Outer Hip Pain After Menopause: What the Tendon and Shilajit Research Shows

What is actually causing the ache on the outside of your hip?

Press on the bony point at the side of your hip, the part you'd feel lying on your side, and if that spot is tender, the source is usually not your hip joint at all. It is the tendons of the gluteus medius and minimus muscles, which attach right at that point and stabilize your pelvis with every single step.

The clinical name is greater trochanteric pain syndrome, or GTPS. It shows up as an ache that worsens with side-lying, climbing stairs, or standing on one leg, and it is common enough that a 2022 randomized clinical trial called it "most prevalent in postmenopausal women."

The misdiagnosis that costs women years

For decades this pain was filed under one label almost by default.

• "Bursitis" implies inflammation of the small fluid-filled sac that cushions the tendon, treated mainly with rest and, sometimes, a cortisone shot
• A 2026 review in Musculoskeletal Surgery states this pain "often" actually involves tendinopathy or tears of the gluteus medius and minimus tendons themselves
• Tendinopathy is a structural change in the tendon's own collagen, not simple inflammation of a nearby sac
• The two conditions sit in almost the same physical location, which is exactly why they get confused

That distinction is not academic. A frayed tendon and an inflamed bursa call for different approaches, and treating one as though it were the other is a large part of why so many women describe this pain lingering for years.

Why does this show up more often after menopause?

Tendons are not passive rope. They are living tissue, built from collagen, and estrogen plays a direct role in how well that collagen gets made and maintained.

Research on estrogen receptor activity has found that "high estrogen levels exert a positive effect on the overall collagen synthesis in tendons," and separate studies have linked estrogen receptor variations to tendon dysfunction specifically in postmenopausal women. When estrogen drops sharply at menopause, tendon collagen synthesis loses one of its main regulators, right as decades of ordinary wear on that same tissue continue.

The estrogen-collagen connection, in plain terms

Think of it less as sudden damage and more as a maintenance crew getting smaller.

• Estrogen signals the body to keep producing and repairing tendon collagen at a steady rate
• Once that signal fades, repair slows down even though the tendon keeps doing the same daily work
• The tendon does not have to be injured to start breaking down, it can simply stop being rebuilt as fast as it wears
• This is a mechanism, not a symptom checklist, which is why the pain can appear gradually rather than after any one event

Does hormone therapy fix a tendon that's already frayed?

If estrogen decline is part of the cause, restoring estrogen sounds like the obvious fix. The actual research is more complicated than that, and it deserves to be stated honestly.

A randomized clinical trial by McMillan and colleagues tested menopausal hormone therapy, exercise, and the combination of both in women with GTPS. Hormone therapy plus exercise improved pain and function, but only in women with a body mass index under 25. A separate, much larger study using health record data from 63,836 matched pairs found something less encouraging. Systemic hormone therapy users actually had higher rates of several tendon injuries, including rotator cuff tears and lateral epicondylitis, though that study never specifically examined the hip and carries its own limitations.

Why the signal and the material are two separate problems

Putting the hormone back does not automatically rebuild tissue that has already changed. The signal and the raw material are two different pieces of the same puzzle, and research on this specific condition suggests both matter.

• Hormone therapy addresses the regulatory signal, when it works
• It does not supply new collagen directly
• A frayed tendon needs the material rebuilt, not only the instruction to rebuild resumed
• This is the same pattern researchers have observed in other estrogen-linked connective tissue conditions after menopause

What does shilajit's own collagen research show?

Shilajit is a mineral resin, rich in fulvic acid, that forms over centuries in the Altai mountains. Two separate human studies have measured its direct effect on collagen, and both used real biological samples rather than a survey or a symptom score.

Das and colleagues took actual muscle biopsies from healthy adults before and after 8 weeks of oral shilajit supplementation and ran a full transcriptome analysis on the tissue. The collagen genes COL1A1, COL1A2, and COL3A1, the exact building blocks of tendon and connective tissue, rose 4.61-fold, 5.13-fold, and 5.18-fold. Fibronectin and decorin, two proteins involved in how collagen fibers organize and hold together, rose as well. A separate randomized trial by Neltner and colleagues measured blood biomarkers over 8 weeks of shilajit supplementation and found collagen synthesis markers rose as much as 94 to 165 percent, while a marker of collagen breakdown fell 29 percent.

Neither study tested gluteal tendinopathy directly, and that limit deserves to be named rather than glossed over.

• Both trials measured healthy adults, not women specifically diagnosed with hip tendon pain
• The tissue sampled was skeletal muscle and blood, not a tendon biopsy
• No trial has tested shilajit on greater trochanteric pain syndrome itself
• What the research does show is a real, human, biologically confirmed increase in the same collagen genes and markers a tendon is built from

Fulvic acid, the active compound in shilajit, has also been shown in human monocyte studies to reduce COX-2 and PGE2, two inflammatory markers, through the same NF-kB pathway that ibuprofen targets. That is a separate line of evidence about inflammation, not about tendon structure, and the two should not be blended into one claim.

Is shilajit safe to try alongside what you're already doing?

Hip pain deserves an actual diagnosis before anything else. A physical therapist or physician can usually tell gluteal tendinopathy apart from bursitis or joint arthritis with a straightforward exam, and that distinction should come first.

Across every human clinical study conducted on shilajit, zero serious adverse events have been reported. Purity varies enormously between products, so the same standards apply here as anywhere else.

What to look for in a shilajit product

• Purified resin, not raw powder, since powder loses much of its fulvic acid during processing
• A verified fulvic acid percentage. Optimum tests every batch at 78 percent fulvic acid
• Third-party testing for heavy metals, since contaminated soil can carry lead and arsenic into a poorly sourced resin
• A clear country of origin. Optimum sources its resin from the Altai mountains, cold pressed with zero heat processing

Optimum is a small, family owned company out of Florida. A specific injury history, a prior tendon tear, or a current treatment plan is exactly the kind of detail a general safety record cannot substitute for. This article is educational, describing what the published research measured, not medical guidance for your own hip.

Optimum Shilajit

If you want the fulvic acid and trace minerals behind the collagen research above, sourced from the Altai mountains and tested for heavy metals on every batch, here is .

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