Bioidentical Hormones for Flexibility and Motion Strategies

Bioidentical Hormones for Flexibility and Motion

Abstract

Bioidentical hormone replacement therapy (BHRT) may indirectly support mobility, joint comfort, muscle function, and physical activity when hormone levels fall with menopause or aging. Estrogen loss is linked with changes in bone density, muscle health, joint discomfort, and stiffness. Testosterone deficiency can also affect muscle mass and strength. However, BHRT is not a direct flexibility treatment, and it should not replace stretching, strength training, rehabilitation, or treatment for an underlying joint or spine condition.

An integrative approach may be more useful because mobility depends on more than hormones. At Injury Medical Clinic PA in El Paso, Texas, the multidisciplinary model described by Dr. Alexander Jimenez, DC, APRN, FNP-BC, CCST, CFMP, IFMCP, ATN, combines integrative chiropractic care, functional medicine, rehabilitation, and personal injury care with medical oversight from Maria Guadalupe Cardenas, MD, a board-certified internal medicine physician. Together, hormone health, joint mechanics, strength, movement, lifestyle, and medical safety are parts of one larger health picture.

What Happens to Mobility When Hormones Decline?

A person does not suddenly lose flexibility because one hormone level drops. Instead, hormonal changes can affect several systems that help the body move comfortably.

Estrogen decline during perimenopause and menopause has been associated with:

• Joint and muscle pain
• Joint stiffness
• Loss of bone mineral density
• Changes in cartilage and connective tissue
• Loss of muscle mass
• Reduced physical performance
• Greater risk of osteoporosis
• Changes in recovery after physical activity

A 2024 review described these changes as part of the musculoskeletal syndrome of menopause. The authors noted that declining estrogen may affect bone, muscle, joints, tendons, and other tissues involved in movement (Wright et al., 2024).

A large systematic review also found that muscle and joint pain become more common during the menopause transition. About 57% of perimenopausal women and 59% of postmenopausal women in the reviewed studies reported muscle or joint pain (Shea et al., 2026).

When joints hurt and muscles feel stiff, people often move less. Less movement can then lead to more stiffness and weakness.

This is one reason hormone health may indirectly affect mobility and flexibility.

Can BHRT Improve Mobility?

Possibly, but mainly in an indirect way.

BHRT uses hormones that have the same chemical structure as hormones naturally made by the human body. For example, certain forms of estradiol and micronized progesterone are considered bioidentical.

When hormone therapy is medically appropriate, it may improve factors that make comfortable movement easier.

It May Reduce Menopause-Related Joint Stiffness

Falling estrogen levels are associated with joint pain and stiffness. Estrogen influences inflammatory signaling, bone metabolism, and tissues around the joints (Wright et al., 2024; Watt, 2024).

Patient education resources from Mobility Bone & Joint Institute and BodyLogicMD also discuss how estrogen decline may contribute to stiffness and changes in joint comfort (BodyLogicMD, 2025; Mobility Bone & Joint Institute, 2025).

If medically appropriate hormone therapy reduces symptoms that make movement uncomfortable, a person may find it easier to walk, exercise, stretch, and perform rehabilitation.

That is different from saying BHRT directly makes a joint more flexible.

Hormone Therapy Helps Protect Bone

Bone health is closely connected to long-term mobility.

Estrogen loss speeds bone loss after menopause. Menopausal hormone therapy can help prevent bone loss in appropriate patients, but the decision depends on the person’s age, symptoms, medical history, and individual risks (Mayo Clinic Staff, 2024).

Stronger bones do not automatically make someone more flexible. However, protecting bone strength can support:

• Safer physical activity
• Resistance training
• Walking
• Balance exercises
• Long-term independence
• Reduced osteoporosis-related limitations

Hormone-related bone protection may therefore support the foundation needed for healthy movement.

Hormones Can Affect Muscle Strength

Muscles stabilize the spine and joints.

Age-related hormone changes can contribute to muscle loss and reduced strength. Testosterone plays an important role in muscle protein development in all individuals, while estrogen also appears to influence muscle function.

If a person has a medically confirmed hormone deficiency and receives appropriate treatment, improved muscle function may make physical activity easier.

Stronger muscles can better support the:

• Knees
• Hips
• Pelvis
• Shoulders
• Spine
• Ankles

But testosterone or other hormone therapy should not be prescribed simply to make someone more flexible. Treatment requires an appropriate medical reason and careful monitoring.

Does BHRT Actually Increase Flexibility?

This is where an important distinction must be made.

BHRT is not a stretching treatment.

Flexibility means that muscles and connective tissues can move through an appropriate range. Mobility is broader. It involves flexibility plus joint movement, muscle strength, coordination, balance, and control.

Hormone therapy may help someone feel better enough to move more, but improving actual flexibility usually requires:

• Regular stretching
• Mobility exercises
• Strength training
• Proper movement mechanics
• Adequate recovery
• Treatment of joint restrictions or injuries

The Mobility Bone & Joint Institute recommends regular exercise, strengthening, stretching, and low-impact activity to maintain joint movement after menopause (Mobility Bone & Joint Institute, 2025).

