Can't Take HRT? Here's What You Need to Know | SOLO

0:02:08 Tyna Moore (host)needs contextmoderate

Estrogen depletion is associated with increased tearing of ligaments and tendons.

"I get that you're having tissues tearing—ligaments and tendons like to start tearing as estrogen leaves the building." (said at 0:02:08)

Estrogen plays a key role in regulating collagen turnover and connective tissue homeostasis. The decline in estrogen during menopause is linked to reduced collagen synthesis, impaired tendon remodeling, and an increased incidence of degenerative tendinopathies and tendon tears (such as rotator cuff and Achilles pathology). However, for ligaments, higher estrogen levels or hormonal fluctuations are typically what increase tissue laxity and susceptibility to acute ligament tears (such as ACL injuries), rather than low estrogen alone. The risk of soft tissue injury across perimenopause and menopause involves an interplay of hormonal shifts, mechanical loading, and age-related tissue degeneration.

supports: Effect of estrogen on tendon collagen synthesis, tendon structural characteristics, and bi… (Journal of applied physiology (Bethesda, Md. : 1985) 2009) · cited 163x in the literature
"In conclusion, estradiol administration was associated with higher tendon FSR and a higher relative number of smaller fibrils. Whereas this indicates stimulated collagen turnover in the resting state, collagen responses to exercise were negatively associated with s-estradiol. These results indicate a pivotal role for estradiol in maintaining homeostasis of female connective tissue." (abstract, results, passage verified)
pubmed full study (doi)
supports: Effects of transdermal estrogen on collagen turnover at rest and in response to exercise i… (Journal of applied physiology (Bethesda, Md. : 1985) 2012) · cited 43x in the literature
"Menopause is associated with loss of collagen content in the skin and tendon as well as accumulation of noncontractile tissue in skeletal muscle." (abstract, results, passage verified)
pubmed full study (doi)
context: Hormonal Shifts and Structural Strain: A Literature Review of Menopause and Perimenopause … (Annals of rehabilitation medicine 2026)
"Estrogen plays a multisystem role in maintaining trabecular bone integrity, collagen turnover, and neuromuscular coordination. Its abrupt loss causes bone demineralization (2%-5% annually in early menopause), impairs tendon repair, and contributes to sarcopenia. Fluctuating estradiol levels during perimenopause may transiently increase ligament laxity, further destabilizing joints. Common injuries such as Achilles and rotator cuff tendinopathies, plantar fasciitis, and stress fractures are amplified by low bone mineral density, prior fracture history, aromatase inhibitor use, and rapid increases in physical activity." (abstract, results, passage verified)
pubmed full study (doi)

0:41:39 Tyna Moore (host)needs contexthigh

Outside of teenagers, middle-aged women have the highest rate of suicide among female age demographics.

"There is a reason why women and middle-aged women are the highest group of women that unalive themselves once we get past like teenagers." (said at 0:41:39)

According to national vital statistics surveillance data from the Centers for Disease Control and Prevention (CDC) and National Center for Health Statistics (NCHS), middle-aged women (typically ages 45–54 and 55–64) consistently have the highest completed suicide rate among all female age groups. The claim is accurate regarding middle-aged women having the peak suicide rate among females, but the qualification "outside of teenagers" requires context: while adolescent females experience high rates of suicidal ideation and suicide attempts, and suicide ranks high as a proportional cause of death among youth, completed suicide mortality rates in teenage females are substantially lower than those observed in middle-aged women.

context: Increase in Suicide in the United States, 1999-2014. (NCHS data brief 2016) · cited 589x in the literature
"The percent increase in suicide rates for females was greatest for those aged 10-14, and for males, those aged 45-64." (abstract, results, passage verified)
pubmed
context: Suicide Mortality in the United States, 1999-2019. (NCHS data brief 2021) · cited 423x in the literature
"As the second leading cause of death for ages 10-34 and the fourth leading cause for ages 35-54, suicide is a major contributor to premature mortality" (abstract, results, passage verified)
pubmed
context: Suicide Mortality in the United States, 2002-2022. (NCHS data brief 2024) · cited 146x in the literature
"Following a period of decline between 2018 and 2020, suicide rates generally increased between 2020 and 2022 for females ages 25 and older." (abstract, results, passage verified)
pubmed full study (doi)

Can't Take HRT? Here's What You Need to Know | SOLO

Needs context

Estrogen depletion is associated with increased tearing of ligaments and tendons.

Outside of teenagers, middle-aged women have the highest rate of suicide among female age demographics.