammatory properties because it is a strong antioxidant. It is great for relieving pain that feels like a swelling rather than an aching. It is also great when you are experiencing bowel changes because that is related to inflammation.

Chiropractic

This is my plug for what I do - chiropractic relieves pain by keeping pressure off your nervous system. Headaches, joint pain, pelvis pain, muscle dysfunction are all things that adding a chiropractor to your health plan during transition could really help to manage without adding extra medications to your daily regime.

With that being said, I am well aware that in some locations it may seem daunting to find a chiropractor who is gender affirming, affordable and approachable.

If this is the case for you- PLEASE PLEASE PLEASE let me help find you one. I assure you they do exist and we can find one if this is something you are interested in!

Wellness Practices

There are also a ton of other wellness practices that can help you along your journey depending on your pain source. Massage is a great way to relieve muscle tension that can occur during transition. A sauna or steam room is great for headaches and chest/breast pain because it keeps your lymphatic system open and draining. Acupuncture is a great way to connect all the dots if there are many new aches and pains during transition.

At some point during any transition, it is helpful to consider finding a pelvic floor physical therapist to work with. This can help with new or old pains, posture, bowel and bladder dysfunction and so much more. This type of physical therapy is also a great resource post-operative, as a way to retrain and relearn all the things that may be different about your pelvic floor.

Therapy

It goes without saying that therapy is a well known practice in the LGBTQIA+ community, but in my line of work I have come to know one thing very important to healing - pain is more often than not linked to or caused by the emotional and mental state.

As you transition, you are taking on a lot of new feelings (fee-fees, if you will) and maybe even leaving behind some old fee-fees. Those fee-fees can manifest as physical pain around your body. Your muscles have a job that does not get enough notoriety and that job is memory! They hold onto memories like you would not believe.

I find myself asking patients all the time if they notice a pain they describe at a certain time or event. The answer is always yes. Maybe it's a posture, maybe it's a memory - maybe it's maybelline. In any case, working through those emotions in some format often resolves many pains felt throughout the body.

This could be talk therapy, eye movement therapy, reiki - whatever type of therapy you find the most effective for you.

Pain is common and expected with transition, but you do not have to suffer through! You can incorporate some or all of these options into your transition journey to relieve and remove aches and pains felt while HRT is working its magic.