A new study, published in the journal Menopause, shows that women receiving menopausal hormone therapy had a significantly lower prevalence of symptomatic knee osteoarthritis compared with women who did not take hormones.

Osteoarthritis is the most common musculoskeletal disorder in older persons and is the leading cause of pain and physical disability.

Caused by degenerative changes in the joints, it affects more women than men, and its incidence is particularly elevated in menopause.

The most common treatments for knee osteoarthritis include surgery or nonsteroidal anti-inflammatory drugs, both of which are associated with risks such as surgical complications or gastrointestinal disorders.

Because a hormone called estrogen has an anti-inflammatory effect at high concentrations, it has been hypothesized that hormone changes in women, especially decreasing estrogen levels, may lead to an increase in osteoarthritis after menopause.

Several small studies have shown that hormone therapy not only reduces histologic changes in the cartilage involved in osteoarthritis, but it also reduces the chronic pain.

To date, however, no large-scale studies have examined symptomatic knee osteoarthritis and hormone therapy.

The current study, led by Korea University Ansan Hospital’s Dr. Sung Jae Choi, analyzed data collected from 4,766 postmenopausal women from the Korea National Health and Nutrition Examination Survey (2009-2012).

Hormone therapy was defined as regular hormone medication for over one year.

The study found that the prevalence of knee osteoarthritis was significantly lower in participants using hormone therapy than those not taking hormones.

“Past and current users of hormone therapy had a lower prevalence of knee joint osteoarthritis, suggesting that hormone therapy may be protective against knee osteoarthritis,” said Dr. JoAnn Pinkerton, Executive Director of the North American Menopause Society.

“This study suggests that estrogen taken at menopause may inhibit cartilage damage and reduce knee deterioration seen on X-rays.”

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Jae Hyun Jung et al. Knee osteoarthritis and menopausal hormone therapy in postmenopausal women: a nationwide cross-sectional study. Menopause, published online December 21,2018; doi: 10.1097/GME.0000000000001280