"It isn’t hip arthritis," my orthopedist said gently.

"What you’re dealing with is called Gluteal Tendinopathy — it’s a breakdown of the tendons in your hip, and it affects millions of women after menopause."

.

She rolled her chair toward me — that familiar squeak echoing in the exam room — and leaned in.

"Let me walk you through why this is happening."

She sketched three overlapping circles on her notepad.

"First—when estrogen drops, it throws off your hormone balance. That alone disrupts everything from your pain response to tissue healing."

"Second—your collagen production slows down. That means your tendons can’t stay strong or elastic. They stiffen. Fray. And eventually, they start to tear under pressure."

"And third—this is crucial—your gut function starts to decline. That causes more inflammatory flareups, slower recovery, and can even block the absorption of the very nutrients your tendons need to heal."

"Wait," I interrupted. "So this isn’t just hormones or aging... the tendon tissue is actually breaking down?"

"Exactly." She nodded. “Which is why you have to support all three systems—hormone balance, collagen synthesis, and gut function. Miss even one, and the pain keeps coming back.”