In some cases, a hysterectomy can also lead to sexual difficulties. This is because the placement of the uterus affects the vaginal opening. When the cervix is removed, the vaginal canal may become shorter, which can make sex less comfortable (5). In addition, some women may feel a loss of nerve sensation in their vagina after a hysterectomy. This loss of sexual feeling is due to the removal of the nerves that supply sensation to the vagina. (6)

Many people and clinicians regard the uterus as a reproductive organ, forgetting its endocrine role. Due to the fact that the uterus is an important organ for the maintenance of good health, different forms of hysterectomy were developed to remove as few of the functional structures of the body as possible.

There are several types of hysterectomy, and the invasiveness of the procedure is determined depending on the individual medical situation.

• Total hysterectomy: The removal of the uterus and the cervix
• Subtotal hysterectomy: Removal of the uterus but leaving the cervix in place
• Radical hysterectomy: Removal of the uterus, cervix, ovaries, fallopian tubes, and nearby lymph nodes (6)

Joint pain is a common problem among older adults, especially those who are approaching or going through menopause. There are a number of reasons why joint pain, joint stiffness and menopause may be linked. One possibility is that the changing hormone levels associated with menopause can cause changes in the capacity to synthesize cartilage and collagen that make up the joints. This can lead to pain and inflammation of the joints. (8)

Additionally, declining levels of the hormone estrogen can lead to an increase in inflammation throughout the body. This inflammation can contribute to the development of conditions such as osteoarthritis. As a result, it is important to be aware of the potential relationship between hormone decline and inflammation.

The risk of osteoporosis is known to significantly increase in post-menopausal women. In older women, the use of oral estrogen was related to a lower incidence of hip osteoarthritis.

A positive correlation was found between a clinical diagnosis of osteoarthritis and serum estrogen levels in premenopausal women with mild knee osteoarthritis. (9)

Menopause can also cause changes in bone strength and density, which can increase the likelihood of developing osteoarthritis, a condition characterized by joint pain and stiffness.

While joint pain can be frustrating and debilitating, there are a number of treatments available that can help to ease the symptoms. Exercise, weight management, and pain medication can all be effective in managing joint pain. (10)

Estrogen has an anti-inflammatory impact on women's bodies. A drop in estrogen levels encourages inflammation in both perimenopausal women and postmenopausal women. It is widely accepted that osteoarthritis increases at or shortly after menopause and that woman who have lower hormone levels are at significant risk of bone density loss and bone fractures. (11)

According to Dr. John Lee MD, progesterone is a natural hormone that gets very little press due to the fact that little profit can be made through its sale. The symptoms of progesterone deficiency include irregular periods, mood swings, headaches, exhaustion, and joint pain. (12)

Due to the fact that progesterone interacts directly with bone-building cells called osteoblasts, ailments such as osteoporosis and arthritis might develop when the body is deficient in progesterone. Some clinicians note that progesterone replacement therapy considerably reduces pain and other symptoms in individuals with bone and joint disorders. (13)

Cortisol levels increase significantly during periods of prolonged stress. This increase leads to weight gain, mood swings, and blood sugar imbalances. Such an increase is usually paid with an increase in inflammation. All those factors play a role in stressing the joints. (14)

Cortisol does alter the body's pain and inflammation response. Several previously published studies found a relationship between cortisol levels and the occurrence of chronic pain in illnesses such as rheumatoid arthritis, low back pain, or physical discomfort. (15)

Women with low serum levels of endogenous estradiol, progesterone, and testosterone are associated with an increased risk of knee swelling, synovitis, and possibly other osteoarthritis-related structural changes.

In a large study, a total of 10,739 postmenopausal women who had undergone hysterectomy were randomly assigned to receive a daily oral dose of conjugated natural estrogens. Joint pain and swelling were evaluated with a questionnaire.

The study followed the women for a total of six years and compared them to a placebo. At the beginning of the research, joint discomfort and edema were equivalent across the estrogen and placebo groups.

After one year, joint pain frequency and intensity were significantly reduced with estrogen alone. The improvement was consistent until the third year. Upon ending the study it was concluded that the use of estrogen alone in postmenopausal women reduces the frequency of joint pain in a small but persistent manner. Interestingly, estrogen alone might exacerbate joint edema. (16, 17)

In a world would there is a huge bias that makes medical practitioners think of estrogens way before they consider natural progesterone, medical hormone regulation is a hard goal to achieve. Additionally, hormone testing with regular bloodwork has many limitations. Salivary testing and dry urine hormone testing are best for getting more accurate results (18). Before considering any hormone replacement, it is important to keep in mind that hormone replacement therapy, if not done correctly may increase the risk of breast cancer and endometrial cancer. It is important to consider the possible benefits and the risk factors.

Serrapeptase is a powerful anti-inflammatory enzyme that has been shown to be effective in the treatment of various conditions associated with inflammation. In joints, for example, serrapeptase can help to reduce inflammation and cartilage breakdown, both of which are major contributors to the development of arthritis (21).

Furthermore, Serrapeptase has also been shown to be effective in the treatment of respiratory conditions such as bronchitis and sinusitis, both of which are characterized by inflammation of the airways (22).

In addition, Serrapeptase has also been shown to be helpful in the healing of wounds and the reduction of scar tissue formation. Overall, Serrapeptase is a potent anti-inflammatory agent that can be effectively used in the treatment of a variety of conditions associated with inflammation.

Moving with physical activity and having a diet rich in healthy fats and cruciferous vegetables may be one of the best ways to start a healthy hormone-regulation journey.

• Reduce built-up inflammation by breaking down inflammatory markers
• Use a proteolytic enzyme to physically breakdown inflammation
• Start moving and exercising to encourage hormonal changes
• Understand that if you have undergone surgical menopause, you need hormone support
• Natural menopause can sometimes also improve with minimal hormone replacement therapy
• Estrogen, natural progesterone and testosterone should all be considered for hormone replacement
• Ask a healthcare provider about the possibility of having a higher risk of breast and endometrial cancer
• Don't rely on blood tests when you are on hormone replacement therapy, they may not be accurate
• Hot flashes, weight loss, discomfort in the pelvic area, and lower back pain are common symptoms experienced after menopause and hysterectomy, report them to your doctor
• Keep physical therapy, like pelvic floor therapy in mind
• Know that regular exercise is your friend!