Estrogen, Whole-Body Physiology, and Evidence-Based Clinically Integrated Care
Abstract:
In this educational post, I present a comprehensive, evidence-informed perspective on sex hormones—emphasizing estrogen’s multi-system roles—and how modern chiropractic, physical therapy, and integrative rehabilitation strategies support whole-person outcomes. Drawing on leading research and my clinical observations, I unpack persistent myths around estrogen and disease risk, clarify receptor pharmacology, and explain why individualized optimization benefits bone integrity, neuroprotection, cardiovascular resilience, and pain modulation. I prioritize musculoskeletal, neurological, and metabolic care pathways: spinal biomechanics, neurodynamic mobilization, neuromuscular re-education, fascial health, and graded, outcome-driven functional rehabilitation.
Evidence-Based Estrogen Physiology, Spine Health, and Functional Rehabilitation: An Integrated Care Guide by Dr. Alexander Jimenez, DC, APRN, FNP-BC, CFMP, IFMCP, ATN, CCST
Setting the Stage: From Symptom Suppression to Systems Integration
I have spent years helping patients move away from an allopathic mindset that equates care with symptom suppression. The better question is not “What can we prescribe to stop a symptom?” but “What physiological process is dysregulated, and how do we restore homeostasis?” In spine and musculoskeletal care, the same principle holds: rather than masking low back pain with short-term fixes, we assess alignment, tissue load, sensory-motor control, inflammatory balance, and lifestyle drivers. This is where the modern evidence on sex hormones—kept in perspective—interfaces with chiropractic and physical therapy: hormones modulate tissue turnover, neural plasticity, pain processing, and endothelial health. That means targeted manual therapy, corrective exercise, gait retraining, and neurodynamic techniques often work better and last longer when the underlying physiology is supported.
Key mindset shifts I encourage:
Focus on root-cause, systems-based thinking
Use individualized, evidence-guided plans over one-size-fits-all protocols
Blend manual therapy, functional exercise, and lifestyle medicine with measured medical input when necessary
Estrogen Is Not Just About Hot Flashes: Whole-System Physiology
The misconception that estrogen is simply about vasomotor symptoms ignores the breadth of its actions. Estrogen receptors (ERα and ERβ) are distributed across bone, brain, heart, gut, immune cells, and connective tissue. In clinical musculoskeletal care, that matters because estrogen influences:
Bone remodeling and osteoblast/osteoclast signaling
Synaptic plasticity and descending pain modulation
Microglial and astrocyte activation states after CNS injury
Endothelial nitric oxide signaling and vascular health
Collagen metabolism and fascial hydration, which affect tissue glide and mobility
Why this matters in rehab:
Patients with insufficient estrogen often present with increased pain sensitivity, slower tissue healing, and reduced tolerance for load progression.
Optimized physiology supports more predictable gains from spinal stabilization, hip-hinge retraining, and eccentric tendon protocols.
Better vascular and neural function improves the efficacy of neurodynamic mobilizations and sensory-motor integration.
Receptor Pharmacology: Precision Matters for Clinical Outcomes
Receptors are not passive docks; they are signal transducers. Progesterone binds the progesterone receptor, androgens bind androgen receptors, and estrogens bind ERα/ERβ. Synthetic molecules (progestins) may occupy receptors without delivering the intended genomic and non-genomic actions, a phenomenon that can block beneficial signaling. From a rehabilitation perspective:
If beneficial signaling is blocked, we may see blunted neuroplastic changes despite effective exercise programming.
An accurate understanding of receptor biology helps anticipate tissue response and time rehabilitation phases more effectively.
In practice at El Paso Back Clinic:
We keep hormones and medications in the background, emphasizing manual therapy, mobility restoration, and load management.
When medical collaboration is needed, we use it to complement—not replace—restorative musculoskeletal care.
Bone Health, Load Tolerance, and Progressive Conditioning
Bone is a living, mechanosensitive tissue. All three sex hormones—estrogen, progesterone, and testosterone—have receptors on osteoblasts, osteoclasts, and osteocytes. Estrogen supports bone mineral density and reduces excessive resorption; testosterone and progesterone also contribute to bone integrity. Clinically, this is why:
Progressive weight-bearing and impact training (when appropriate) stimulates osteogenesis through mechanotransduction.
Spinal alignment and hip control distribute forces safely, avoiding stress concentrations.
Eccentric loading of tendons helps collagen alignment, improving functional stability around load-bearing joints.
Treatment reasoning:
We sequence care: mobility and pain modulation first, then neuromuscular control, then graded strength, then task-specific power and endurance.
For osteopenic patients, we use low- to moderate-impact drills with careful progression, augmented by balance training to reduce fall risk.
Breathing mechanics and rib-pelvis coordination enhance axial load management through the thoracolumbar fascia.
Brain Health, Pain Processing, and Neurodynamic Rehabilitation
Estrogen and testosterone influence apoptosis, beta-amyloid deposition, and synaptic signaling. Estrogen exhibits neuroprotective and immunomodulatory effects, stabilizing microglial and astrocytic behavior. In clinical practice:
Central sensitization is addressed with layered strategies: education, graded exposure, sensorimotor retraining, breath-led parasympathetic activation, and movement variability.
Neurodynamic tests and mobilizations (median, ulnar, radial, and sciatic biasing) are more effective when systemic inflammation is controlled.
Cognitive clarity and mood stability improve adherence and motor learning; sleep quality amplifies consolidation of motor patterns.
What I see in the clinic:
Patients with more stable physiology (including balanced estrogen) progress faster in lumbar stabilization and cervical deep flexor training.
Headache and neck pain with neurovascular components respond better to upper cervical mobilization, rib mobility, and scalene/SCM load management when endothelial and autonomic tone are optimized.
Cardiovascular Protection, Endothelial Function, and Exercise Capacity
Vascular health influences how well tissues are perfused during rehabilitation. Estrogen supports nitric oxide signaling, reduces vascular inflammation, and slows the progression of atherosclerosis in appropriate contexts. Clinical application:
Interval walking, tempo cycling, or rower intervals increase endothelial nitric oxide bioavailability; this improves recovery between strength sets and accelerates tissue oxygenation.
Calf pump drills and thoracic expansion work aid venous return, complementing manual therapy for patients with leg heaviness or postural orthostatic issues.
Better endothelial function correlates with improved VO2 kinetics and perceived exertion; patients sustain longer, more productive sessions.
Gut-Brain Axis, Inflammation, and Tissue Recovery
The gut metabolizes estrogen and communicates via immune and neural pathways. Dysbiosis and barrier dysfunction can amplify systemic inflammation and pain. In PT-chiropractic care:
We encourage anti-inflammatory nutrition, hydration, movement, healthy snacks, and stress modulation to support the microbiome.
Improved gut-brain signaling often leads to reduced hyperalgesia and faster normalization of myofascial tone.
Clinical protocols I favor:
Low-friction gliding techniques and pin-and-stretch when fascial adhesions are prominent
Segmental stabilization with diaphragmatic breathing to reduce sympathetic drive
Chiropractic and Physical Therapy Integration: Practical Pathways
I design integrated plans that prioritize spinal mechanics, functional strength, and neuromuscular timing, reserving medical adjustments to support—not lead—the process.
Core elements we use:
Manual therapy:
High-velocity, low-amplitude (HVLA) adjustments for segmental dysfunction when indicated
Joint mobilizations (grades I–IV) to restore physiological motion
Soft tissue release for paraspinals, deep hip rotators, and thoracic extensors
Spinal stabilization sequences: dead bug progressions, bird dog with anti-rotation focus, short-lever side planks
Hip hinge and split-stance patterns to load glutes and protect the lumbar spine
Neurodynamics:
Sliders and tensioners are applied judiciously with symptom-guided dosing
Cervicobrachial interface mobilization with scapular control
Mobility:
Thoracic extension and rotation drills to offload lumbar segments
Hip external/internal rotation restoration to normalize gait mechanics
Conditioning:
Stationary cycling, incline walking, or sled pushes for controlled metabolic load
Eccentric calf and hamstring protocols for tendon resiliency
Why these techniques:
HVLA can reset aberrant segmental mechanics, enabling more efficient firing of stabilizers.
Joint mobilizations and soft tissue work reduce nociceptive input, clearing the way for motor learning.
Neurodynamic work normalizes nerve glide, often reducing distal symptoms and improving strength expression.
Conditioning ensures that tissues tolerate the demands of life; mitochondria and capillaries adapt to support performance and pain resilience.
Clinical Observations at El Paso Back Clinic
Across thousands of patient encounters, I consistently observe:
When we stabilize the spine and retrain movement, symptoms improve faster if systemic inflammation is reduced.
Women entering perimenopause often report new-onset visceral fat and diffuse pain; restoring movement patterns and engaging progressive strength rapidly improves function, while physiology support fine-tunes consistency.
Post-stroke and concussion patients benefit from breath-paced mobility, vestibular-visual integration, and gentle cervical/thoracic mobilizations; progress accelerates when sleep and autonomic balance improve.
Men with persistent low back pain frequently show poor hip internal rotation and gluteal inhibition; targeted hip work plus spinal mechanics yields durable change.
