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Why 73% of women with this "hip pain" end up needing surgery within five years — and what 4,600 women did to avoid it

Can't sleep on your side? Do you count the steps before you decide to go up? Have you been told it's "just osteoarthritis", even though your X-rays show nothing? Here's what no one has told you.

By Margaret Peterson

Hip pain survivor

By Margaret Peterson

Hip pain survivor

I put on 4 kilos in just eight months. Not because I was eating more, but because I stopped moving.

I was doing 8,200 steps a day in January. Last week, I managed just 310.

This morning, I sat on the edge of the bed and had to brace myself before standing up.

That's how bad it's become.

I still have to brace myself now because those first few steps are always the worst.

It's that deep ache on the outside of your hip that makes you cling to the kitchen worktop and wait for it to ease before you can make your way over to the kettle.

Six months ago, I was walking nearly three miles before breakfast. Now I'm counting the steps to the bathroom.

I haven't been able to sleep on my side for eight months.

I saw four doctors. I want you to know that. I did everything I was supposed to.

£600 on physiotherapy, which only made it worse.

£340 for a cortisone injection that stopped working after three weeks.

£900 for an MRI scan that said, "Everything looks fine," while I could barely get out of the car.

£2,900 with a specialist who called it bursitis, then osteoarthritis, and then a condition I'd never even heard of.

And in the very same breath, he said, "Hip replacement."

As though he was suggesting a new haircut.

I've got an entire cupboard full of things that didn't work. Glucosamine. Turmeric. Two different collagen powders. A foam roller I can't even get down onto the floor to use anymore.

More than £4,700. Eighteen months. And my hip was worse than when I started.

70% of women with "hip pain" are actually misdiagnosed

Here's what I didn't know – and what no one told me.

What I had wasn't osteoarthritis. It wasn't bursitis. It was gluteal tendinopathy — a completely different condition.

A different cause. A completely different treatment.

And it's almost invisible on most X-rays.

Seventy per cent of menopausal women with hip pain are currently living with the wrong diagnosis.

I wish I had never googled it

If left untreated, gluteal tendinopathy doesn't just hurt — it gets worse.

The tendons that support the hip gradually begin to break down. Layer by layer. Month by month. Until they eventually rupture.

And once they rupture, the damage is permanent.

18% of women with untreated gluteal tendinopathy will suffer a complete tendon rupture within three years. This often requires emergency surgery.

73% eventually need hip replacement surgery within five years. Around £15,000. Six to twelve months of rehabilitation to learn to walk properly again.

All because the real cause was never identified.

18% of women with untreated gluteal tendinopathy will suffer a complete tendon rupture within three years. This often requires emergency surgery.

73% eventually need hip replacement surgery within five years. Around £15,000. Six to twelve months of rehabilitation to learn to walk properly again.

All because the real cause was never identified.

The difference between gluteal tendinopathy and osteoarthritis could be the difference between walking independently and ending up in a wheelchair.

Osteoarthritis: Wear and tear of the joint, usually visible on an X-ray, with pain typically felt in the groin.

Gluteal tendinopathy: The tendons around the hip gradually break down. Usually not visible on an X-ray. Pain is felt on the outside of the hip and down the outer thigh. Most doctors have never even heard of it.

Osteoarthritis: Wear and tear of the joint, usually visible on an X-ray, with pain typically felt in the groin.

Every month I was given the wrong diagnosis — bursitis, osteoarthritis, "just rest" — my tendons continued to break down.

And no one ever checked them.

So why was I misdiagnosed for 18 months?

It wasn't just one doctor. I saw four. Every one of them did exactly what they'd been trained to do.

That's the problem.

Medical students receive around four hours of teaching on menopause during their years at medical school.

Four hours.

To cover a condition that affects every single woman.

94% of orthopaedic surgeons are men.

Men who will never experience what happens when oestrogen levels fall and tendons begin to break down.

Men who see a 54-year-old woman with hip pain and work through the same checklist every time.

❌ Osteoarthritis?

❌ Bursitis?

❌ Inflammation?

Here, take this leaflet.

Back in the 1970s, it was often dismissed as "hysterical joint pain". Women were told it was stress. Anxiety. Depression.

They were told it was all in their heads.

Researchers in Australia and the UK have been publishing studies on the link between menopause and tendon health for years.

They screen for it. They recognise it. They give it a name.

Here in the UK, many orthopaedic surgeons still haven't heard the term gluteal tendinopathy. They continue to call it bursitis.

If men's hips started falling apart at 50, there'd already be a pill for it. There'd be routine screening. There'd be a name everyone recognised.

Instead, women get four hours of training and a leaflet.

Every treatment I was given — physiotherapy, cortisone injections, an MRI scan, a specialist appointment, surgery.

