BHRT Support for Joint Health and Flexibility Solutions

BHRT Support for Joint Health and Flexibility

Abstract

Hormone levels naturally change with age. During menopause, estrogen levels can fall sharply, while aging men may experience a gradual decline in testosterone. These changes can affect bones, muscles, joints, sleep, energy, and overall physical function. For some properly selected patients, hormone therapy may indirectly support better mobility by helping manage menopause symptoms, preserve bone health, or improve muscle function. However, bioidentical hormone replacement therapy (BHRT) is not a direct treatment for flexibility, and it should not be viewed as a way to instantly loosen tight muscles or restore joint range of motion.

The strongest approach often combines medical evaluation with movement-based care. At Injury Medical Clinic PA in El Paso, Texas, Dr. Alexander Jimenez, DC, APRN, FNP-BC, CCST, CFMP, IFMCP, ATN, integrates chiropractic care, functional medicine, rehabilitation, and movement training. Dr. Maria Guadalupe Cardenas, MD, a board-certified internal medicine physician with more than four decades of experience, provides medical direction and collaborative physician oversight. This type of multidisciplinary approach allows hormone-related health concerns and mechanical movement problems to be evaluated as different but connected parts of a patient’s health.

Can Bioidentical Hormone Therapy Help With Mobility and Flexibility?

The short answer is possibly—but mostly in an indirect way.

Bioidentical hormone therapy may help certain people feel more comfortable moving when symptoms are related to hormone loss. For example, declining estrogen during menopause has been associated with increased joint and muscle symptoms. Research shows that muscle and joint pain become more common during perimenopause and after menopause (Overton et al., 2026).

If properly prescribed hormone therapy improves symptoms such as joint discomfort, poor sleep, loss of muscle strength, or bone loss, a patient may find it easier to exercise, stretch, walk, and participate in rehabilitation.

That is different from saying BHRT directly creates flexibility.

Mobility describes how well a joint moves through its usable range of motion with control.

Flexibility describes how well muscles and other soft tissues can lengthen.

Hormones may affect some of the tissues that make movement possible, but flexibility still requires movement, stretching, strength, coordination, and healthy joint mechanics.

Why Hormone Changes Can Affect the Way You Move

Hormones communicate with tissues throughout the body. Estrogen and testosterone do much more than influence reproductive health.

Hormonal changes can affect:

• Muscles
• Bones
• Tendons
• Connective tissues
• Cartilage
• Sleep
• Pain sensitivity
• Energy
• Body composition
• Exercise recovery

This is one reason a person going through menopause may suddenly notice that the knees, hips, shoulders, hands, or lower back feel different.

A recent review of more than 93,000 women found that about 40% of premenopausal women reported muscle or joint pain, compared with about 57% of perimenopausal women and 59% of postmenopausal women (Li et al., 2026).

Mobility Bone & Joint Institute also notes that falling estrogen during menopause may be associated with more inflammation, stiffness, and discomfort, while reduced physical activity, changing body weight, and lower bone density can add additional stress to joints.

Estrogen, Joint Stiffness, and Movement

Estrogen receptors are found in many musculoskeletal tissues. This gives estrogen several possible connections to joint health.

Researchers have studied whether falling estrogen may contribute to:

• Increased joint pain
• Changes in inflammatory signaling
• Faster loss of muscle mass
• Changes in cartilage metabolism
• Changes in bone density
• Greater pain sensitivity

Maven Clinic’s 2026 review explains that estrogen decline may be one part of menopause-related joint pain, while poor sleep, muscle loss, weight changes, and reduced activity can also contribute (Maven Team, 2026).

Hormone therapy has shown some benefits for joint symptoms, but the effect should not be exaggerated.

In the Women’s Health Initiative randomized trial involving 10,739 postmenopausal women with previous hysterectomy, estrogen therapy produced a modest but sustained reduction in joint pain compared with placebo (Chlebowski et al., 2013). The difference was real but relatively small.

A newer systematic review involving 57 studies and almost four million participants found no significant overall effect of hormone replacement therapy on generalized musculoskeletal pain. Results for conditions such as osteoarthritis also varied between studies (Overton et al., 2026).

In other words, hormone therapy may help some patients, but it should not be prescribed simply as a joint-pain medication or flexibility treatment.

Hormone Therapy and Bone Health

Bone strength is another important part of long-term mobility.

Estrogen helps control the normal cycle in which old bone is removed and new bone is created. After menopause, falling estrogen can speed bone loss. Weaker bones increase the risk of osteoporosis and fractures, which can greatly reduce a person’s ability to stay active.

