Follow up on a prior post of how hormones affect the whole body and that long term estrogen suppression may affect the whole body in many ways:
"Estrogens have long been known as a regulating factor of metabolism in tissues such as bone, muscle, cartilage, tendon and ligament, affecting the musculoskeletal functions [1]. The estrogen-beta receptor has also been described recently in the tissue of tendons and ligaments [2], and only in one of our recent works [3] the expression of sex hormone receptors was also demonstrated in the muscular fasciae....
...Lee and Park [12] described how musculoskeletal pain characteristics are caused by the severity of menstrual pain. Lee and Petrofsky [13] demonstrated that changes in plantar fascia elasticity during the menstrual cycle may involve sexual hormones in the increasing elasticity of human connective tissue.
Various trails have shown that women treated with aromatase inhibitors, which stop the production of estrogen in post-menopausal women, often experience joint pain and musculoskeletal aching. These manifestations may be reduced after cessation of therapy, and one explanation for these findings is that a rapid drop in estrogen levels enhances nociception [14]....
It is possible that women with hormonal dysfunctions may present a dysregulation of extracellular matrix production, causing stiffness, fibrosis and inflammation which create sensitization of fascial nociceptors [38,39]. This may explain why oral administration of estrogen (the dose of β-estradiol via oral administration is usually 50 pg/mL) may resolve myofascial pain in women."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6762168/