Pain Modulation: Descending Inhibition and Predictable Progressions
Estrogen has documented effects on pain circuitry, including regulation of descending inhibitory pathways. Rather than discussing hormones directly with every patient, we operationalize the concept:
Educate on pain neurobiology to reduce fear
Use graded exposure with tolerable, repeatable tasks
Pair manual therapy with precise motor tasks immediately afterward to lock in pattern changes
Reinforce daily rituals: short mobility blocks, walking intervals, breath cues
This sequence exploits neuroplastic windows:
Manual therapy reduces nociception
Movement patterns encode efficient muscle synergies
Repetition consolidates synaptic changes
Sleep and recovery protect gains
Alzheimer’s, Cognition, and Rehabilitation Adherence
Cognition influences adherence, safety, and learning. The research base links balanced estrogen physiology to improved executive function in specific populations. Clinically, we:
Simplify instructions and use chunked, repeatable cues
Add dual-task drills at the right time (e.g., marching with head turns)
Use a metronome or breath cues to enhance rhythm and memory encoding
Gate progression by consistent performance rather than calendar dates
Cardiometabolic Integration: Weight, Visceral Fat, and Movement
Visceral adiposity can reduce tissue perfusion and amplify inflammatory signaling. Movement is medicine:
Prioritize daily steps and posture resets
Add glute and midline strength to redistribute loads from passive structures
Use intervals to improve insulin sensitivity and autonomic balance
Track waist circumference, step count, and perceived exertion; these map to functional outcomes in spine care
Individualized Care Over Rigid Rules
Consensus statements have evolved toward individualized decision-making for therapy type, dose, route, and duration in specialized contexts. In our rehab-first model:
We do not rely on blanket discontinuation or time-limited protocols
We reassess regularly, adjusting exercise intensity, manual therapy frequency, and home programming
Medical collaboration is case-based, primarily for safety and systemic support, while the backbone remains movement, alignment, and neuro-muscular conditioning
Safety, Nuance, and Clinical Reasoning
Safety is anchored in thorough assessment:
Screen for red flags, neurological deficits, vascular risk, and bone integrity
Tailor mobilization and manipulation intensity to tissue status and patient response
Advance loads using “stable form, stable symptoms” criteria
In complex cases (e.g., cancer history, stroke), coordinate with medical teams and emphasize gentle, progressive care with clear outcome metrics
What Patients Can Expect at El Paso Back Clinic
A detailed movement and neurological assessment
A clear plan anchored in functional goals
Manual therapy to unlock mobility
Progressive strength and neurocontrol to protect gains
Education and lifestyle guidance to support inflammation control and recovery
Transparent outcome tracking and friendly accountability
Step accrual goals matched to baseline (e.g., +1,000 steps from current baseline)
Foundational strength: hinges, rows, carries, and anti-rotation presses
Sleep routine and light exposure to anchor the circadian rhythm
Hydration and protein targets to support tissue repair
Closing Perspective: Teach People How Not To Be Sick
The best testimonial is a patient who no longer needs constant care. When physiology supports tissue health and when movement patterns are robust, people return to life—lifting kids, walking hills, and working without pain. My role is to guide, adjust, and progress your plan thoughtfully. Evidence keeps us honest; clinical observation keeps us human. At El Paso Back Clinic, chiropractic precision and physical therapy science meet to build durable outcomes.
In-text citations:
Estrogen and cognition, neuroprotection, and immunomodulation (e.g., Brinton, 2009; Pike et al., 2022).
Bone health and sex hormone receptors; osteogenesis under load (e.g., Khosla, 2010; Manolagas, 2010).
Cardiovascular endothelial function with estrogen; nitric oxide signaling (e.g., Mendelsohn & Karas, 2005).
Pain modulation and estrogen’s role in CNS injury responses (e.g., Vegeto et al., 2003).
Clinical practice position statements emphasizing individualized approaches (e.g., The North American Menopause Society, 2017).
Proactive Spine and Joint Care: Evidence-Based Chiropractic, Physical Therapy, and Integrative Rehabilitation for Better Patient Outcomes
Abstract
This post explores the historical evolution of modern medicine, tracing its path from protocol-driven practices in the 19th and 20th centuries to the rise of the pharmaceutical industry and the current “pill-for-an-ill” model. I will discuss the widespread use of medications like statins and the emerging evidence suggesting potential downsides, particularly regarding brain health and immune function. As a Doctor of Chiropractic and Advanced Practice Registered Nurse, I have observed the limitations of a purely reactive, symptom-based system. This article advocates for a fundamental shift towards proactive, personalized healthcare that integrates evidence-based chiropractic care, physical therapy, and nutritional science. We will delve into why a “one-size-fits-all” approach is failing our patients and how a holistic, patient-centered model that addresses the root cause of dysfunction—rather than just masking symptoms—is essential for restoring true health and vitality. We’ll examine the importance of critical thinking, medical freedom, and the powerful role of integrative therapies in transforming patient outcomes and reshaping the future of medicine.
As a healthcare professional with a diverse background spanning chiropractic (DC), advanced practice nursing (APRN, FNP-BC), and functional medicine (CFMP, IFMCP), I’ve had a unique vantage point from which to observe the landscape of modern health. My clinical experience at the El Paso Back Clinic has reinforced a core belief: to truly heal, we must look beyond symptoms and address the whole person. This post presents the latest findings from leading researchers and my own clinical observations to advocate for a more integrated, proactive approach to your health.
The Rise of the Pill: A Shift in Medical Thinking
The trajectory of modern medicine has been fascinating and, in some ways, troubling. The early 1900s saw science and industry reshape healthcare, leading to incredible advancements. However, this era also paved the way for a business-centric model. By the 1980s, a significant shift occurred, with a prioritization of standardized protocols that aligned perfectly with the rise of Big Pharma.
A landmark moment came in 1987 with the introduction of the first statin medication. This event solidified a new paradigm in patient care: conduct a blood test, identify a number outside the “normal” range, and prescribe a pill to correct it. This “number-and-a-pill” approach became the cornerstone of chronic disease management.
Let’s look at the most prescribed medications in the United States today. Data projections for 2025 are staggering:
Statins: Over 200 million patients.
Metformin: 150 million patients.
Ibuprofen: 56 million patients.
These numbers reveal a system heavily reliant on pharmaceutical intervention. While these drugs can be life-saving in acute situations, their long-term use for chronic conditions requires careful consideration, particularly in light of the physiological consequences.
The Statin Dilemma: Unintended Consequences for Brain and Body
For decades, the prevailing medical wisdom has been to lower cholesterol levels aggressively to prevent heart disease. While the intention is beneficial, we must ask critical questions about the downstream effects of this strategy.
What is cholesterol? It’s not an evil substance to be eradicated. In fact, cholesterol is a vital component of every cell membrane in your body. It is particularly crucial for the brain. Your brain’s volume is largely composed of cholesterol, which is essential for forming neuronal connections and ensuring proper neurological function.
So, when we systemically suppress cholesterol levels with statins, what are the potential long-term effects? Emerging research and clinical observations suggest we may be inadvertently contributing to another epidemic: Alzheimer’s disease and dementia. What was once considered a rare disease is now frighteningly common. A growing body of evidence indicates a correlation between chronically low cholesterol levels and an increased risk of cognitive decline (Du et al., 2018). We are, in essence, potentially shrinking our patients’ brains in the pursuit of a specific number on a lab report.
Furthermore, a study from February 2025 revealed another critical role of cholesterol: it fuels dendritic cells, which are key players in the immune system. These cells are activated by tumors and help mount a stronger immune response to cancer (Ringel et al., 2023). By reflexively crushing cholesterol, are we also dampening our body’s natural ability to fight disease? This is a question we must have the courage to ask.
From a chiropractic and physical therapy perspective, I see patients whose primary complaints of musculoskeletal pain, weakness, and fatigue are often intertwined with systemic issues. It is not uncommon for patients on long-term statin therapy to report muscle aches and weakness, which can significantly hinder their progress with physical rehabilitation and chiropractic adjustments. Addressing the whole physiological picture is paramount.
The Current System: Reactive, Impersonal, and Ineffective
My experience with the conventional medical system, even as a patient, has often felt cold and impersonal. The typical waiting room experience—the sterile environment, the focus on insurance cards and numbers—reflects a larger problem. The system is designed for efficient processing of people, not for fostering healing relationships. This is the “here’s your pill, see you in six months” model of sick care.
This reactive approach was further entrenched in 2010 with the Affordable Care Act, which brought big insurance and big government into an even closer alliance with big pharma. The result has been a multi-trillion-dollar industry focused on medical research and pharmaceutical sales, while reimbursement for practitioners—the ones providing hands-on care—continues to shrink. The global pharmaceutical industry’s net profit in 2024 was estimated at a staggering $1.7 trillion.
Despite this massive expenditure, we are sicker than ever. We spend nearly $4.9 trillion annually on healthcare in the U.S., yet chronic diseases like diabetes, heart disease, and autoimmune conditions are rampant. The people I see every day in my clinic—our friends, family, and neighbors—are not getting well. They are being managed, their symptoms band-aided, but the underlying causes of their diseases are rarely addressed.
A New Path Forward: Proactive, Personalized Healthcare
The good news is that patients and practitioners are starting to question this broken model. There is a growing demand for something different, something better. The core principle that medicine has forgotten is that choice isn’t optional; it’s everything.
A “one-size-fits-all” approach to health makes no logical sense. Each of us is genetically and biochemically unique. We have different histories, lifestyles, and environmental exposures. How can we possibly expect the same protocol, the same medication, and the same dosage to work for everyone? At my clinic, this is a foundational principle. Treatment plans for chronic low back pain or post-surgical recovery are always tailored to each individual’s specific needs, functional capacity, and health goals.
Today, we stand at a crossroads. We can continue down the path of reactive sick care, or we can choose to become proactive champions of true healthcare. This means shifting our mindset:
We go to the doctor to stay well, not just because we are sick.
