Osteoarthritis and Menopause

Osteoarthritis (OA) is the most frequent joint disease encountered in the clinical practice and is the most common cause of locomotor disability in the elderly. OA strikes women more often than men and it increases in prevalence and incidence after menopause. Females are found to have more severe OA, more number of joint are involved, have more symptoms and increased hand and knee OA. Many experimental, clinical and epidemiological studies suggest that loss of estrogen at the time of menopause increases a woman’s risk of getting osteoarthritis and use of HRT did seem to be associated with not only relieving of symptoms but also reduced rate of progression of osteoarthritis. Moreover, antiresorptive drugs like alendronate may also protect against the development of bone abnormalities associated with knee OA. On the contrary few studies have proposed that estradiol mediates the damage to cartilage tissue and estrogen is chondrodestructive suggesting that HRT is associated with a higher prevalence of clinical OA. Furthermore, polymorphisms in the ER alpha gene have been suggested to be associated with radiographic OA of the knee. Hence with the current level of evidence, HRT can not be recommended as a first-line treatment against progression of OA, but the fact can not be denied that if somebody is taking estrogen therapy for some other reason may get benefited. Otherwise treatment will include conventional non-pharmacological and pharmacological treatment.