Can menopausal hormone therapy, exercise improve pain and function in postmenopausal women with greater trochanteric pain syndrome?

Greater trochanteric pain syndrome (GTPS) is a debilitating chronic disorder that is most prevalent in postmenopausal women

The aim of this study was to determine the effect of MHT and exercise on tendon pain and function in postmenopausal women with GTPS, which was level 1 evidence following a randomized controlled clinical trial

Figure 1 Source of the article

The study randomized postmenopausal women with GTPS (N = 132; n = 12, lost to follow-up) to MHT and a placebo transdermal cream, with or without specific tendon exercise

Figure 2 Flowchart of participants moving through the trial

The primary outcome was the Victorian Sports Injury Rehabilitation Research Centre (VISA-G) to assess the specific condition of gluteal tendinopathy, the VISA-G score, and the secondary outcome was a global change rating measured at baseline and at 12 and 52 weeks, using Linear mixed effects models were used to assess differences

Figure 3 Changes in outcome measure scores over time: (A) participants with BMI <25, (B) participants with BMI <30, (C) participants with BMI ≥30 and (D) VISA-G for all participants Score, BMI as a covariate; (E) AQoL score for participants with BMI <25; (F) HOOS-QoL score for participants with BMI <25

There were no differences between exercise groups for all outcome measures (VISA-G: Baseline, P = .

The population was stratified according to BMI level (<25, <30, ≥30)

MHT or placebo, with or without specific muscle exercise, combined with exercise education, reduced pain and enhanced tendon function to varying degrees in this population

Targeted exercises, or strategies to avoid fixed-zone exercises, are effective when educating on glute stress avoidance and load management

This treatment option could be explored in people with other persistent tendinopathy, such as Achilles tendon, rotator cuff, and lateral elbow tendinopathy in the postmenopausal population

The results of this study suggest that topical MHT absorption may change with increasing BMI, but there is no evidence to support this theory

But the study did not follow participants between 12 and 52 weeks after the intervention

In conclusion, MHT or placebo in combination with tendon-specific or sham exercises, coupled with education on avoidance of gluteus tendon compression and load management, reduced pain and enhanced function in this population
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Women with a BMI <25 who were assigned MHT in any exercise plus mission had better outcomes than women who were assigned a placebo cream in any exercise plus mission
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Original article:

Cowan RM, Ganderton CL, Cook J, Semciw AI, Long DM, Pizzari T.
Does Menopausal Hormone Therapy, Exercise, or Both Improve Pain and Function in Postmenopausal Women With Greater Trochanteric Pain Syndrome? A 2 × 2 Factorial Randomized Clinical Trial.
Am J Sports Med.
2021 Dec 13:3635465211061142.