We treat patients, not lab reports or imaging studies.
We dig into the root cause of disease rather than just silencing symptoms.
The Return of Curiosity and Critical Thinking
To make this shift, we must revive curiosity and critical thinking in medicine. It takes character to admit that what we’ve been doing may not be the best way. It’s easy to defend the status quo, but it takes courage to step back, look at the evidence, and say, “We can do better.”
I am not anti-allopathic medicine. We have the most remarkable surgical and emergency care in the world. The problem isn’t the tools; it’s the over-reliance on a single tool—the prescription pad—for every problem. The cycle of “a pill for this, and another pill for the side effect of that” has led us astray.
We must remember that we are treating human beings, not pieces of paper. How often does a practitioner stare at a lab report while the patient sits before them, unheard? True healing begins when we put down the paper and engage with the person. In my practice, the patient’s story—their subjective experience of pain, their daily struggles, their goals—is just as important as the objective findings from a physical exam or an X-ray. It’s in that conversation that we uncover the clues to the root cause of their suffering.
Nutrition and Lifestyle: The Missing Pillars of Health
For years, integrative practitioners have championed the role of nutrition in health, often to the skepticism of the mainstream. Now, the tide is turning. Major institutions are finally acknowledging that advising patients on nutrition fosters a more holistic and comprehensive approach to health. Addressing a patient’s diet can dramatically increase their response to other therapies, including chiropractic care and physical therapy. Chronic inflammation, often driven by a poor diet, can stall healing and perpetuate pain cycles. By incorporating nutritional guidance, we can reduce systemic inflammation, providing a better physiological environment for tissues to heal and respond to manual therapies.
Your cells don’t have a political affiliation. They respond to the information they are given—whether it comes from food, movement, or stress. We must start treating food as the powerful medicine it is. The change may be slow, but the science is clear. Following the evidence on nutrition will profoundly shift our patients’ health over the next five to ten years.
Similarly, we are seeing a re-evaluation of long-held beliefs, such as the idea that estrogen causes cancer. New evidence has led the FDA to reconsider its stance, recognizing that bioidentical hormone therapy may actually protect the heart, brain, and bones. While our clinic’s focus is on musculoskeletal health, we recognize that hormonal balance plays a crucial role in tissue repair, inflammation, and overall well-being. Acknowledging this interplay is part of a truly integrative approach.
Breaking Free from Cognitive Inertia
One of the major obstacles to progress is a psychological phenomenon known as cognitive inertia. This is the human tendency to stick with familiar mental models and resist information that challenges our existing beliefs—a form of confirmation bias.
Albert Einstein famously said, “We cannot solve our problems with the same thinking we used when we created them.” We must get out of our own way. We have to be willing to challenge our biases and embrace a new way of thinking that prioritizes the individual.
This means transitioning from treating the masses to personalizing medicine. We must remember the humanity of our patients. They are mothers, fathers, teachers, and grandparents. They are the fabric of our community. When they don’t feel well, they cannot fully participate in their own lives. Helping them regain their health, vitality, and life itself is the true calling that brought most of us to medicine in the first place.
The Future of Medicine Begins Now
On March 27, 2026, we embark on a new journey. This is the day we commit to a different path. History remembers the practitioners who didn’t just follow the system, but transformed it. Today, that responsibility belongs to us. We have the option to either remain within the confines of an outdated model or to initiate a change.
Let’s make this our finest hour. Let’s:
Treat patients, not cases.
Provide proactive healthcare, not reactive sick care.
Be integrative, not just allopathic.
Become true wellness and healthcare providers.
The future of medicine is about restoring health freedom—your freedom as a patient to choose the care that is right for you, and our freedom as practitioners to provide it. It’s about empowering you with the knowledge and tools to take control of your health. It’s about digging deeper, treating smarter, and never forgetting the person behind the pain.
References
Du, F., Yu, Q., Li, X., & Cao, Y. (2018). The role of cholesterol in the pathogenesis of Alzheimer’s disease. Journal of Alzheimer’s Disease, 63(4), 1223–1235. https://doi.org/10.3233/JAD-180026
Ringel, A. E., Drijvers, J. M., Baker, G. J., Cato, L., Sir-Dane, K. A., Gyonfi, A., & Haigis, M. C. (2023). Cholesterol biosynthesis inhibition reprograms the tumor immune microenvironment to allow for effective combination immunotherapy. Science Advances, 9(33), eadg7537. https://doi.org/10.1126/sciadv.adg7537
BHRT, EvexiPEL, and Whole-Body Hormone Care at El Paso Back Clinic
Bioidentical Hormone Replacement Therapy, or BHRT, is often discussed as a way to help people feel more like themselves again when hormone levels drop or become unbalanced. It may help with symptoms such as low energy, poor sleep, mood changes, lower sex drive, mental fog, and body composition changes. But at El Paso Back Clinic, the message should be clear: hormone care should never be treated like a stand-alone shortcut. It works best when hormonal symptoms are reviewed alongside thyroid health, metabolic health, inflammation, gut function, stress load, and overall body mechanics. That type of full-picture care aligns with the clinic’s integrative model, which combines chiropractic care, functional medicine, and advanced nursing under the care of Dr. Alexander Jimenez, DC, APRN, FNP-BC. (Cleveland Clinic, 2022; EVEXIAS Health Solutions, n.d.; El Paso Back Clinic, 2026).
What BHRT Means
Bioidentical hormones are hormones designed to closely match those the human body naturally produces. Cleveland Clinic explains that BHRT is used to help manage symptoms related to menopause or other hormone imbalances, and that these hormones can come in several forms, including pills, creams, patches, gels, injections, and pellets. Cleveland Clinic also notes that some bioidentical options are FDA-approved, while custom-compounded versions are less studied and may carry more uncertainty. That matters because patients often hear the word “natural” and assume “risk-free,” but that is not always true. (Cleveland Clinic, 2022; Cleveland Clinic, 2024).
In simple terms, BHRT is not just about replacing hormones. It is about determining whether hormones are the primary issue, which hormones are low or imbalanced, and whether other systems are also involved. A person with fatigue, weight gain, poor focus, low motivation, or digestive problems may have a hormone imbalance, but they may also have thyroid dysfunction, insulin resistance, poor sleep, chronic stress, inflammation, or nutritional problems. That is why careful medical review matters before treatment begins. (Cleveland Clinic, 2024; EVEXIAS Health Solutions, n.d.).
Why This Topic Fits El Paso Back Clinic
El Paso Back Clinic is not just a back pain site. The published clinical model emphasizes integrative care that connects structural health, metabolic health, gut function, inflammation, and advanced nursing support. The clinic’s materials describe a team approach that combines chiropractic care, functional medicine, lab testing, and personalized plans. Dr. Alexander Jimenez’s published content also connects thyroid health, metabolism, inflammation, and gut function rather than treating each complaint as a separate issue. That makes BHRT a natural fit for the site when it is presented as one part of a broader healing strategy, not as a single magic answer. (El Paso Back Clinic, 2026; Jimenez, n.d.).
For a spine and wellness audience, this matters even more because hormone problems can affect the whole body, including:
energy and recovery
sleep quality
muscle tone and body composition
inflammation levels
mood and stress tolerance
motivation for exercise and rehab
digestive comfort and gut regularity
When those systems are off, recovery from back pain, mobility, and overall function can also suffer. That is why a whole-person clinic can add value to hormone care. (El Paso Back Clinic, 2026; EVEXIAS Health Solutions, n.d.).
What EvexiPEL Pellet Therapy Is
EVEXIAS Health Solutions describes EvexiPEL as a clinically advanced BHRT method that uses tiny hormone pellets placed just under the skin during a simple in-office procedure. According to EVEXIAS, those pellets then release a steady, physiologic dose of hormones over about 3 to 6 months. The company presents this as a way to reduce the ups and downs that some people experience with daily creams, pills, patches, or more frequent injections. (EVEXIAS Health Solutions, n.d.).
That steady-release idea is one reason many patients are interested in pellet therapy. EVEXIAS states that pellets are designed to provide more consistent delivery and fewer “peaks and valleys” than some other delivery methods. For patients who do not want to remember daily or weekly dosing, that convenience can be appealing. At the same time, pellets are still a medical treatment, which means the patient needs the right workup, the right dosing plan, and the right follow-up. Convenience should never replace careful clinical judgment. (EVEXIAS Health Solutions, n.d.; Cleveland Clinic, 2024).
Why Thyroid and Metabolic Health Must Be Checked
One of the most important points for El Paso Back Clinic readers is that not every “hormone problem” starts with estrogen or testosterone. EVEXIAS says its testing protocols include sex hormone panels, advanced thyroid profiles with antibodies, adrenal stress and cortisol rhythm assessments, and metabolic markers such as insulin and A1C. That is a strong reminder that hormonal complaints often overlap with thyroid, adrenal, and metabolic health. (EVEXIAS Health Solutions, n.d.).
Dr. Jimenez’s metabolic thyroid content makes a similar point. His published thyroid articles explain that thyroid dysfunction can affect metabolism and can overlap with inflammation, chronic symptoms, and gut-related problems. In his educational materials, he also connects endocrine function with nutrition and whole-body recovery. This supports an important clinical idea: if someone has fatigue, poor exercise recovery, digestive symptoms, stubborn weight changes, or brain fog, the best next step is often a full workup rather than a guess. (Jimenez, n.d.).
This full workup may help answer questions like:
Is the problem mainly estrogen, progesterone, or testosterone related?
Is low thyroid function part of the picture?
Is stress chemistry affecting symptoms?