The North American Menopause Society states that menopausal hormone therapy can prevent bone loss and reduce fracture risk in appropriately selected patients (The North American Menopause Society Advisory Panel, 2022).

Protecting bone density does not directly make someone more flexible. However, strong bones provide a better foundation for:

• Walking
• Resistance exercise
• Balance training
• Chiropractic rehabilitation
• Strength development
• Maintaining independence with age

This is an important example of how hormone therapy may support mobility indirectly.

Testosterone, Muscle Strength, and Physical Function

It also deserves attention, especially in men with confirmed testosterone deficiency.

Testosterone helps support muscle protein, lean body mass, and strength. Research involving older men with low testosterone has found modest improvements in muscle strength and certain measures of physical performance after testosterone treatment.

A 2023 systematic review of 13 randomized studies involving more than 2,000 older men found that testosterone replacement improved muscle strength, especially among men starting with lower testosterone levels (Nam et al., 2023).

A three-year randomized study also found improvements in lean mass, muscle power, and stair-climbing performance, although researchers noted that the long-term clinical importance of these changes remained uncertain (Storer et al., 2017).

This does not mean testosterone should be used in people with normal hormone levels simply to improve mobility. Testosterone therapy requires proper diagnosis, medical evaluation, laboratory monitoring, and ongoing risk assessment.

BHRT Does Not Replace Movement

One of the most important points is simple:

Hormones cannot replace exercise.

Even when hormone therapy reduces symptoms, the body still needs movement to build strength and mobility.

A useful mobility program may include:

• Regular walking
• Resistance training
• Gentle stretching
• Hip and shoulder mobility exercises
• Core strengthening
• Balance exercises
• Proper breathing mechanics
• Progressive rehabilitation

Maven recommends regular movement, resistance exercise, and other lifestyle measures alongside appropriate medical care for menopause-related joint symptoms.

Essentrics describes mobility as a combination of flexibility, strength, control, and connective-tissue function. This helps explain why simply changing a hormone level cannot replace physical training (Cyr, 2025).

Where Integrative Chiropractic Care Fits

This is where integrative chiropractic care may complement medical hormone management.

Hormone therapy addresses a medical and hormonal problem when a qualified clinician determines treatment is appropriate.

Chiropractic care and rehabilitation address many mechanical aspects of movement.

Depending on the patient’s condition, integrative chiropractic care may focus on:

• Restoring comfortable joint motion
• Improving spinal and extremity mechanics
• Reducing muscle guarding and tension
• Improving posture
• Addressing movement imbalances
• Building strength around vulnerable joints
• Improving coordination and stability
• Gradually returning the patient to exercise

Chiropractic treatment should not be presented as a method for directly correcting estrogen, progesterone, or testosterone levels. Instead, its value in an integrated hormone program is largely mechanical and functional: helping the person use the mobility that better overall health may make possible.

Dr. Jimenez’s Clinical Observations

Dr. Alexander Jimenez, DC, APRN, FNP-BC, CCST, CFMP, IFMCP, ATN, has written extensively about combining functional medicine, hormone evaluation, chiropractic care, and movement-based rehabilitation.

In his published clinical observations, Dr. Jimenez reports that gentle pelvic and lower-back care may help some patients improve hip mechanics and reduce pelvic tension when used alongside appropriate medical treatment. He also emphasizes pain-free movement prescriptions so patients can participate more consistently in aerobic and resistance exercise. These observations represent clinical experience and should be considered alongside published scientific research rather than treated as proof that chiropractic care changes hormone levels.

This concept creates an important distinction:

Medical care can address appropriate hormonal needs, while chiropractic and rehabilitation can address how the body moves.

A Multidisciplinary Model in El Paso, Texas

At Injury Medical Clinic PA in El Paso, this approach involves collaboration between different licensed professionals.

Dr. Maria Guadalupe Cardenas, MD, is listed by the practice as:

• Board-certified in internal medicine
• Medical Director and Collaborative Physician
• NPI #1164426749
• Texas MD License #J2933
• An internist with more than 40 years of clinical experience

Dr. Cardenas works alongside Dr. Alex Jimenez, DC, APRN, FNP-BC, whose clinical focus includes chiropractic care, functional medicine, rehabilitation, personal injury care, musculoskeletal health, and related wellness services.

In this multidisciplinary setting, responsibilities can remain within each professional’s licensed scope.

