Menopause and Osteoarthritis: Any Association?

The menopause is a natural part of ageing that usually occurs between 45 and 55 years of age, as a woman’s estrogen levels decline.

Osteoarthritis (OA) is progressive joint disease characterized by joint inflammation and a reparative bone response and is one of the top five most functional impairment and disability conditions that affects more than one-third of persons >40 years of age, commonly affecting hands, feet, spine, hips, and knees.

OA strikes women more often than men and it increases in prevalence, incidence, severity with preponderance to polyarticular involvement, with increased hand and knee OA after menopause. The effects of age on both hip and knee OA risk in women follow similar patterns, increasing rapidly between the age of 50 and 75 years. Conversely, risk of hand OA peaks in women after menopause with ≥3.5-fold higher rates in women aged 50–60 years when compared to men of similar age. A large epidemiological study was conducted in Italy supporting the hypothesis that estrogen deficiency may increase the risk of OA (Parazzini F, Progretto Menopausa Italia Study Group. Maturitas. 2003 Nov 20; 46(3):207-12.)

OA affects all articular tissues and finally leads to joint failure. Although articular tissues have long been considered unresponsive to estrogens or their deficiency, there is now increasing evidence that estrogens influence the activity of joint tissues through complex molecular pathways that act at multiple levels. Several experimental studies have shown that estrogens are implicated in the regulation of cartilage metabolism.