Maven Clinic similarly notes that strength training, movement, weight management, and other nonhormonal treatments remain important whether or not hormone therapy is being used (Maven Clinic, n.d.).

What Does the Research Say About HRT and Joint Pain?

The answer is promising in some areas but not final.

A 2026 systematic review and meta-analysis examined 57 studies involving almost four million participants. Researchers found that the overall evidence linking hormone replacement therapy to improvements in general musculoskeletal pain remains inconsistent. The authors concluded that better studies are still needed before HRT can be recommended specifically for musculoskeletal pain (Overton et al., 2026).

This means hormone therapy should not be presented as a cure for:

• Arthritis
• Chronic back pain
• Cartilage damage
• Tendon injuries
• Joint degeneration
• Poor flexibility

Instead, joint or muscle improvement may be an additional benefit for certain patients who already have a medical reason for hormone therapy.

What About Cartilage and Inflammation?

Estrogen has biological effects on cartilage, bone, and inflammatory pathways. This may explain why some people notice changes in their joints around menopause.

Commercial BHRT resources such as BodyLogicMD and Renew Health & Wellness discuss reductions in joint discomfort following hormone optimization (BodyLogicMD, 2025; Renew Health & Wellness, n.d.).

However, these patient education sources should not be interpreted as proof that BHRT can regrow damaged cartilage.

Current research supports a relationship between hormones and musculoskeletal health, but the effect of hormone replacement on established osteoarthritis and chronic musculoskeletal pain remains mixed (Overton et al., 2026; Watt, 2024).

How Integrative Chiropractic Care Fits Into the Plan

Hormone treatment addresses biology. Chiropractic care and rehabilitation focus more directly on how the body moves.

For someone dealing with stiffness, reduced mobility, or movement problems, integrative chiropractic care may include:

• Joint and spinal assessment
• Appropriate chiropractic manipulation or mobilization
• Soft-tissue techniques
• Corrective exercises
• Stretching
• Strengthening
• Posture training
• Balance exercises
• Movement retraining
• Rehabilitation
• Lifestyle and nutritional guidance when appropriate

Manual therapy has shown possible benefits for musculoskeletal pain in menopausal women. A 2024 systematic review found improvements in several small clinical trials, although the researchers cautioned that many studies had a high risk of bias and short follow-up periods (Espírito Santo et al., 2024).

Chiropractic care, therefore, should not be described as changing estrogen or testosterone levels. Its more reasonable role is addressing the mechanical side of movement.

For example, improving joint motion and reducing muscle guarding may make stretching and exercise more comfortable. Rehabilitation can then build strength and better movement patterns.

Combining Hormone Health With Better Movement

Dr. Alexander Jimenez, DC, APRN, FNP-BC, CCST, CFMP, IFMCP, ATN, describes an integrative clinical approach that considers hormone health alongside biomechanics, exercise, nutrition, sleep, functional medicine, and musculoskeletal care.

In his published clinical observations, Dr. Jimenez emphasizes that comfortable biomechanics can make it easier for patients to perform consistent resistance and aerobic exercise—activities that are important for bone, muscle, and metabolic health (Jimenez, 2026a).

His clinical model combines:

• Integrative chiropractic care
• Functional medicine
• Movement rehabilitation
• Personal injury care
• Musculoskeletal assessment
• Nutrition and lifestyle strategies
• Medical collaboration when needed

These observations are clinical experience and should not be treated as proof that chiropractic care changes hormone levels. Rather, they show how mechanical care can complement medically directed hormone management.

Medical Oversight With Dr. Maria Guadalupe Cardenas, MD

At Injury Medical Clinic PA in El Paso, Texas, clinic materials identify Dr. Maria Guadalupe Cardenas, MD, as a board-certified internal medicine physician who works collaboratively with Dr. Jimenez.

Clinic information lists Dr. Cardenas as:

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

Clinic materials describe Dr. Cardenas as providing medical direction alongside the chiropractic, rehabilitation, functional medicine, and injury-care services provided by Dr. Jimenez and the multidisciplinary team.

This type of collaborative model can be useful because hormone therapy requires medical screening and monitoring, while musculoskeletal problems often require a separate evaluation of joints, muscles, nerves, posture, and movement.

A patient may need both.

What an Integrated Plan May Look Like

A patient experiencing menopause-related stiffness might receive a plan that addresses several areas instead of relying on BHRT alone.

Medical and Hormonal Evaluation

This may include:

• Medical history
• Menopause symptoms
• Medication review
• Laboratory testing when indicated
• Bone health assessment
• Cardiovascular risk review
• Evaluation of risks and benefits of hormone therapy

Chiropractic and Musculoskeletal Evaluation

This may examine:

• Joint range of motion
• Spine mechanics
• Muscle tightness
• Posture
• Strength
• Balance
• Movement patterns
• Previous injuries

Rehabilitation

A gradual rehabilitation plan could include:

• Resistance exercises
• Walking
• Core stabilization
• Hip strengthening
• Mobility drills
• Controlled stretching
• Balance exercises

Lifestyle Support

Nutrition, sleep, stress management, adequate protein, calcium, vitamin D, and regular physical activity can also contribute to healthy aging.

