Non-contraceptive hormones and the risk of rheumatoid arthritis in menopausal women.
BACKGROUND
Several reproductive factors appear to affect a women's risk of developing rheumatoid arthritis. This study's purpose was to determine whether use of non-contraceptive hormones is among them.


METHODS
A population-based case-control study was conducted in King County, Washington and Group Health Cooperative of Puget Sound, a prepaid health plan. New cases of rheumatoid arthritis in peri- or postmenopausal women (n = 135) were verified through clinical examination and compared with 592 controls. Both groups were interviewed in person about hormone use and demographic and reproductive factors.


RESULTS
The age-adjusted relative risk (RR) among women who had ever used non-contraceptive oestrogens was 1.04 (95% confidence interval [CI]: 0.70-1.55), and among women who had ever used progestins it was 0.66 (95% CI: 0.40-1.08). For current users of oestrogen only, the RR was 0.97 (95% CI: 0.62-1.53), and among current users of oestrogen plus progestin it was 0.81 (95% CI: 0.45-1.45). Multivariate analyses yielded similar results. There was little evidence of a dose-response relationship with duration of use or with frequency of progestin use.


CONCLUSIONS
Use of non-contraceptive oestrogens appears to have little effect on the risk of developing rheumatoid arthritis in menopausal women. There may be a modest reduction in risk among progestin users.
Koepsell
T D
TD
Department of Epidemiology, University of Washington, Seattle 98195, USA.
Dugowson
C E
CE
Nelson
J L
JL
Voigt
L F
LF
Daling
J R
JR
D000293:Adolescent; D000328:Adult; D001172:Arthritis, Rheumatoid / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D004967:Estrogens / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D015999:Multivariate Analysis; D011372:Progestins / Q000009:adverse effects*; D012307:Risk Factors; D014861:Washington / Q000453:epidemiology
D003278:Contraceptives, Oral, Hormonal; D004338:Drug Combinations; D004967:Estrogens; D011372:Progestins