Osteoarthritis and the postmenopausal woman: Epidemiological, magnetic resonance imaging, and radiological findings.
BACKGROUND
There is some observational evidence to suggest an effect of hormones on osteoarthritis (OA), especially in perimenopausal women.


OBJECTIVE
To review the epidemiological evidence for an effect of estrogen replacement therapy (ERT) on the incidence and prevalence of OA, especially radiological OA, and the effect of ERT on articular cartilage in women.


METHODS
The literature relating to these questions was reviewed using OVID Medline (1966 to March 2003).


RESULTS
Some studies which have suggested a protective effect of ERT on the incidence and prevalence of OA. However, many of the confidence intervals include unity. Although a protective effect also was seen on articular knee cartilage in long-term users of ERT compared with never users, no difference in change in cartilage was seen over 2 years.


CONCLUSIONS
There is weak epidemiological evidence suggesting a role for estrogen therapy in joint health in postmenopausal women. The data are more suggestive of an effect on large joint OA than small joint OA.
Hanna
Fahad S
FS
Jean Hailes Foundation, Clayton, Australia.
Wluka
Anita E
AE
Bell
Robin J
RJ
Davis
Susan R
SR
Cicuttini
Flavia M
FM
D001175:Arthrography; D002358:Cartilage, Articular / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D003430:Cross-Sectional Studies; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D008279:Magnetic Resonance Imaging; D010003:Osteoarthritis / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D017698:Postmenopause; D015995:Prevalence; D012307:Risk Factors