The Hidden Link Between Hormones and Pain 激素与疼痛之间的隐藏关联

许多进入围绝经期或绝经期的女性，都会预期出现潮热、情绪波动或睡眠困难。但常让她们意外的是，疼痛会突然出现或明显加重。无论是关节僵硬、背部不适、头痛还是月经痛，许多女性发现身体出现了自己意料之外的疼痛，而且这些往往没有人讨论过，也没有人提前告知。

Many women entering perimenopause or menopause expect hot flashes, mood swings, or difficulty sleeping. What often surprises them,  however, is the onset or intensification of pain. Whether it’s joint stiffness, back discomfort, headaches, or menstrual pain, many women find that their bodies hurt in ways they didn't expect, and often in ways that weren't discussed or prepared for.

这一阶段的疼痛常被归结于衰老或压力，但女性很少被告知：激素波动是这类不适的重要驱动因素。雌激素、孕酮和睾酮等激素会影响身体对疼痛的反应；当这些激素在围绝经期和绝经期波动并下降时，疼痛体验可能加重。

Pain during this stage is often dismissed as part of aging or stress, but what women are rarely told is that hormonal fluctuations are a major driver of this discomfort. Hormones like estrogen, progesterone, and testosterone influence how our bodies respond to pain, and as these levels fluctuate and decrease during perimenopause and menopause, the experience of pain can intensify.

1️⃣关节僵硬和疼痛

许多女性会出现手、膝、髋和肩部不适，常在早晨或长时间不活动后加重。这通常与雌激素下降有关，因为雌激素对关节和组织有保护作用。

2️⃣ 肌肉酸痛

有些女性会发现，进行相对轻微的活动后就会出现肌肉疼痛，或者日常活动后也会感到酸痛。激素变化可能干扰肌肉修复和组织柔韧性，使肌肉更容易发生拉伤和僵硬。

3️⃣ 颈部、肩部和上背部疼痛

颈部、肩部和上背部的紧张性疼痛在绝经期较为常见，常与这一时期许多女性面临额外的心理和身体压力有关。肩周炎（即粘连性关节囊炎）会导致肩关节僵硬和疼痛，在这一时期也更常见。不良姿势、久坐办公、情绪压力，以及影响关节和结缔组织健康的激素变化，都可能促成这些疼痛。

4️⃣ 头痛和偏头痛

雌激素水平波动会诱发头痛和偏头痛。许多女性反馈头痛模式发生改变，在围绝经期变得更频繁或更剧烈。

5️⃣ 下背部和盆腔不适

激素变化可影响盆腔区域，导致下背痛或盆腔沉重感。这通常与盆底肌和韧带的变化有关，这些结构会因雌激素下降而失去力量和柔韧性。

6️⃣ 疼痛敏感性增强

许多围绝经期和绝经期女性反馈，疼痛比以前更敏锐。这称为痛觉过敏，即对疼痛的敏感性增高，与激素变化直接相关。

1️⃣ Joint Pain and Stiffness

Many women experience discomfort in their hands, knees, hips, and shoulders, often exacerbated in the morning or after periods of inactivity. This is commonly linked to the decline in estrogen, which protects the joints and tissues.

2️⃣ Muscle Aches and Soreness

Some women notice muscle pain after relatively light activity or feel sore after routine movements. Hormonal changes can interfere with muscle repair and tissue flexibility, leaving muscles more prone to strain and stiffness.

3️⃣ Neck, Shoulder, and Upper Back Pain Tension pain in the neck, shoulders, and upper back is common during menopause, often linked to the additional mental and physical stress many women face at this time. Frozen shoulder (adhesive capsulitis), a condition that causes stiffness and pain in the shoulder joint, is also more common during this period. Poor posture, desk jobs, emotional stress, and hormonal changes that affect joint and connective tissue health can all contribute to these pain patterns.

4️⃣ Headaches and Migraines

 Fluctuating estrogen levels are a known trigger for headaches and migraines. Many women report that their headache patterns change, becoming more frequent or intense during perimenopause.

5️⃣ Lower Back and Pelvic Discomfort

Hormonal shifts can affect the pelvic region, leading to lower back pain or pelvic heaviness. This is often due to changes in the pelvic floor muscles and ligaments, which lose strength and flexibility due to declining estrogen.

6️⃣ Increased Pain Sensitivity

Many women in perimenopause and menopause report that they experience pain more acutely than before. This is known as hyperalgesia, a heightened sensitivity to pain, which is directly related to hormonal changes.

激素与疼痛之间的这种关联不常被讨论，原因有几个：

疼痛常被归因于压力或衰老： 女性常被告知疼痛只是变老的一部分，尤其是关节不适或肌肉酸痛。

症状重叠： 许多症状与其他疾病重叠，容易造成混淆或误诊。

认识不足： 更年期在临床教育中代表性仍不足，许多医生可能未充分了解激素波动如何导致疼痛。

文化沉默： 围绝经期和绝经期疼痛很少被公开讨论，使女性更难求助，也更难被理解。

There are a few reasons why this hormonal connection to pain is not commonly discussed:

• Pain is often dismissed as stress or aging: Women are often told that pain is simply part of getting older, especially when it comes to joint discomfort or muscle aches.

• Symptom overlap: Many of these symptoms overlap with other medical conditions, leading to confusion or misdiagnosis.

• Lack of awareness: Menopause is still a subject that is underrepresented in clinical education, and many doctors may not be fully aware of how hormone fluctuations contribute to pain.

• Cultural silence: Pain in perimenopause and menopause is rarely openly discussed, making it harder for women to seek help or feel understood.