What is Menopause?
Menopause is a natural time in a woman’s life when menstrual periods permanently stop, signalling the completion of reproductive potential and gynaecological maturity. It is usually initiated by a natural cause, most often after the age of 45 [1]. This state indicates a permanent transition when ovarian function ceases, leading to an irreversible loss of fertility and diminished production of reproductive female hormones [2].
What Causes Menopause?
Menopause is almost the inevitable result of ageing and consequent changes in ovarian function and hormone levels [1]. Women experience Menopause as a result of declining levels of hormones produced naturally in their ovaries – in particular, the sex hormones estrogen and progesterone. Simultaneously, the presence of mature eggs situated in the ovaries declines, hence triggering infrequent ovulation [3].
Sometimes Menopause occurs a few years earlier than usual because of surgery, radiation therapy, chemotherapy treatment, a pelvic injury, or other problems affecting the organs involved in reproduction. This is called induced Menopause [3].
What is Hip Bursitis?
Hip Bursitis, also known as trochanteric bursitis, can develop when bursae (the fluid sacs that cushion bones from other moving parts, such as muscles, tendons or skin) on the outer region of the hips are inflamed [4, 5]. Too much pressure on the outsides of the hips could cause the bursae to inflame, leading to shooting pain around the hips and legs. This pain could become so severe that every step, such as walking up stairs, feels burdensome [4].
Causes of Hip Bursitis
Various factors can cause Hip Bursitis. One of the most common consists of overuse of the joints, such as when one exercises the same movements repeatedly or applies too much pressure on the hip for an elongated period [5]. This most commonly occurs among individuals who work with the same movements daily or work with heavy objects that apply pressure on the joints [5].
Another cause is injury: either a bump or a fall that’s bad enough to cause damage to the bursa, which results in inflammation [4]. Or hip bone spurs, which are bony protuberances that form along the margins of joints [4].
Bad posture is another cause of hip bursitis. Poor posture can put extra pressure on the bursa, leading to inflammation [4].
Other diseases and conditions can also promote the development of Hip Bursitis, including rheumatoid arthritis, osteoarthritis of the hip, and other chronic degenerative, infectious or rheumatic joint diseases that induce chronic hip synovitis (infection) followed by bursitis [6].
In some cases, hip bursitis can be a secondary condition resulting from other hip diseases or due to athletic activity [7].
Menopause and Hip Bursitis
Menopause is one of the important turning points of life and raises various alterations in women's physiology. One of these may be related to a woman's hip joint health. However, the link between Menopause and Hip Bursitis is not explicitly stated in the given studies.
Does Menopause influence Hip Bursitis?
Hip Bursitis is an inflammation of the bursa at the hip joint. One study found that 14.5% of total hip arthroplasty (replacement of the hip joint because of degenerative joint disease osteoarthrosis) had trochanteric bursitis; more than 90 per cent of the cases found in female patients [8]. Nevertheless, this does not indicate that the bursitis was directly related to Menopause.
Evidence of this increased fracture risk comes from the finding that declining Bone Mineral Density (BMD) is related to Menopause, with consequent increased risk of fracture [9, 10]. Women who underwent Menopause before the age of 40 years had lower hip BMD when compared to those who acquired Menopause at the age of 50 or above [10]. Between 20% of lifetime femoral neck loss and 30 % of lifetime trochanteric loss occurred early in the postmenopausal period [9]. These changes in bone health may result in increased rates of various joint disorders but a direct correlation to Hip Bursitis is not stated in these studies.
Managing Hip Bursitis during Menopause
One of the most important methodologies for Menopause Hip Bursitis management is to keep muscle mass and muscle force. Because femoral neck strength (FS) and muscle force (MF) decrease with age, and decreases are exacerbated when Menopause commences [11].
Exercising at home, with a physical therapist, can also help to improve or maintain leg strength and hip flexibility [12]. For example, a physical therapist can help provide exercises or other treatments, such as massage, ultrasound, ice or heat.
Activities that further exacerbate Hip Bursitis symptoms should be avoided, including repetitive exercises such as jogging and excessive stair climbing [12].
Nonsteroidal anti-inflammatory drugs, such as ibuprofen (Motrin) or naproxen (Aleve), can be used to treat inflammation and pain caused by Hip Bursitis [12, 4].
Furthermore, being at a healthy body mass index (BMI) helps to prevent Hip Bursitis; an exam of overweight and normal-weight older women showed that those with a BMI of 25 or greater at age 40 had a 2.9 times higher risk of developing hip arthrosis that eventually leads to a total hip replacement after the age of 50 [13].