Sex Hormones, Fascia & Pain: The Missing Link in Women’s Musculoskeletal Health
- Stella Azzurra Squadroni
- May 12
- 4 min read
Updated: May 13
Have you ever felt like your body becomes stiffer or more prone to pain at certain times of the month, or noticed changes in flexibility during perimenopause and menopause? You’re not imagining it. The secret may lie in your fascia — and how your sex hormones influence its texture and function.
Research shows that women experience musculoskeletal pain differently than men, and often more frequently. Increasingly, evidence suggests that sex hormones, such as oestrogen, progesterone, and testosterone, significantly influence pain perception, fascia behaviour, and tissue healing.
Why Women Experience More Chronic Pain
From chronic pain to joint stiffness, from osteoarthritis to 'fibromyalgia-like' symptoms, women are disproportionately affected. Yet, shockingly, most medical research has been historically conducted on men.
This gender pain gap has left many women without the answers or care they truly need. But emerging research is finally shedding light on what makes women's pain pathways unique, especially the role sex hormones like oestrogen play in shaping fascia and pain sensitivity.
It has also been discovered that in men, when testosterone levels are low or absent, the body can switch to a different pain pathway, one that’s more commonly seen in women, involving an immune response.
Oestrogen’s Surprising Role in Fascia & Injury Risk
Fascia, the connective tissue webbing that supports and surrounds every structure in the body, is highly responsive to hormonal signals, particularly oestrogen. Here's what research is starting to reveal:
Oestrogen increases fascial elasticity, but peaks can also result in joint laxity. This may be why female athletes are more prone to injuries just before ovulation, when oestrogen is elevated.
Oestrogen deficiency (as in menopause) is associated with increased fibrosis and tissue stiffness, even in women with no previous pain conditions.
Fascia becomes denser and less responsive when oestrogen levels drop, contributing to the aches, joint pain, and reduced flexibility often reported in midlife.
So, if you've entered menopause and suddenly feel like your body is stiff, heavy, or inflamed, it’s not in your head — it’s likely your fascia responding to a shift in hormones.
Personalised Hormonal Support Matters
If you're navigating hormonal changes, consider fascia and hormone health together. Hormone replacement therapy (HRT) can help, but it needs to be personalised. What works for one woman may not suit another, especially when pain, fascia, and lifestyle factors come into play.
Did you know that...
Hormone replacement therapy (HRT) can help postmenopausal women build stronger muscles and bones, but it might also weaken tendons over time?
That means you could end up with powerful muscles pulling on smaller, more brittle tendons, which increases the risk of injury, especially if you’re active.
The challenge? Skipping HRT can speed up muscle and bone loss, but using it long-term needs careful attention to tendon health.
The Future of Fascia & Female Pain Research
The scientific understanding of how sex hormones influence fascia is still evolving. Ongoing studies are beginning to explore not just oestrogen, but also progesterone and testosterone, in fascia remodelling and pain response.
At Bowen Technique Bristol, we stay on top of the latest fascia and hormone science to make sure every session supports your phase of life.
How Bowen Therapy Helps Fascia Reset
When fascia becomes thick, stuck, or dense, it restricts not just movement but circulation, nerve function, and hormonal signalling. This is where Bowen therapy comes in.
Bowen therapy applies precise, gentle movements to specific fascial and muscular points, allowing the body to:
Hydrate and realign connective tissue
Stimulate the parasympathetic nervous system
Encourage balanced fascia remodelling
Reset tension patterns driven by stress or hormonal changes
Superficial connective fibres often respond quickly to Bowen Therapy. Denser and deeper fascia takes more time, but treatment is still effective when approached with patience.
🔬 Key Takeaways: Fascia, Hormones & Pain
Women experience chronic musculoskeletal pain more often than men, partly due to differences in hormone levels and pain pathways.
Estrogen plays a major role in fascia health: It increases flexibility and hydration but can also lead to joint laxity when levels peak.
During menopause, declining oestrogen levels are linked to increased stiffness, fascial thickening, and a higher risk of chronic pain, even in women with no prior symptoms.
Collagen composition matters: Collagen Type I is the most rigid, and it dominates in ageing or fibrotic tissue.
Testosterone may also influence collagen, but more research is needed.
Fascia becomes more viscous in acidic or inflamed environments (often linked to stress, poor recovery, or inflammation), making movement more restricted and painful.
Bowen therapy supports hormone-sensitive fascia by gently improving hydration, reducing tension, and calming the nervous system, especially effective during hormonal transitions.
Personalised treatment is essential: Hormonal context matters. What works for one person may not work for another, especially around menstruation, pregnancy, or menopause.
Ready to experience hormone-informed fascia therapy?
Let’s connect! Book a consultation now!
Source: Webinar hosted by the Fascia Research Society with researcher Caterina Fede.
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