Is insulin resistance driving fatigue and weight gain?
Is chronic inflammation making everything worse?
Are gut issues interfering with absorption and recovery?
That kind of careful thinking aligns with how El Paso Back Clinic presents its broader care philosophy. (EVEXIAS Health Solutions, n.d.; El Paso Back Clinic, 2026).
Gut Health, Inflammation, and Hormone Balance
Many people who seek BHRT do not just complain about hormones. They also talk about bloating, constipation, poor digestion, mood swings, sleep trouble, and stubborn inflammation. The recent gut-health content from El Paso Back Clinic indicates a practical connection between the spine, gut, inflammation, and metabolism. The clinic’s published articles describe root-cause approaches that combine lab testing, nutrition support, and structural care. Dr. Jimenez’s thyroid and gut education also connects chronic inflammation with digestive imbalance and endocrine stress. (El Paso Back Clinic, 2026; Jimenez, n.d.).
This does not mean BHRT alone fixes gut health. It means hormone symptoms should be reviewed in a broader context. If a patient is exhausted, inflamed, constipated, bloated, gaining abdominal weight, and sleeping poorly, it makes sense to look at hormones, thyroid function, gut health, stress load, and nutrition together. That whole-body view is one of the strongest ways to position BHRT at El Paso Back Clinic. (EVEXIAS Health Solutions, n.d.; El Paso Back Clinic, 2026).
How an Integrative Clinic Can Improve BHRT Results
EVEXIAS says its broader model can include advanced lab testing, hormone therapy, targeted nutraceuticals, and peptide therapy as part of a personalized plan. Its functional and integrated health framework also includes support for the thyroid, adrenal, metabolic, and gut systems, as well as inflammation. That approach lines up well with the type of clinical ecosystem readers expect from El Paso Back Clinic. (EVEXIAS Health Solutions, n.d.).
At an integrative clinic, BHRT may be stronger when it is paired with:
full lab testing before treatment
thyroid and metabolic review
nutrition counseling
gut and inflammation support
peptide support when clinically appropriate
sleep, stress, and lifestyle coaching
chiropractic and rehab strategies that help the body move and recover better
El Paso Back Clinic’s own content states that the strongest results occur when chiropractic, functional medicine, and advanced nursing work together. The site describes this mix as a way to improve mobility, calm inflammation, support nerve function, and build long-term health. For a patient who is also struggling with low energy, hormone imbalance, or metabolic stress, that kind of coordinated care can be especially helpful. (El Paso Back Clinic, 2026; EVEXIAS Health Solutions, n.d.).
Clinical Observations From Dr. Alexander Jimenez
Dr. Alexander Jimenez’s published materials describe a multidisciplinary model built around chiropractic care, advanced nursing, functional medicine, imaging, lab review, and personalized recovery plans. El Paso Back Clinic’s recent clinical posts state that when structural treatment is paired with nutrition, hormone support, and metabolic care, patients often report increased energy, reduced inflammation, and improved overall function. The clinic also emphasizes that improved alignment, nerve function, and reduced inflammation can support recovery beyond just pain relief. (El Paso Back Clinic, 2026; Jimenez, n.d.; LinkedIn, n.d.).
For a BHRT article geared toward El Paso Back Clinic, the clinical takeaway is simple: the body functions as a single system. If hormones are off, the patient may also struggle with movement, sleep, inflammation, digestion, and stress resilience. If the spine and nervous system are stressed, that may also affect recovery, activity levels, and how well a patient responds to lifestyle changes. The strongest plan is one that respects both structure and chemistry. (El Paso Back Clinic, 2026).
Risks and Why Monitoring Matters
Cleveland Clinic is clear that all hormone replacement therapy comes with risks and that compounded bioidentical hormones may carry additional uncertainty because their long-term effects are not as well studied. Cleveland Clinic also says some people are not good candidates for hormone therapy and that treatment decisions should be based on symptoms, medical history, and an informed discussion with a healthcare provider. (Cleveland Clinic, 2022; Cleveland Clinic, 2024).
That is why a responsible BHRT program should include the following:
a full health history
lab work before treatment
a review of thyroid and metabolic markers
discussion of risks, benefits, and alternatives
regular follow-up for symptoms and side effects
dose adjustments when needed
For El Paso Back Clinic readers, this is an important message: smart hormone care is individualized, monitored, and tied to the patient’s bigger health picture. It is not just about giving more hormones. It is about finding the right level of support for the right patient at the right time. (Cleveland Clinic, 2024; EVEXIAS Health Solutions, n.d.).
Final Thoughts
BHRT can be a useful tool for the right patient, especially when symptoms are truly linked to hormone decline or imbalance. EvexiPEL pellet therapy offers a steady-delivery option that many patients find appealing, as it is designed to release hormones over 3 to 6 months. Still, the best hormone care does not stop at pellets or prescriptions. It looks at thyroid health, metabolism, inflammation, gut function, stress, nutrition, sleep, and physical recovery as a whole. That whole-body approach is exactly what makes this topic a strong fit for El Paso Back Clinic. (EVEXIAS Health Solutions, n.d.; El Paso Back Clinic, 2026; Cleveland Clinic, 2024).
Why Gut Pain Persists Even When Eating Healthy: Root Causes and Integrative Chiropractic Solutions at El Paso Back Clinic
Many people switch to salads, fresh fruits, whole grains, and lean proteins, hoping their stomach troubles will finally end. They cut out fast food and feel optimistic. Yet the bloating, cramps, and pain often continue or even worsen. At El Paso Back Clinic in El Paso, Texas, Dr. Alex Jimenez, DC, APRN, FNP-BC, CFMP, IFMCP, sees this pattern daily. As a leading injury specialist and scientific chiropractor, he explains that persistent gut pain often stems from underlying issues such as leaky gut, hidden food sensitivities, low stomach acid, and insufficient digestive enzymes. The clinic’s integrative chiropractic approach identifies and addresses these root causes rather than just masking symptoms. They blend gentle spinal adjustments, functional medicine testing, and targeted nutrition for real, lasting relief.
Leaky gut, also known as increased intestinal permeability, is a common hidden reason why pain lingers. The lining of the small intestine should work like a smart filter. It lets nutrients pass into the bloodstream while keeping out bacteria, toxins, and undigested food. When the lining gets damaged, tiny gaps form. Harmful particles slip through and trigger immune responses. This creates inflammation that shows up as gut pain, fatigue, brain fog, or skin problems.
Here are key factors that can weaken the gut lining:
Frequent use of pain relievers like ibuprofen or antibiotics
Too much alcohol or processed foods
Ongoing stress that keeps the body in fight-or-flight mode
Dysbiosis, an imbalance of good and bad gut bacteria
Environmental toxins or past infections
These triggers break the tight junctions between cells, allowing leaks that spark body-wide inflammation.
Hidden food sensitivities make the problem even trickier
You might eat what seems like healthy food—avocados, chicken, or broccoli—yet still feel discomfort hours later. These are often delayed reactions, unlike the rapid swelling seen in true allergies. Once particles leak through a damaged gut, the immune system makes antibodies. This leads to constant low-level irritation and pain in the intestines.
Low stomach acid and insufficient digestive enzymes add to the struggle. Stomach acid normally breaks down food and kills harmful germs. Enzymes from the pancreas chop proteins, fats, and carbs into pieces the body can absorb. Stress, aging, or antacid medicines lower acid levels, so food sits half-digested. Undigested bits then feed harmful bacteria, create gas, and irritate the lining. Healthy meals alone cannot fix this cycle.
The spine plays a surprising role in gut health, which is why El Paso Back Clinic specializes in connecting back care to digestion. The vagus nerve runs from the brain through the neck and spine down to the stomach and intestines. It controls acid production, enzyme release, and proper gut movement. Misalignments in the upper back or neck tension from poor posture, injuries, or desk work can pinch or irritate this nerve. When vagus signaling slows, digestion lags, bacteria overgrow, and leaky gut worsens. Many patients who come in for back pain or sciatica also report stubborn gut issues that improve once spinal alignment is restored.
Dr. Alex Jimenez has observed these spine-gut connections for years in his clinical practice at El Paso Back Clinic
His dual training as a Doctor of Chiropractic and a Family Nurse Practitioner allows him to treat both structural problems and functional imbalances. Gentle chiropractic adjustments restore proper nerve flow, reduce inflammation, and support better digestion. Patients with chronic back pain, bloating, and fatigue often see major improvements when the clinic addresses the full picture. Dr. Jimenez uses advanced testing and personalized plans that include nutrition, supplements, and spinal care to resolve symptoms standard diets miss.
Dysbiosis and chronic stress frequently hide behind “healthy” eating struggles. Dysbiosis means the trillions of gut microbes get out of balance. Helpful bacteria that digest fiber and make vitamins decline, while harmful ones produce gas and toxins. Stress keeps the body from entering the calm “rest-and-digest” mode. The vagus nerve cannot function well, so acid and enzymes stay low, and the gut lining stays irritated.
Small Intestinal Bacterial Overgrowth (SIBO) takes this further. When nerve interference or low acid slows movement, bacteria that belong in the large intestine migrate upward. They ferment food too early in the small intestine, causing pressure, bloating, and pain. Even a vegetable-rich diet can feed SIBO if the root spinal or nerve issue remains untreated.
El Paso Back Clinic stands out because they treat the whole person. They do not simply hand out another diet sheet. Instead, the team listens to your full story—back pain history, stress levels, sleep, past injuries, and posture. They order precise functional tests and combine them with chiropractic adjustments for a custom plan.
