Margaret Bennett - MargieBennett@earthlink.net
A common problem with low estradiol, the dominant estrogen made by the female ovaries, is lower back and coccyx pain. Estradiol affects the ligaments by keeping them healthy and firm, and helps protect them from oxidative damage. When the estradiol levels dip as they do before the menstrual period, or at perimenopause and menopause, the ligaments become less taut, and no longer hold the hips and pelvis as tightly as they once did. An excess of progesterone relative to estradiol also encourages relation of the pelvic joints. The result for some women is pain in the lower back and or coccydynia. I am one of them, and I know a number of other women who have had the same problem.
The good news is that appropriate estradiol replacement therapy resolves the problem substantially to completely.
When should you suspect that your coccydynia is related to low estradiol levels? If you are premenopausal, does the pain worsen just prior to your period, when estradiol is at its lowest level? Did the pain begin after age 35, when estradiol production typically begins to decline, and worsen through menopause? Did the pain appear about the time your periods became heavier and or more uncomfortable? Did the pain start around the time you developed thyroid disease? (Low thyroid typically causes the ovaries to reduce their estradiol output). These are important clues that your pain may be a sign of insufficient estradiol.
I developed coccydynia after the birth of my first child, which triggered Hashimoto's Thyroiditis, hypothyroidism, and low estradiol levels. I had resigned myself to the pain, as the doctors were not helpful. A few later, I was fortunate enough to come under the care of a wonderful doctor who is expert in hormone therapies. After she corrected my thyroid imbalance, and prescribed supplemental estradiol in the form of patches, I noticed that my coccyx pain had disappeared, as had the aches in my hips. I have sent well over a dozen women with coccyx pain to this same doctor, and every one of them has gotten rid of all or most of their pain thanks to replacement hormones. I strongly suspect this is a very common cause of coccyx pain for women. Unfortunately, most doctors are completely unaware of this, and will pooh pooh this suggestion,. Women have to be firm and demand to try estradiol replacement for a couple of months to see if it is a solution for them. Premenopausal women typically need estradiol levels of 200 or higher on day 20 of their period, and postmenopausal women typically need a level of about a 100 to escape pain. Many premenopausal women find that a high estrogen, low progestin birth control pill to be the solution.
I hope this information helps some women. For further information, I highly recommend "Screaming to Be Heard", by Elizabeth Lee Vliet, M.D, for thorough coverage of hormones and their effects.