Medical evaluation and oversight can address issues such as:

• Hormone-related symptoms
• Medical history
• Laboratory findings
• Medication considerations
• Cardiovascular and metabolic risk
• Treatment monitoring
• Referral when necessary

Chiropractic and rehabilitation services can focus on:

• Spine and joint function
• Movement mechanics
• Strength
• Posture
• Mobility
• Injury rehabilitation
• Return to activity

The clinic describes this team-based structure as integrating chiropractic care, medical oversight, nurse practitioner care, rehabilitation, diagnostics, functional medicine, and injury recovery.

An Important Note About the Term “Bioidentical”

Patients should understand what bioidentical actually means.

A bioidentical hormone has a chemical structure that matches a hormone produced by the human body. Importantly, bioidentical does not automatically mean compounded, natural, safer, or better.

Many FDA-approved prescription hormone products contain bioidentical estradiol or progesterone.

Other bioidentical hormones are custom compounded by pharmacies.

Mayo Clinic states that there is no evidence that compounded bioidentical hormones are safer or more effective than conventional FDA-approved hormone therapy. Compounded products also do not go through the same FDA approval and quality-control process as commercially manufactured prescription products (Mayo Clinic Staff, 2024).

The Endocrine Society similarly recommends caution with compounded hormone products because dose and purity may vary and strong evidence showing advantages over FDA-approved therapy is lacking.

So, Can BHRT Make You More Flexible?

Not directly.

BHRT does not automatically loosen tight hamstrings, restore a restricted hip, correct poor posture, or improve a stiff spine.

But when a true hormone-related condition is contributing to problems such as joint discomfort, loss of muscle mass, poor sleep, low energy, or bone loss, carefully selected hormone therapy may remove some of the barriers that make movement difficult.

That can create a better opportunity for exercise, chiropractic care, rehabilitation, nutrition, and strength training to do their jobs.

The most useful goal, therefore, is not simply to “raise the hormones.”

The goal is to help the patient:

move better, become stronger, protect the joints and bones, and remain physically active for as many years as possible.

Final Thoughts

Bioidentical hormone therapy can be one part of a broader mobility and healthy-aging plan, but it is not a stand-alone flexibility treatment.

The best results are more likely to come from identifying why someone has become stiff or less mobile. Hormone changes may be one piece of the problem. Joint restrictions, previous injuries, muscle weakness, poor posture, inactivity, sleep problems, weight changes, and degenerative conditions may be other pieces.

A multidisciplinary model can evaluate these factors together.

For patients in El Paso, the collaboration between Dr. Maria Guadalupe Cardenas, MD, and Dr. Alexander Jimenez, DC, APRN, FNP-BC, at Injury Medical Clinic PA represents this type of integrated approach: medical oversight for appropriate health and hormone concerns combined with chiropractic care, functional medicine, personal injury care, rehabilitation, and movement-based strategies.

Treatment should always be individualized. Hormone therapy has benefits and risks, and the right medication, dose, route, and duration depend on a person’s age, symptoms, medical history, laboratory findings, and individual risk factors.

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References

BodyLogicMD Medical Review Board. (2025, April 10). How BHRT supports joint health and reduces chronic pain. BodyLogicMD.

Chlebowski, R. T., Cirillo, D. J., Eaton, C. B., et al. (2013). Estrogen alone and joint symptoms in the Women’s Health Initiative randomized trial. Menopause, 20(6). https://doi.org/10.1097/GME.0b013e31828392c4

Cyr, A. (2025). Mobility for menopause. Essentrics.

Endocrine Society. (2019). Compounded bioidentical hormone therapy. Endocrine Society.

Jimenez, A. (2026). Patient wellness and health with bioidentical hormones. DrAlexJimenez.com.

Jimenez, A. (2026). Physician-led integrative chiropractic care in El Paso. DrAlexJimenez.com.

Maven Team. (2026, July 14). HRT and joint pain in menopause: Causes, relief, and evidence. Maven Clinic.

Mayo Clinic Staff. (2024, October 3). Bioidentical hormones: Are they safer?. Mayo Clinic.

Mobility Bone & Joint Institute. (2025). A guide to joint health after menopause. Mobility Bone & Joint Institute.

Nam, Y. S., et al. (2023). Effects of testosterone replacement therapy on muscle strength in older men with low to low-normal testosterone levels: A systematic review and meta-analysis. Gerontology.

Overton, R., Amini, P., Chew, A., Babatunde, O., Mason, K. J., Rathod, S., Welsh, V., & Burton, C. (2026). The effect of hormone replacement therapy on musculoskeletal pain in menopausal women: A systematic review and meta-analysis. https://doi.org/10.1177/20533691251403087

The North American Menopause Society Advisory Panel. (2022). The 2022 hormone therapy position statement of The North American Menopause Society. Menopause, 29(7), 767–794. https://doi.org/10.1097/GME.0000000000002028