Here are common steps in a gut-healing protocol used at the clinic:
Temporarily remove irritants while testing to find exact triggers
Add bone broth, fermented foods like sauerkraut, and fiber-rich vegetables to feed good bacteria
Use digestive enzymes and herbal bitters before meals to boost acid and break down
Sip warm ginger or chamomile tea to calm the nervous system and improve motility
Practice slow, mindful eating with deep breaths to activate the vagus nerve
Include supportive herbs like marshmallow root and calendula to repair the lining
These steps work best when paired with spinal adjustments and lab results
Testing matters more than guessing. Simply changing diets without knowing the cause often fails. One person might need extra acid support. Another might fight SIBO linked to vagus nerve pressure from neck strain. A third could have a hidden sensitivity to gluten or dairy. Functional labs check stool microbes, measure gut permeability, or scan for food antibodies. Dr. Jimenez and the El Paso Back Clinic team use these tools, plus chiropractic exams, to build plans that last.
The nervous system strongly affects digestion. Eating while stressed or in a rush keeps the body in fight-or-flight. Digestion slows, food sits longer, and the gut lining stays open. Simple daily habits help: take five slow breaths before meals, chew thoroughly, and eat without distractions. These cues tell the vagus nerve it is safe to produce acid, release enzymes, and move food smoothly.
Healing takes time
The gut lining renews every few days, but full repair often needs weeks or months of consistent care. Professional guidance at a clinic like El Paso Back Clinic prevents wasted effort on random changes. Many patients feel surprised when pain fades once the real issue is fixed. One client who ate only clean foods still had daily cramps until tests revealed SIBO and low enzymes. After chiropractic adjustments, targeted nutrition, and stress work, digestion normalized. Another person who had ongoing back pain and bloating felt better when integrated care fixed hidden sensitivities and tension in the vagus nerve.
El Paso Back Clinic also links low secretory IgA—a key gut defense—to leaky gut and autoimmunity. Their approach combines stress reduction, anti-inflammatory eating, and supplements to rebuild defenses. The team emphasizes functional nutrition that heals from the inside out while keeping the spine aligned to optimize nerve flow.
In the end, ongoing gut pain despite healthy eating is your body’s way of asking for help. It often points to leaky gut, sensitivities, poor digestion, dysbiosis, or nerve interference due to spinal issues. Targeted testing and root-cause care at El Paso Back Clinic deliver real results. Dr. Alex Jimenez and the team show how chiropractic science, functional medicine, and personalized protocols turn pain into steady wellness. Listen to the signals, get evaluated, and take step-by-step action. Your gut—and your back—will thank you.
Embrace functional wellness to enhance your quality of life. Find valuable insights to help you feel your best during menopause.
Flourishing Through Menopause: A Comprehensive Guide to Functional Wellness, Chiropractic Care, and Integrative Therapies for Symptom Relief
Introduction: Understanding Functional Wellness During Menopause
Menopause represents one of the most significant transitions in a woman’s life, marking the end of reproductive years while ushering in a new chapter of health and wellness. For millions of women worldwide, this natural biological process brings with it a constellation of symptoms that can significantly impact quality of life, from hot flashes and mood changes to joint pain and musculoskeletal discomfort. The clinical rationale for functional wellness becomes particularly important during menopause, as this approach addresses the root causes of symptoms rather than simply masking them with medications. nourishhousecalls+1
Functional wellness emphasizes a holistic, patient-centered approach that considers the interconnected nature of body systems, lifestyle factors, and environmental influences. During the menopausal transition, when hormonal fluctuations can trigger cascading effects throughout the body, this integrative perspective offers women comprehensive strategies to manage symptoms while optimizing overall health. Rather than viewing menopause as a disease requiring treatment, functional wellness recognizes it as a natural process that can be supported through targeted nutrition, physical therapies, stress management, and lifestyle modifications. clevelandclinic+2
The musculoskeletal system deserves special attention during menopause, as declining estrogen levels directly impact joint health, bone density, muscle mass, and connective tissue integrity. Research indicates that approximately 71% of perimenopausal women experience musculoskeletal pain, making it one of the most common yet often overlooked symptoms of this life transition. Joint stiffness, muscle aches, and widespread body pain can significantly diminish quality of life and limit physical activity precisely when exercise becomes most crucial for maintaining health. orthopedicsri+2
Nonsurgical treatments such as chiropractic care, acupuncture, and massage therapy offer evidence-based options for addressing menopausal symptoms without the potential side effects associated with pharmaceutical interventions. These therapies can be combined with nutritional strategies, exercise programs, and lifestyle modifications to create personalized care plans that address each woman’s unique needs and health goals. dutchessbraincore+2
What is Menopause?
Menopause is a natural biological process that marks the permanent end of menstrual cycles and fertility. It is clinically defined as occurring after 12 consecutive months of amenorrhea (absence of menstruation) not linked to a pathological cause. While menopause itself is a single point in time—the moment when a full year has passed without a menstrual period—the transition encompasses several years of hormonal changes that can produce symptoms affecting virtually every system in the body. pmc.ncbi.nlm.nih+1
The average age of menopause for women in the United States is 51 years old, though this can vary significantly between individuals. Some women experience menopause in their early 40s, while others may not reach this milestone until their late 50s. The timing is influenced by genetics, lifestyle factors, and overall health status. myobgynvegas
The Biological Mechanism of Menopause
Menopause results from the natural depletion of ovarian follicles over a woman’s reproductive lifespan. Each woman is born with a finite number of eggs, and as these are gradually used during monthly ovulation or naturally degenerate, the ovaries’ capacity to produce hormones diminishes. The pathophysiology involves a rapid decline in the number of primary ovarian follicles, resulting in an inadequate number to respond to follicle-stimulating hormone (FSH). ncbi.nlm.nih+1
When the ovaries can no longer respond adequately to FSH signals from the pituitary gland, several hormonal changes occur: pmc.ncbi.nlm.nih+1
Estrogen production declines significantly, though small amounts may still be produced through conversion from testosterone released by the adrenal glands.
Progesterone production decreases and eventually stabilizes at very low levels.
FSH and luteinizing hormone (LH) levels remain elevated for years after menopause onset due to the lack of negative feedback from ovarian hormones
Testosterone levels do not change as dramatically early in menopause, leading to a relative increase in the testosterone-to-estrogen ratio (ncbi.nlm).nih
This hormonal shift affects virtually every organ system in the body, as estrogen receptors are present throughout tissues, including the brain, heart, bones, joints, skin, and reproductive tract. arthritis+1
The menopausal transition unfolds over three distinct phases, each characterized by different hormonal patterns and symptom experiences.columbusobgyn+3
Perimenopause: The Transitional Phase
Perimenopause represents the years leading up to menopause when the body begins its transition away from reproductive function. This phase typically begins 8 to 10 years before menopause, often starting in a woman’s mid-40s, though it can begin earlier. During perimenopause, hormone levels fluctuate unpredictably, creating a rollercoaster of symptoms that can be challenging to manage. mcpress.mayoclinic+2
The early perimenopause stage is characterized by:columbusobgyn
Shortened follicular phase leading to more frequent menstrual cycles
Occasional hot flashes lasting from seconds to minutes
Mild changes in skin elasticity and breast tenderness
Subtle mood variations and increased stress sensitivity
As perimenopause progresses into the middle and late transition stages, women typically experience: columbusobgyn
Menstrual cycles that vary by seven or more days from normal patterns
More frequent and potentially more severe hot flashes
Increased vaginal dryness and sleep disruption
Daily hot flashes and night sweats that may feel more intense and last longer
Heightened anxiety or mood fluctuations
Menopause: The Defining Moment
Menopause itself is not a phase but rather a single point in time—the day when a woman has gone 12 consecutive months without a menstrual period. At menopause, the body’s production of estrogen, progesterone, and testosterone is significantly reduced, while FSH and LH levels are elevated. samitivejhospitals+2
Postmenopause: The Years Beyond
Postmenopause begins immediately after menopause is confirmed and continues for the remainder of a woman’s life. Most menopausal symptoms gradually decrease in intensity during postmenopause, with some women experiencing significant relief within the first few years. However, certain changes require ongoing attention: joinmidi+1
Bone density continues to decline due to reduced estrogen’s effects on bone remodeling.
Cardiovascular health becomes more vulnerable as estrogen’s protective effects diminish.
