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25-03-2013 | Gynaecology | Article

Joint pain benefits suggested for hormone therapy


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medwireNews: Postmenopausal women with joint pain may benefit from taking estrogen-only hormone therapy, research suggests.

Findings from the Women's Health Initiative (WHI) showed that women randomly assigned to receive daily oral conjugated equine estrogen (0.625 mg/day) after hysterectomy were significantly less likely to experience joint pain at 1 year than women given placebo (76.3 vs 79.2%).

Estrogen treatment was also associated with a significant reduction in mean joint pain severity scores at 1 year (1.16 vs 1.22 out of 3.0), and both benefits persisted for up to 3 years of follow-up, say Rowan Chlebowski (Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, California, USA) and co-authors.

At baseline, 77% of the 10,739 patients across both groups reported some joint pain and 40% reported joint swelling. Analysis showed that women using estrogen had no increase in pain score in the first 3 years of treatment compared with an average 0.15 score increase for controls. The trend continued for up to 6 years, although this did not reach statistical significance.

"Likely mechanisms mediating estrogen's influence on joint pain include reduction in inflammation markers and reduction in cartilage turnover as potential contributors to arthritis risk in both preclinical and clinical settings," the team comments in Menopause.

They add: "If future studies could confirm associations among cartilage turnover, joint pain, and estrogen levels, a clinical model for more rapidly identifying potential intervention strategies for joint problems could result."

However, the researchers also found that women taking estrogen were significantly more likely to experience joint swelling than controls (42.1 vs 39.7%) at 1 year, and had significantly greater swelling severity scores (0.58 vs 0.52 out of 3.0).

They note that the WHI trial was not designed to look for joint complaints, and admit that the apparently contradictory results for pain and swelling may be due to issues with the scoring scales used, which have not been validated against other measures of joint symptoms.

By Lynda Williams, Senior medwireNews Reporter

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