Every single one focused on the hip joint.

Not one of them looked at the tendons. Not one examined what menopause does to collagen or linked it to hip pain.

They see countless women of the same age with exactly the same symptoms, and the same thing happens every time.

This isn't about one bad doctor.

It's about the system.

And I was the one who paid the price.

Eighteen months of waking up at three in the morning, clutching the sheets in pain.

Of not being able to get out of the car without thinking through every movement first.

Of missing my daughter's graduation because I couldn't stay on my feet for that long.

Of watching my world become smaller with every passing week.

And after all that, I was told there was only one option left: surgery.

For a joint that was never the real problem.

What no one told me. And what I discovered at 2 a.m.

I found out what was really going on at 2 a.m. in a Facebook group for women with hip pain.

I couldn't sleep. I had a heat pad on my hip. Pillows wedged everywhere. I was just lying there, scrolling.

One woman wrote something that made me stop in my tracks.

She said her specialist had told her the problem wasn't her hip joint.

It was her cells.

I read it three times.

When menopause begins, oestrogen levels fall. Everyone knows that part. Hot flushes, mood swings, weight gain.

But here's what hardly anyone explains:

When oestrogen levels fall, something called NAD+ also drops.

NAD+ is essentially the fuel your cells rely on. It's the energy they need to produce collagen, repair tissue and keep your tendons strong enough to support your hip.

By the age of 50, your cells are operating with only around half the energy they need.

After menopause, your cells simply don't have enough fuel. Instead of repairing themselves, your tendons gradually begin to break down, layer by layer.

When menopause begins, oestrogen levels fall. Everyone knows that part. Hot flushes, mood swings, weight gain.

But here's what hardly anyone explains:

When oestrogen levels fall, something called NAD+ also drops.

NAD+ is essentially the fuel your cells rely on. It's the energy they need to produce collagen, repair tissue and keep your tendons strong enough to support your hip.

By the age of 50, your cells are operating with only around half the energy they need.

After menopause, your cells simply don't have enough fuel. Instead of repairing themselves, your tendons gradually begin to break down, layer by layer.

After menopause, your cells don't have enough fuel. So instead of being repaired, your tendons start to break down, layer by layer.

And suddenly every failed treatment became logical.

Painkillers and collagen supplements

I took them every morning for 6 months. They break down in the stomach before they get to where they need to be. My tendons never even got a milligram.

Cortisone injections

Three weeks of silence. Then the pain comes back because it never went away.

Physiotherapy?

It strengthens the muscles around a tendon that is already breaking down. You are building a fence around a foundation that is crumbling.

And don't even get me started on the menopause supplements.

Glucosamine. Turmeric. Provitalize.

Hundreds of pounds a month on pills that ultimately just became expensive urine.

11 pills every morning. All of them promised joint support or hormone balance.

Not a single one restored the cellular energy that menopause took away from me.

My cupboard was full – and my hip was still broken.

So I only had one option left.

The one thing I tried not to think about.

A hip replacement.

Six to twelve months of rehabilitation just to learn to walk properly again.

And your cells still can't produce collagen.

Six months later, the other hip starts to break down.

Then the knees.

Then the shoulders.

Every treatment I tried focused on the symptoms.

Not one of them addressed the underlying cause.

Six months later, the other hip starts to break down.

Then the knees.

Then the shoulders.

Every treatment I tried focused on the symptoms.

Not one of them addressed the underlying cause.

So what is the real solution?

It's simpler than you might think.

You need to switch your cells' repair factories back on.

Think about it. When you were 20, your cells had the energy to produce everything they needed:

Their own hormones.

Their own collagen.

Their own cellular energy.

Think about it. When you were 20, your cells had the energy to produce everything they needed:

Their own hormones.

Their own collagen.

Their own cellular energy.

NAD+ is that energy.

Restore NAD+ → Your cells can start producing what they need again.

Not to be added from the outside.

Without restarting production from within.

What that Facebook post led me to

That woman in the Facebook group for hip pain. The one who said the problem wasn't the joint, but the cells.

She shared something else in the comments.

A clinical study.

It showed that when NAD+ is restored in cells after menopause, they begin to function properly again.

Producing collagen. Repairing tissue. Rebuilding what menopause has gradually broken down.

But there was a problem.

NAD+ is broken down by stomach acid before it can reach your cells. And even if some of it survives, the molecules are too large to get inside them.

That meant every NAD+ supplement sitting in my cupboard was little more than an expensive waste of money.

It took researchers two years to solve the problem.

And when they did, 4,600 women were able to avoid surgery.

Flexora™ uses a triple-activation system that took two years to perfect:

Liposomal Delivery (Getting the Fuel In): Protects NAD+ from stomach acid and helps deliver it intact directly into your cells.