Genitourinary changes may persist or develop, including vaginal atrophy and urinary symptoms joinmidi
Common Symptoms of Menopause
Menopause produces a wide spectrum of symptoms that vary dramatically between individuals. myobgynvegas+2
Vasomotor Symptoms
Hot flashes and night sweats are among the most recognizable menopausal symptoms, affecting approximately 75% to 80% of women with varying severity. Hot flashes typically begin as a sudden sensation of warmth spreading through the upper body and face, often accompanied by flushing, sweating, and heart palpitations.templehealth+2
Mood and Cognitive Changes
Hormonal fluctuations during menopause significantly impact brain function and emotional regulation: endocrine
Mood swings ranging from irritability to sadness
Anxiety and increased stress sensitivity
Brain fog is characterized by difficulty concentrating and memory lapses
Depression or persistent low mood
These symptoms result from estrogen’s relationship with serotonin and other neurotransmitters that regulate mood. endocrine
As estrogen declines, significant changes occur in the vulva, vagina, and urinary tract: ncbi.nlm.nih+1
Vaginal dryness and thinning of vaginal tissue
Increased urinary tract infections
Urinary urgency and incontinence
Musculoskeletal Symptoms
Nearly half of menopausal patients experience musculoskeletal symptoms like joint pain: tandfonline+1
Joint pain and stiffness
Muscle aches and loss of grip strength
Frozen shoulder
Loss of lean muscle mass
How Menopause Affects Hormones in the Body
Understanding the hormonal changes that occur during menopause provides crucial insight into why symptoms develop.samitivejhospitals+1
Estrogen: The Primary Change
Estrogen is the primary female hormone with receptors distributed throughout the body. During menopause, estrogen levels drop dramatically—often to less than 10 pg/mL—creating widespread effects. aarp+2
Brain: Impacts mood regulation, memory, and cognitive function
Bones: Accelerates bone resorption, increasing osteoporosis risk
Heart: Removes protective effects on blood vessels
Joints: Reduces cartilage protection and synovial fluid production
Progesterone and Testosterone
Progesterone production decreases during perimenopause as ovulation becomes irregular, then stabilizes at low levels after menopause. Testosterone levels do not decrease as dramatically during early menopause, creating a relative increase in the testosterone-to-estrogen ratio. samitivejhospitals+1
FSH, LH, and Cortisol
FSH and LH levels increase significantly as the pituitary attempts to stimulate unresponsive ovaries. Cortisol levels may be elevated during menopause, contributing to sleep disturbances, weight gain, and mood changes. ncoa+2
How Fluctuating Hormones Affect the Musculoskeletal System
The musculoskeletal system is profoundly affected by the hormonal changes of menopause, yet these effects are often overlooked or misattributed to normal aging. Research has established what experts now term the “musculoskeletal syndrome of menopause.” dralisongrimaldi+2
The Role of Estrogen in Joint and Bone Health
Estrogen plays a vital role in maintaining musculoskeletal health through multiple mechanisms:jointrehab+2
Cartilage Protection: Estrogen helps keep cartilage flexible and supports the production of synovial fluid, which lubricates joints. As estrogen levels decline, cartilage may degrade more rapidly. orthopedicsri
Anti-Inflammatory Effects: Estrogen exhibits anti-inflammatory properties by inhibiting the release of inflammatory cytokines, such as TNF-α and IL-1β. When estrogen declines, inflammation increases throughout the body. pmc.ncbi.nlm.nih+2
Bone Remodeling: Estrogen deficiency leads to accelerated osteoclast activity and increased bone resorption, resulting in bone loss of up to 20% during the menopausal transition. puregym+1
Prevalence of Musculoskeletal Pain
The overall prevalence of musculoskeletal pain in perimenopausal women is approximately 71%. A study including more than 40,000 women found that osteoarthritis was more common among women who had undergone menopause at least one year prior, compared with those who had a recent menstrual period (31% vs. 24%). rheumatologyadvisor+2
Specific Musculoskeletal Effects
Joint Pain and Osteoarthritis: The decline in estrogen accelerates the progression of osteoarthritis, particularly in weight-bearing joints. pmc.ncbi.nlm.nih+1
Muscle Loss (Sarcopenia): Research indicates that compared to women in early perimenopause, those with menopause have 10% less muscle mass in their arms and legs. puregym
Bone Density Loss: Weakened bones are more prone to fractures, increasing the risk of injury in the spine, hips, and wrists. orthopedicsri+1
Weight Gain Impact: Many women experience weight gain during menopause, which can add extra stress to joints. Visceral fat increases from 5-8% to 10-15% of total body weight. puregym
Chiropractic Care for Menopausal Symptoms
Chiropractic care offers a safe, effective, and natural approach to managing menopausal symptoms, particularly those affecting the musculoskeletal system. accidentcarechiropractic+2
How Chiropractic Care Supports Menopausal Women
Hormone Regulation Through Nervous System Support: The spine houses the nerves that control the endocrine system. The hypothalamus plays a significant role in hormone production, and misalignments in the spine can interfere with its functioning. By correcting subluxations, chiropractic care can help regulate hormone production and improve menopausal symptoms. raleighchiropractic+3
Reduced Nervous System Stress: Chiropractic adjustments relieve pressure on the spine and restore proper nervous system function, supporting the body’s ability to regulate hormones more efficiently.familychiropracticcolumbus+1
Improved Circulation: Chiropractic adjustments improve circulation by freeing up restrictions in the spine, helping reduce hot flashes and night sweats. dutchessbraincore+1
Stress Management and Better Sleep: Chiropractic care promotes relaxation, stimulates the parasympathetic nervous system, and improves sleep quality in menopausal women. integratedchiropracticofboca+2
Evidence for Chiropractic Care
Studies published in the Journal of Vertebral Subluxation Research found that chiropractic care was effective in reducing hot flashes, night sweats, and mood swings in menopausal women. The Journal of Manipulative and Physiological Therapeutics reported improved sleep quality in menopausal women receiving chiropractic treatment. dutchessbraincore
Acupuncture Benefits for Menopause
Acupuncture, rooted in Traditional Chinese Medicine, involves inserting thin needles into specific points to stimulate energy flow and restore balance. pmc.ncbi.nlm.nih+1
Research on Acupuncture and Menopause
A study of Japanese women in menopause found that menopausal symptoms were significantly reduced with individualized acupuncture treatments, exclusively due to improvement of musculoskeletal symptoms. Participants experienced relief from fatigue, chronic neck pain, and low back pain. pmc.ncbi.nlm.nih
How Acupuncture Works
Acupuncture provides benefits through several mechanisms: pmc.ncbi.nlm.nih+1
Pain Modulation: Stimulates the release of natural painkillers (endorphins)
Hormonal Effects: May help regulate cortisol and melatonin
Nervous System Regulation: Activates the parasympathetic nervous system
The number of menopausal women is expected to increase from 467 million in 1990 to 1.2 billion in 2030, suggesting acupuncture’s role as an integrative therapy will continue to grow. pmc.ncbi.nlm.nih
Massage Therapy for Menopausal Relief
Massage therapy provides valuable benefits for both physical and emotional well-being during menopause. pubmed.ncbi.nlm.nih+2
Evidence for Massage Therapy
A randomized controlled trial found that both massage and aromatherapy were effective in reducing menopausal symptoms. Research demonstrates that therapeutic massage: pubmed.ncbi.nlm.nih
Decreases the severity of sleep disturbance related to menopause
Reduces insomnia and anxiety-depressive symptoms pmc.ncbi.nlm.nih
Improves overall mood through endorphin release and cortisol reduction westernregionhealth
Benefits of Massage During Menopause
Stress Reduction: Massage reduces stress and anxiety by promoting endorphin release and reducing cortisol levels. westernregionhealth
Muscle Pain Relief: Massage targets muscle knots and tension, providing relief from discomforts common during menopause. westernregionhealth
Physical Therapy and Exercise for Menopausal Health
Physical therapy and exercise represent cornerstones of managing menopausal musculoskeletal symptoms.resilienceorthopedics+2
The Importance of Exercise
Exercise is one of the best treatments for menopause and joint pain:resilienceorthopedics
Joint Health: Strengthens supporting muscles and promotes synovial fluid circulation.