The goal is not simply to increase a hormone number on a laboratory report.

The goal is to help the person move, function, and remain active safely.

Bioidentical Does Not Automatically Mean Safer

Patients should also understand what the term bioidentical means.

Bioidentical hormones have the same chemical structure as hormones naturally produced by the body. Some FDA-approved hormone medications contain bioidentical estradiol or progesterone.

However, compounded bioidentical hormones are different from FDA-approved products.

The Mayo Clinic notes that compounded bioidentical hormones have not been proven safer or more effective than conventional hormone therapy, and their quality and dose consistency may vary (Mayo Clinic Staff, 2024).

Hormone therapy should therefore be individualized and medically supervised.

The Bottom Line: Can BHRT Help Mobility and Flexibility?

Yes, it may help indirectly in properly selected patients—but it is not a direct flexibility treatment.

When declining hormones contribute to menopause symptoms, loss of bone density, reduced muscle function, or joint discomfort, medically appropriate hormone therapy may help make movement and exercise easier.

The best results are more likely to come from addressing several parts of the problem:

• Hormone health
• Joint mobility
• Muscle strength
• Flexibility training
• Nutrition
• Bone health
• Sleep
• Weight management
• Rehabilitation
• Regular exercise

An integrative model brings these pieces together.

At Injury Medical Clinic PA in El Paso, the team model described by Dr. Alex Jimenez combines chiropractic and musculoskeletal care with functional medicine, personal injury care, rehabilitation, and collaborative medical oversight from Dr. Maria Guadalupe Cardenas.

Rather than asking whether BHRT or chiropractic care alone will “fix flexibility,” a better question is:

What combination of medical, mechanical, nutritional, and lifestyle factors is limiting movement—and how can each one be addressed safely?

That approach creates a clearer path toward better mobility, stronger movement, and healthier aging.

Medical disclaimer: This article is for educational purposes and is not a diagnosis or treatment recommendation. Hormone therapy has benefits, risks, contraindications, and monitoring requirements. Anyone considering BHRT or other hormone therapy should discuss individual risks and treatment options with a qualified healthcare professional.

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References

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

Charleston Pain Relief Center. (n.d.). Balancing your body: Benefits of hormone replacement therapy for energy and aging.

Espírito Santo, J., Moita, J., & Nunes, A. (2024). The efficacy of manual therapy on musculoskeletal pain in menopause: A systematic review. Healthcare, 12(18), 1838.

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

Jimenez, A. (2026b, April 21). Integrative hormone optimization and chiropractic protocols. EP Wellness & Functional Medicine Clinic.

Jimenez, A. (2026c). Regenerative medicine and integrative chiropractic strategies. El Paso Back Clinic.

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

Maven Clinic. (n.d.). HRT and joint pain in menopause: What the evidence says.

Mobility Bone & Joint Institute. (2025, March 12). A guide to joint health after menopause.

Nguyen, T. T. B., & Hsu, Y.-Y. (2024). Features, measurements, determinants, treatments, and outcomes of musculoskeletal symptoms in postmenopausal women: A scoping review. Geriatric Nursing, 58, 416–429.

Overton, R., Amini, P., Chew, A., Babatunde, O., Mason, K. J., Rathod, S., Welsh, V., & Burton, C. (2026). The effect of hormone replacement therapy on musculoskeletal pain in menopausal women: A systematic review and meta-analysis. Post Reproductive Health, 32(1), 52–68.

Sota Wellness. (2025, July 30). Bioidentical hormone therapy benefits for men and women.

Watt, F. E. (2024). The influence of sex hormones on musculoskeletal pain and osteoarthritis.

Wright, V. J., Schwartzman, J. D., Itinoche, R., & Wittstein, J. (2024). The musculoskeletal syndrome of menopause. Climacteric, 27(5), 466–472.

Additional Patient-Education Resources

Mobility for Menopause — Essentrics

The Benefits of Bioidentical Hormone Replacement Therapy — Balance Hormone Center

How BHRT Helps Relieve Joint Pain — Renew Health & Wellness

Estrogen Therapy and Menopause — Ruthie Harper, MD

Weight Loss and Bioidentical Hormone Therapy — The Riegel Center

Hormone Replacement Therapy — Desert Sands Aesthetics

Dr. Alex Jimenez — Professional Website

Dr. Alexander Jimenez — LinkedIn

Supplemental Video and Social Media Resources Supplied for Review

Hormone and mobility educational video — YouTube

Hormone health educational video — YouTube

Hormone and wellness educational video — YouTube

Science of Flexibility: Estrogen vs. Testosterone — Facebook video

Hormonal Changes, Joint Health, and Bone Strength — Arthritis Foundation Facebook resource