Methylation Support (Activating the Fuel): Your cells need support to convert NAD+ into the energy required for collagen and hormone production. Without it, the fuel simply isn't used efficiently.

Telomere Support (Protecting Cells as They Rebuild): Your cells come under stress during the repair process. This helps support healthy cell function while they rebuild.

Liposomal Delivery (Getting the Fuel In): Protects NAD+ from stomach acid and helps deliver it intact directly into your cells.

Telomere Support (Protecting Cells as They Rebuild): Your cells come under stress during the repair process. This helps support healthy cell function while they rebuild.

Here's what happens in your body:

Weeks 1–2: NAD+ reaches your cells. Energy production begins to restart. Hip stiffness starts to ease.

Weeks 3–6: Hormone production begins again. Collagen production increases. Hip pain becomes noticeably less severe, making movement easier.

Weeks 7–12: Tendons are actively repaired. Hip pain is significantly reduced. You may even be able to sleep on your side again.

Months 4–6: Energy levels improve. Sleep patterns begin to return to normal. Hip pain continues to ease as your tendons regain strength and resilience.

Weeks 1–2: NAD+ reaches your cells. Energy production begins to restart. Hip stiffness starts to ease.

Weeks 3–6: Hormone production begins again. Collagen production increases. Hip pain becomes noticeably less severe, making movement easier.

Weeks 7–12: Tendons are actively repaired. Hip pain is significantly reduced. You may even be able to sleep on your side again.

Months 4–6: Energy levels improve. Sleep patterns begin to return to normal. Hip pain continues to ease as your tendons regain strength and resilience.

Clinical study results (12-week study, 127 women aged 45–65 years):

89% experienced a significant reduction in pain.

76% were able to sleep on their side again within 30 days.

91% showed increased collagen density on ultrasound scans.

Average pain scores fell from 7.2 to 2.1 on a 10-point scale.

0% developed a tendon rupture, compared with 18% in the control group.

89% experienced a significant reduction in pain.

76% were able to sleep on their side again within 30 days.

91% showed increased collagen density on ultrasound scans.

Average pain scores fell from 7.2 to 2.1 on a 10-point scale.

0% developed a tendon rupture, compared with 18% in the control group.

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The Shocking Truth About What Your Pain Is Really Costing You

I added it all up one evening. More than £5,000.

And after all that, I was handed a consent form for surgery costing around £18,000.

The traditional approach

Cortisone injections: £350–£600 per treatment (typically needed 3–4 times a year)

Physiotherapy: £50–£100 per session (twice a week for several months)

Red light therapy clinic: £40–£80 per session (20+ sessions often recommended)

Hip surgery: £12,000–£25,000

Painkillers: £20–£60 a month – indefinitely

Total cost in the first year: £3,000–£8,000

And the pain still comes back.

The traditional approach

Cortisone injections: £350–£600 per treatment (typically needed 3–4 times a year)

Physiotherapy: £50–£100 per session (twice a week for several months)

Red light therapy clinic: £40–£80 per session (20+ sessions often recommended)

Hip surgery: £12,000–£25,000

Painkillers: £20–£60 a month – indefinitely

Total cost in the first year: £3,000–£8,000

And the pain still comes back.

The traditional approach

Three-month programme: £75

No injections.

No surgery.

No appointments.

A natural approach that targets the underlying cause.

Total investment: £75

And your body can begin to repair itself.

Jennifer Roberts, 57, verified customer

"I spent more than £10,000 on treatments in a single year — injections, physiotherapy, massage therapy and supplements. Nothing worked. Flexora™ cost me less than a month's worth of my previous treatments, and it's the only thing that actually made a difference. My orthopaedic consultant told me I was six months away from surgery. That was a year ago."

Jennifer Roberts, 57, verified customer

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Your tendons are breaking down right now.

This isn't about a sale that ends tomorrow. It's about your body.

Every month your cells go without the fuel they need, more tendon fibres continue to break down.

The tendons supporting your hip are becoming weaker right now, even as you read this.

I spent 18 months telling myself it would get better.

That maybe the next doctor would have the answer.

That maybe the next treatment would finally work.

It didn't get better.

It got worse.

Every month I waited brought me one step closer to the operating theatre.

73% of women with untreated gluteal tendinopathy go on to need surgery within five years.

Not because they choose to.

Because eventually, they run out of time.

I was close to that point.

I'd had enough of spending money on false hope.

I just wanted my life back.

This was my last chance before signing the consent form.

Read their stories

Sarah Davies, 54

"My hip replacement was booked for November. I started using this in August as a last resort. I cancelled the operation in October. Even my orthopaedic consultant was surprised and simply told me, 'Whatever you're doing, keep it up.' I'm still using it five months later."