Bone Density: Weight-bearing exercises stimulate bone building uclahealth+1
Muscle Preservation: Resistance training counters sarcopenia puregym
Types of Exercise for Menopausal Women
Resistance Training: The most recommended exercise for menopausal joint pain. Women over 60 with osteoporosis who participated in strength training showed significant improvements in bone density. uchealth+1
Weight-Bearing Exercise: Walking, dancing, and stair climbing promote bone strength. Specialists recommend at least 150 minutes per week of moderate cardiovascular activity. nyulangone
Mind-Body Exercise: Yoga, tai chi, and Pilates significantly improve bone mineral density, sleep quality, anxiety, depression, and fatigue in perimenopausal and postmenopausal women. pmc.ncbi.nlm.nih+1
Aligned & Empowered: Chiropractic Conversations on Women’s Health-Video
Nutrition and Diet for Menopausal Wellness
Nutrition plays a crucial role in managing symptoms and supporting long-term health. pmc.ncbi.nlm.nih+2
The Mediterranean diet has shown particular benefits for menopausal women, associated with better bone mineral density and improved symptoms. rebellehealth+1
Key Nutrients
Calcium: Recommendations of 1200-1300 mg daily for postmenopausal women. pubmed.ncbi.nlm.nih+1
Vitamin D: Intake between 800-900 IU daily, combined with calcium, increases bone mineral density and reduces fracture risk. frontiersin+1
Omega-3 Fatty Acids: Possess anti-inflammatory properties that reduce joint pain. Women who consumed more omega-3 fatty acids had fewer menopausal symptoms. goodrx+1
Protein: Higher intake (approximately 1.2 g/kg body weight) is associated with a 32% lower risk of frailty. pmc.ncbi.nlm.nih
Sleep Hygiene for Menopausal Women
Sleep disturbances affect more than half of menopausal women.swanstudy+1
Evidence-Based Sleep Strategies
Research emphasizes addressing sleep issues early during the menopausal transition. Recommended strategies include: swanstudy
Establish a Regular Sleep Schedule: Go to bed and wake up at the same time each day. womens-health-concern+1
Create an Optimal Sleep Environment: Keep the bedroom cool, dark, and quiet; use cooling sheets; consider a fan. healthline+2
Develop a Relaxing Routine: Allow time to unwind; avoid screens for at least one hour before bed. ncoa+1
Mind Dietary Habits: Avoid caffeine after lunchtime; limit alcohol; avoid spicy foods close to bedtime. swanstudy+1
Cognitive Behavioral Therapy for Insomnia (CBT-I): The most effective treatment for chronic insomnia during menopause. womens-health-concern
Lifestyle Changes for Managing Symptoms
Beyond specific therapies, broader lifestyle changes significantly impact the menopausal experience. whsobgyn+2
Mindfulness meditation: Significantly reduces anxiety, depression, and menopausal symptoms
Yoga: Improves psychological symptoms, sleep, and musculoskeletal pain
Deep breathing exercises: Helps manage hot flashes
Smoking Cessation and Alcohol Moderation
Women who smoke experience more frequent and severe hot flashes. Alcohol can trigger hot flashes and disrupt sleep; limiting intake to no more than one serving per day is recommended. nyulangone
Weight Management
Maintaining a healthy weight reduces joint stress, helps manage hot flashes, and supports cardiovascular health. medlineplus+1
Dr. Alexander Jimenez’s Clinical Observations on Integrative Menopause Care
Dr. Alexander Jimenez, DC, APRN, FNP-BC, CFMP, IFMCP, based in El Paso, Texas, brings over 25 years of expertise in integrative medicine to menopausal care. His dual licensure as a Family Practice Nurse Practitioner and Chiropractor enables patient-centered care, bridging physical medicine, functional medicine, and advanced diagnostics. a4m+1
The Functional Medicine Approach
Dr. Jimenez’s practice emphasizes functional medicine principles, viewing the body as one integrated system. Key elements include: dralexjimenez+1
Comprehensive health assessments evaluating genetics, lifestyle, and environmental factors
Personalized treatment plans tailored to individual health profiles
Integration of conventional and complementary therapies
Patient empowerment through education and active participation
Integrative Treatment Protocols
Dr. Jimenez’s protocols integrate multiple modalities: a4m+1
Chiropractic adjustments for spinal alignment and nerve function
Acupuncture and electro-acupuncture for pain and hormonal balance
Targeted exercise programs focusing on flexibility, mobility, and strength
Massage therapy for muscle tension and stress management
Nutritional counseling supporting hormonal balance and bone health
As Dr. Jimenez emphasizes in his clinical practice, addressing root causes rather than simply treating symptoms produces lasting improvement. His team at Injury Medical & Chiropractic Clinic in El Paso collaborates to deliver personalized treatment plans, ensuring each patient receives care tailored to their unique needs. dralexjimenez+1
Conclusion: Embracing Functional Wellness Through the Menopausal Transition
Menopause represents a significant life transition that, with the right support, can be navigated successfully. The clinical rationale for functional wellness is particularly compelling during this time, as hormonal changes create interconnected effects throughout the body that benefit from integrative, whole-person care. nourishhousecalls+1
The musculoskeletal syndrome of menopause, affecting up to 71% of perimenopausal women, responds well to integrative approaches, including: tandfonline+1
Chiropractic care for spinal alignment and nervous system support
Acupuncture for pain relief and hormonal balance
Massage therapy for muscle tension and stress reduction
Physical therapy and exercise for strength, flexibility, and bone health
Anti-inflammatory nutrition to reduce systemic inflammation
Sleep hygiene to support recovery and hormonal regulation
Stress management through mind-body practices
By embracing functional wellness principles and utilizing evidence-based integrative therapies, women can not only manage menopausal symptoms but truly flourish through this natural life transition. The goal is not merely symptom relief but optimal health, vitality, and quality of life for the years ahead.
Alameda Acupuncture. (2025, March 23). The synergy of acupuncture and chiropractic care: A path to holistic healing. https://alamedaacupuncture.com/?p=5010
Hirota, J., Takayama, M., Nasu, M., Schlaeger, J. M., Yajima, H., & Takakura, N. (2023). Exploration of Japanese women seeking acupuncture for menopausal symptoms: A preliminary study. International Journal of Complementary and Alternative Medicine, 16(6), 344–346. https://doi.org/10.15406/ijcam.2023.16.00674
Hwang, L., & Kolasinski, S. L. (2012). Aromatherapy massage effects on menopausal symptoms: A randomized placebo-controlled study. Menopause, 19(9), 995–999. https://pubmed.ncbi.nlm.nih.gov/22549173/
Innes, K. E., Selfe, T. K., & Vishnu, A. (2010). Mind-body therapies for menopausal symptoms: A systematic review. Maturitas, 66(2), 135–149. https://doi.org/10.1016/j.maturitas.2010.01.016
Oliveira, D., Hachul, H., Tufik, S., & Bittencourt, L. (2011). Effect of massage in postmenopausal women with insomnia – A pilot study. Clinics (São Paulo), 66(2), 343–346. https://doi.org/10.1590/S1807-59322011000200026
Silva, T. R., Oppermann, K., Reis, F. M., & Spritzer, P. M. (2021). Nutrition in menopausal women: A narrative review. Nutrients, 13(7), 2149. https://doi.org/10.3390/nu13072149
Vickers, A. J., Vertosick, E. A., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., … & Acupuncture Trialists’ Collaboration. (2018). Acupuncture for chronic pain: Update of an individual patient data meta-analysis. Journal of Pain, 19(5), 455–474. https://doi.org/10.1016/j.jpain.2017.11.005
Yang, J. L., Hodara, E., Sriprasert, I., Shoupe, D., & Stanczyk, F. Z. (2024). Estrogen deficiency in the menopause and the role of hormone therapy: Integrating the findings of basic science research with clinical trials. Menopause, 31(10), 926–939. https://doi.org/10.1097/GME.0000000000002407
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Find useful information on perimenopause, including potential symptoms and expert tips to cope effectively.
Introduction
Regarding one’s health and well-being, many people often become aware of how their bodies are naturally changing. This may include both male and female hormonal changes as well as the normal skeletal deterioration that occurs inside the joints. Andropause is the period of time when male testosterone levels begin to diminish. Menopause is the natural aging process that begins for women when their levels of the hormones progesterone and estrogen start to decline. Nevertheless, women experience perimenopause prior to menopause taking place. This article will discuss the definition and symptoms of perimenopause, its effects on the musculoskeletal system, and strategies for managing these problems.
What Is Perimenopause?
Do you experience mental fogginess, where you can’t remember what you were doing? How often do your joints ache after doing a simple errand? Or how frequently does your bladder feel full that you constantly need to go to the bathroom? Many of these issues are associated with hormonal changes within the body. For women, perimenopause is a transformative menopausal stage that usually occurs in women in their 40s and early 50s, which is widely recognized for hormonal shifts and reproductive changes in the body.
Additionally, perimenopause usually starts when a woman is dealing with a persistent difference in their menstrual cycle length after 12 months. (Lega & Jacobson, 2024) This is due to the ovarian hormone production of estrogen and progesterone fluctuating unpredictably.
Common Symptoms Of Perimenopause
When it comes to perimenopause, it can affect women differently with its symptoms. Since hormones during perimenopause fluctuate unpredictably. This is because for women, ovarian hormones like estrogen play an important role in maintaining health and homeostasis by modulating the body’s nervous, endocrine, and immune function. (Priyanka & Nair, 2020) Some of the other symptoms that are included with perimenopause are:
Menstrual irregularities: Skipped, prolonged, or heavy periods
Additionally, since perimenopausal symptoms vary from woman to woman, perimenopause can also affect the musculoskeletal system in the body.
Assessing Hormone Therapy- Video
How Perimenopause Affects The Musculoskeletal System
The musculoskeletal system’s various muscles, tissues, andligaments allow the body to be mobile and flexible without pain. However, environmental factors like physical inactivity, poor dietary habits, andchronic issues affect the musculoskeletal system, leading to overlapping risk profiles affecting the body. For perimenopausal women, their musculoskeletal system is affected by fluctuating estrogen hormone levels. When it comes to perimenopause, the musculoskeletal system will begin to develop various issues that can affect the body over time. When a woman is going through perimenopause, their bone mineral density is reduced as well as their muscle mass due to the decline of estradiol. (Wright et al., 2024) This causes the musculoskeletal system to develop:
Increased joint stiffness (especially in the morning) and muscle pain
Osteopenia and osteoporosis
Sarcopenia (loss of muscle mass)
This is due to hormones being associated with inflammation. When a woman has low or fluctuating estrogen hormone levels, it can lead to developmental changes in their pain perception in their muscles. The hormone estrogen is responsible for inhibiting the actions of inflammatory mediators in osteoblasts and stromal cells to ensure that bone mass is reabsorbed into the skeletal system. When perimenopause naturally occurs in the body, estrogen levels decline, and the development of musculoskeletal issues starts to appear.
Managing Perimenopausal Symptoms
Now, when it comes to managing perimenopausal symptoms, many women can start researching non-surgical treatments and incorporating various techniques to help manage the symptoms and reduce any pain from musculoskeletal issues associated with perimenopause. Below are some therapeutic options for perimenopausal women to manage their symptoms and restore their musculoskeletal system.
Hormone Therapy
For many women, hormone replacement therapy remains the gold standard for treating moderate to severe vasomotor and musculoskeletal symptoms. Hormone therapy for perimenopausal women can help restore estrogen production to the body and accelerate skeletal growth. (Moustakli & Tsonis, 2023) Estrogen therapy can:
Reduce joint and muscle pain
Slow bone density loss
Improve overall well-being
Note: HRT is not suitable for everyone, particularly those with a history of breast cancer, thromboembolic disease, or certain cardiovascular conditions. Always conduct a thorough risk-benefit analysis.
