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Low oestrogen and HGH and musculoskeletal symptoms

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Kahuna, Jan 7, 2012.

  1. Kahuna

    Kahuna Active Member


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    Hello all,

    I have a patient who is a 25 year old female and a serious athlete (at county level) for sprinting and hurdling.

    She was initially referred by her coach, and has presented each month over the past year with a different location of localised muscle pain each time (initially itb, then medial knee on opposite limb, then SIJs, then plantar fascia). She was attending many Physio's who could not improve her symptoms, so I referred her for serology, concluding that the issue may not be biomechanical.

    The blood results came back with some remarkable data, so her physician referred her for repeats under the guidance of an endocrinologist. The results show depleted levels of oestrogen and human growth hormone.

    I wanted to ask if anyone can help us understand what the implications of this means at a musculoskeletal level please? (I am more aware that changing oestrogen levels in menopausal women can cause hypermobility and make them susceptible to injury, but I have no experience in what low oestrogen coupled with low HGH would mean for a young athlete).

    Many thanks in advance
     
  2. blinda

    blinda MVP

    Re: Low oestrogen and HGH

    Think osteoporosis. Just one or two years without the correct level of estrogen can really compromise bone strength. Any idea of the cause of endocrine abnormality? Any hx of pituitary adenoma or thyroid disorder?

    My sister was dx with prolactinoma (symptoms included reduced levels of estrogen and HGH) at 23 and now, at 46, has substantial osteoporosis and, unfortunately, acquired acromegaly from (wrongly) prescribed excessive synthetic growth hormone. There is a fantastic thyroid support forum here,;

    http://www.tpa-uk.org.uk/index.php

    Cheers,
    Bel
     
  3. toomoon

    toomoon Well-Known Member

    I think it would depend on how low we are talking here.

    the research i have been involved with at Melbourne Uni look at groups of women on the MOCP and those not on the pill, and how circulating oestragen affected neuromuscular coordination and tendon compliance in the Achilles tendon, amongst other things.

    what we found was that the MOCP downregulated plasma oestragen levels by approximately 70%, and that unlike women not taking the pill, oestragen levels were linear across a 28 day menstual cycle.
    We found there was not difference in muscle size or strength between the groups, and both these findings are consistent with the literature.
    We found an increase in tendon compilance (stretchiness) at about day 14 (ovulation) in the group NOT taking the pill, and that gross mediolateral acceleration in the NP group had significantly (P=0.022) increased variability at the time of menstruation compared to ≈ovulation, and was also significantly (P=0.011) more variable than the MOCP group at the corresponding time point. No significant difference was observed for any measure in the MOCP group. I have attached 3 papers that may be of interest to you and others, that also go into some detail inrelation to the mechanical, neuromuscular and physiologic actions of oestragen in the female athlete.

    i have no experienc ewith HGH

    none of this may help you in your dilemma, but I would suggest that perhaps the fact that the issues seem to be primarily musculoskeletal vs bone, it may be worth working with the physician and endocrinologist to look at re-establishing endogenous oestragen to a level expected in a woman taking the MOCP. All the evidenc points towards this being protective of musculoskeletal and neuromotor motivated injury in women

    best
    Simon
     
  4. Kahuna

    Kahuna Active Member

    Thanks Bel and Simon ... Great stuff!
     
  5. blinda

    blinda MVP

    Noticed the tag on this thread `female issues` :confused: Do we have tags for `unmentionables`, or `male issues`and of course `midlife crisis`? :D

    Just me then.
     
  6. admin

    admin Administrator Staff Member

    Can you think of a better term? The female issues tag is for topics such as this one; pregnancy issues; menopause; the female athlete triad etc
    Tags get created when there are more than a few threads on related topics ... unfortunately, there are not enough threads on any of those topics!
     
  7. blinda

    blinda MVP

    Nah, just made me smile :drinks
     
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