Uploaded July 2026 | Updated September 2026, 2 weeks ago

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This is why you can't just go on HRT and call it a day.

You must, must, must, must, must pair it with mechanical loading.

When you combine estrogen with adequate mechanical loading, estrogen will actively and positively Support tendon stiffness, ligament stiffness, and force transmission. But here is the part that nobody talks about. In the absence of mechanical loading. The increase in collagen turnover can result in tissue that is weaker, not stronger.

So without the mechanical signal of load from weights, estrogen drives collagen remodeling, but the new collagen doesn't organize along the lines of force from the gym. It just kind of turns over.

So it's literally rebuilding without a blueprint

**P.S. When you're ready, here are two ways Dr. Stephanie can help you:

Subscribe: The Mini Pause — My weekly newsletter packed with the most actionable, evidence-based tools for women 40+ to thrive in midlife. drstephanieestima.com/newsletter

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