Exercise & Nutrition
For perimenopausal women, proper nutrition and exercise can help manage the perimenopausal symptoms and maintain muscle tone. Incorporating nutritional foods with high protein, calcium, and vitamin D can help maintain skeletal muscle mass and regulate proper hormone functioning. (Erdélyi et al., 2023) Combined with exercises, itcan help strengthen weak muscles, improve bone density, and promote flexibility while retaining the joint’s range of motion. Exercises like tai chi are excellent for perimenopausal women as they combine meditation through slow and gentle movements that can lower fracture risk, improve muscle strength, and restore balance functionality. (Li et al., 2023)
Manual Therapies
Many women find relief with:
Acupuncture: Shown to help reduce chronic pain affecting the joints and provide anti-inflammatory effects to the musculoskeletal system. (Zhao et al., 2023)
Mind-body therapies: Meditation, cognitive-behavioral therapy (CBT) to address mood swings and insomnia
Chiropractic and physical therapy: Effective in managing musculoskeletal discomfort
Final Thoughts
For many women, the perimenopause is a normal time of life, and it significantly affects musculoskeletal health. Women may handle this shift with fortitude and resiliency if they remain proactive with lifestyle changes, medical treatments, and routine monitoring. In order to help women feel strong and supported throughout their perimenopausal journey, a customized treatment plan that honors their individual needs might be helpful.
Injury Medical & Functional Wellness Clinic
We associate with certified medical providers who understand the importance of assessing individuals dealing with musculoskeletal issues related to perimenopause. When asking important questions to our associated medical providers, we advise patients to incorporate numerous techniques to reduce pain-like symptoms related to the musculoskeletal system. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.
References
Erdélyi, A., Pálfi, E., Tűű, L., Nas, K., Szűcs, Z., Török, M., Jakab, A., & Várbíró, S. (2023). The Importance of Nutrition in Menopause and Perimenopause—A Review. Nutrients, 16(1), 27. https://doi.org/10.3390/nu16010027
Li, J., Guo, J., Wang, X., Zhang, X., Zhang, Y., Bu, M., Yao, X., & She, Y. (2023). Efficacy and safety of tai chi exercise on bone health: An umbrella review. Osteoporos Int, 34(11), 1853-1866. https://doi.org/10.1007/s00198-023-06830-7
Moustakli, E., & Tsonis, O. (2023). Exploring Hormone Therapy Effects on Reproduction and Health in Transgender Individuals. Medicina (Kaunas, Lithuania), 59(12). https://doi.org/10.3390/medicina59122094
Wright, V. J., Schwartzman, J. D., Itinoche, R., & Wittstein, J. (2024). The musculoskeletal syndrome of menopause. Climacteric, 27(5), 466-472. https://doi.org/10.1080/13697137.2024.2380363
Zhao, F.-Y., Zheng, Z., Fu, Q.-Q., Conduit, R., Xu, H., Wang, H.-R., Huang, Y.-L., Jiang, T., Zhang, W.-J., & Kennedy, G. A. (2023). Acupuncture for comorbid depression and insomnia in perimenopause: A feasibility patient-assessor-blinded, randomized, and sham-controlled clinical trial. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1120567
When it comes to our bodies, many functioning systems help the body regulate its temperature, provide mobility and stability when in motion, and protect the host from pathogens that enter inside to cause havoc. One of the systems that helps the body is the endocrine system, which produces many hormones to keep the body functioning properly. The thyroid, a small, butterfly-shaped organ at the base of the neck, produces the hormones in the body. The thyroid helps regulate hormone production; however, when pathogen factors affect the body’s hormonal production, it can lead to musculoskeletal pain and dysfunction. Today’s article examines how the thyroid produces hormones, how hormone imbalances are connected with musculoskeletal pain, and how MET therapy can help restore hormone imbalances from affecting the body in the future. We utilize information about our patients to certified medical providers using soft tissue therapies like MET to reduce musculoskeletal pain associated with hormonal imbalances. We encourage patients by referring them to associated medical providers based on their diagnosis while supporting the fact that education is a marvelous way to ask our providers the most interesting questions at the patient’s acknowledgment. Dr. Alex Jimenez, D.C., incorporates this information as an educational service. Disclaimer
How Does The Thyroid Produce Hormones?
Do you feel muscle weakness or pain in certain parts of your body? Do you feel out of breath after walking for a short distance? Or do you feel sluggish throughout the entire day? When many individuals are dealing with these numerous issues, it could be due to their hormones being imbalanced from their thyroids. When it comes to the body, the endocrine system is the mastermind of producing different hormones for the body to help regulate all the biological processes. One of the vital organs of the endocrine system is the thyroid. Studies reveal that the thyroid is an endocrine gland located in the inferior anterior neck of the body and produces T4 and T3 hormones for the body to function properly. The thyroid hormones affect many of the vital organs and body tissues as they help with the following:
Cardio output and increased resting heart rate
Increases BMR (basal metabolic rate), heat production, and oxygen consumption
Stimulates resting respiratory rate and the nervous system
Plays a role in reproductive health and other endocrine organ function
Additional studies have revealed that thyroid hormones help control the body’s metabolism, growth, and other bodily functions while having a casual relationship with the HPT (hypothalamic-pituitary-thyroid) axis. What this relationship does is that it makes sure that the body is working properly in any environment. However, when unwanted pathogens start to affect thyroid hormone production, it can cause a hormone imbalance and lead to unwanted pain-like symptoms in the vital organs and musculoskeletal tissues.
Hormone Imbalances & Musculoskeletal Pain
When unwanted pathogens are associated with environmental factors affecting the body, it can lead to pain-like symptoms that can lead to musculoskeletal pain. In the book, “Clinical Applications of Neuromuscular Techniques,” written by Dr. Judith Walker DeLany, L.M.T., and Leon Chaitow, N.D., D.O., stated that there is a connection between hormonal imbalances and musculoskeletal pain as there are many environmental factors that can influence how much or how little hormone production is being produced from the thyroid. The book also mentions that some of the clinical signs of thyroid hormone deficiency include:
Dry skin and thinning hair
Unnatural fatigue
Unexplained weight increase
Aching muscles
Mental confusion
When the body is dealing with hormone imbalances associated with musculoskeletal pain, studies reveal that symptoms of fatigue, anxiety, irritability, and increased oxidative stress can cause the muscular tissues and ligaments to be weak and cause overlapping risk profiles when the body is in motion. To that point, hormone imbalances could lead to muscle and joint pain associated with myofascial trigger points and muscle shortness.
Finding Hormonal Harmony- Video
Have you been experiencing muscle or joint pain? Do you often feel anxious or irritable constantly? Or have you noticed that you are extremely sensitive to the cold? Many of these pain-like issues are signs and symptoms associated with hormone imbalances in the body and can lead to musculoskeletal pain. The body needs hormones to help regulate body temperature, control the body’s metabolism, and help stimulate the endocrine and body systems. Hormones are secreted from the thyroid and travel to the important muscles, organs, and tissues through the bloodstream to assist and help each body section function properly. When pathogens start to disrupt hormone production, the thyroid can overproduce or underproduce hormone secretion and cause many overlapping risk profiles to the body and musculoskeletal system. Fortunately, there are many ways to regulate hormones and reduce the effects of musculoskeletal pain. The video above explains that increasing certain vitamin intake, eating healthy, whole-nutritional foods, and getting adequate exercise and sleep can regulate hormone production and reduce the effects of musculoskeletal pain. These various treatments can be combined with therapy to help realign the body and restore it naturally.
MET Therapy Restoring Hormone Imbalances
Many available therapies can reduce the effects of hormonal imbalances associated with musculoskeletal pain. Treatments like MET (muscle energy techniques) allow many pain specialists to use soft tissue techniques to reduce pain-like symptoms and will enable the body to restore itself naturally. Research studies have revealed that soft tissue therapies like MET can reduce pain, improve body function, and reduce disability. MET therapy can be combined with nutritional foods, hormone therapies, and bodywork strategies that can help regulate hormone production in the thyroid. When a person starts to go to treatment for any ailments affecting their body, it allows these individuals to be more mindful of what is happening to their bodies and make small meaningful changes to their health and wellness.
Conclusion
When it comes to maintaining the body’s health and wellness, it’s important to ensure that unwanted pathogens don’t start affecting thyroid hormone production. The thyroid is a small gland located at the base of the neck that secretes out hormones to the rest of the body. When the thyroid over or under-produces hormones in the organs, muscles, and tissues, it can lead to pain-like symptoms that affect the body’s system and potentially lead to musculoskeletal disorders. Treatments like MET therapy combined with nutritional whole foods and exercises can reduce the effects of hormone imbalances associated with musculoskeletal disorders. This amazing combination allows the body to heal naturally and allows the individual to be pain-free.
References
Armstrong, Maggie, et al. “Physiology, Thyroid Function – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), 13 Mar. 2023, www.ncbi.nlm.nih.gov/books/NBK537039/.
Chaitow, Leon, and Judith Walker DeLany. Clinical Applications of Neuromuscular Techniques. Churchill Livingstone, 2003.
Day, Joseph M, and Arthur J Nitz. “The Effect of Muscle Energy Techniques on Disability and Pain Scores in Individuals with Low Back Pain.” Journal of Sport Rehabilitation, May 2012, pubmed.ncbi.nlm.nih.gov/22622384/.
Shahid, Muhammad A, et al. “Physiology, Thyroid Hormone – StatPearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), 8 May 2022, www.ncbi.nlm.nih.gov/books/NBK500006/.
VandeVord, Pamela J, et al. “Chronic Hormonal Imbalance and Adipose Redistribution Is Associated with Hypothalamic Neuropathology Following Blast Exposure.” Journal of Neurotrauma, 1 Jan. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4700394/.
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