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Connection between joint pain and menstruation?

Question
Dear expert team,
for half a year I suffer increasingly from spasmodic joint pain. I first assumed a time-connection to the intake of certain drugs, now however, I stated that those batches are especially severe at the first days of my menstruation.
As I have read in the meantime, the age-related osteoporosis of women is seemingly in connection with the menstruation resp. menopause. I am however still far from that. Has the osteoporosis, that occurs as a consequence of CF, something to do with that or is the occurence of joint pain and menstruation at the same time in me rather an accidental conincidence? Would this be relevant to treat in any respect?
Many thanks for your answer in advance.
Yours sincerely,
Answer
Dear questioner,
indeed, it is not unususal, that different complaints get worse in connection with the menstruation. In case of joint pain however, this is not as frequent as in case of migraine. However, on can imagine the changed water balance which occurs in connection with the hormonal changes around the time of the menstruation, as an explanation.
Due to the decrease of hormones at the beginning of the menstruation (=bleeding due to hormone withdrawl) it is possible, that joint pain increases. After the menopause, many women complain about joint pain, so that a protective effect of oestrogen is assumed. Therapeutically one can try to replace the lacking oestrogen just before the menstruational bleeding until about the 5th day with low dosage oestrogen. The exact dosage and preparation should be discussed with the gynaecologist. In case the joint pain should get better under this kind of therapy, this medication can also be continued in the long runs (e.g. beginning about 2 days before menstruational bleeding until the 5th day).
In case of joint pain in relation with CF one has more the CF-arthropathy in mind than osteoporosis. You should discuss this again with your CF doctor in charge. Indeed the therapy here is not different form the one in case of other joint problems - assumed that it does not occur in connection with a badly controlled infection.
The essentials in brief: we have not been able to observe a real accumulation of joint pain in female CF patients in connection with the menstruation, however it is conceivable.
Please talk to your gynaecologist, if it would make sense to do a trial with the corresponding treatment.
Yours sincerely,
Prof. Dr. TOF Wagner, Dr. Christina Smaczny and Dr. Anja Undine Stücker


20.06.2011