Hormone Therapy Can Decrease Prevalence of Knee Osteoarthritis Postmenopause

Menopausal hormone therapy can lower the risk of women developing knee osteoarthritis (OA) in postmenopause, according to findings from a new study.

“Maintaining normal levels of the reproductive hormones estrogen and progesterone appear to decrease the joint aching and arthralgias for some women,” Dr JoAnn Pinkerton, a professor of obstetrics and gynecology at the University of Virginia Health system and executive director of The North American Menopause Society, who was not involved with the study, told Rheumatology Consultant.

IF YOU LIKE THIS, READ MORE...

Ultrasonography-Guided Injections for Knee Osteoarthritis in Primary Care

Easy & Low-Impact Exercises for People With Osteoarthritis

While estrogen deficiency is known to affect the development of OA and previous studies have suggested menopausal hormone therapy is related to the development of OA, the relationship between knee OA and hormone therapy has remained controversial.

“Estrogen receptors are found in joint tissues and their presence suggests that estrogen may play a role by protecting their biomechanical structure and function,” Pinkerton said. “Several studies have shown that joint aching (arthralgias) worsens over the course of the menopause transition and that women on estrogen have less symptoms.”

To determine the association between knee OA and menopausal hormone therapy, the researchers collected data on 4766 postmenopausal women from the Korea National Health and Nutrition Examination Survey between 2009 and 2012.

In this study, menopausal hormone therapy was defined as having taken regular hormone medication for at least 1 year. Knee OA was defined according to symptoms and radiographic findings.

The OA odds ratio among participants taking the hormones was .70 and showed that the prevalence of knee OA was lower among participants on the therapy than among participants not on the therapy.

“Benefit would be more likely to occur closer to menopause,” Pinkerton said. “Hormone therapy has the best benefit/risk profile when started close to menopause, under age 60 or within 10 years of menopause.”

The study data is similar to what is known about estrogen and arthritis in U.S. populations, according to Pinkerton.

Still, not all women will feel better on hormone therapy due to the potential for adverse events.

“Some of the side effects of hormone therapy include fluid retention, breast tenderness or swelling, headaches, or mood changes [and] may be problematic,” Pinkerton said. “Some women [also] see a flare in arthritis symptoms on estrogen, the cause of which is unknown.”

—Colleen Murphy

Reference:

1. Jung, JH, Bang, CH, Song, GG, Kim C, Kim J-H, Choi SJ. Knee osteoarthritis and menopausal hormone therapy in postmenopausal women: a nationwide cross-sectional study [published online December 21, 2018]. Menopause. doi: 10.1097/GME.0000000000001280.