Does Postmenopausal Hormone Therapy Really Lower the Risk for Arthritis?

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We have millions of patients worldwide who are using some sort of hormone replacement therapy. One of the reasons they are using hormones as they age is the promise of looking and feeling younger. Hence, a research study that looks at whether female hormone replacement helps arthritis is a big deal. Hence, let’s dig in this morning.

Menopause and the Musculoskeletal System

Menopause is a natural biological process that every woman experiences as she ages and her reproductive cycles end. Typically this occurs in her 40s or 50s and is identified by the cessation of her menstrual periods (for at least 12 months). Following this, she enters postmenopause, and it’s important to take extra steps to stay healthy at this point. Menopause and postmenopause are associated with hormonal imbalances, and this is when I see many women develop orthopedic problems, like knee arthritis.

Interestingly, a few months ago I covered an outer-space study on gravity-deprived mesenchymal stem cells (MSCs) that found that without gravity (less pressure), MSCs from bone marrow differentiate into fat. With normal gravity (more pressure), our bone marrow MSCs differentiate into bone. A similar process naturally occurs in women: after menopause, a genetic switch is flipped and this combined with less pressure on the cells due to inactivity makes bone marrow stem cells begin differentiating into fat cells rather than bone cells. This is one cause, for example, for osteoporosis, a bone disease that occurs due to lost density in the bone.

Arthritis is another musculoskeletal condition that is common after menopause and is one of many reasons hormone therapy is often prescribed. Now, a new study explores whether postmenopausal hormone therapy really lowers the risk for arthritis, specifically in the knee. Let’s review.

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Postmenopausal Hormone Therapy and Knee Arthritis

The new study consisted of survey data collected on over 4,700 postmenopausal women and investigated the potential cause of the increase in knee arthritis in women after menopause. Postmenopausal women who’d been on hormone therapy for at least one year were compared to those who’d not been on hormone therapy. The results? The group on hormone therapy had less incidence of knee arthritis following menopause and had 30% lower odds of developing knee arthritis than the group not on hormone therapy. In other words, taking hormones after menopause, according to this study, does provide some protection against postmenopausal arthritis.

More on Ways to Stay Healthy After Menopause

Musculoskeletal health, in general, can be particularly challenging after menopause. I’ve covered a variety of ways to address this in the past. A couple of these follow:

If you are younger and haven’t yet reached menopause, making sure you are proactive by exercising regularly, maintaining a healthy diet, and taking high-quality supplements, such as fish oil, now should help prepare you for menopause and postmenopause when it occurs. In addition, as the new study seems to confirm, as you enter menopause and beyond, postmenopausal hormone therapy really does appear to make a difference in bone and joint health.

The upshot? This is comforting research for those on hormonal therapy to delay or reduce the effects of aging. While more research is needed, this all makes common sense.

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Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile

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