Menopausal hormone therapy for rheumatic diseases: osteoarthritis


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Abstract

Osteoarthritis (OA) is one of the diseases of great sociomedical importance. Primary OA generally develops between the ages of40-45years, which corresponds to the onset of the menopausal transition and postmenopause in women. Women have a higher prevalence and incidence of OA than men over 50 years of age. Several studies have shown a higher incidence of joint pain and stiffness in postmenopausal women than in premenopausal women. The chronological association makes it possible to actualize the relationship between OA and age-related estrogen deficiency that develops with natural depletion of the ovarian reserve, as well as the possible positive effect of menopausal hormone therapy (MHT) on the course of this disease. The review presents current data on the effect of estrogens on the structural components of the joints, as well as on joint pain. It also considers the impact of MHT on the course and progression of OA. The biological effect of estrogens is produced by binding to one of two specific intracellular estrogen receptors that are expressed in chondrocytes, subchondral osteocytes, synoviocytes, as well as in fibroblasts of the ligaments and in myoblasts. In general, the effect of estrogens on articular structures can be characterized as anabolic. The presence of estrogen receptors and aromatase in the structures of the antinociceptive system is responsible for the potential analgesic effect. The results of studying the impact of MHT on the course of OA of different localizations are generally multidirectional and do not allow one to unambiguously recommend its use in the treatment of this disease. Conclusion: The impact of MHT on joint pain and on the regulation of cartilage tissue homeostasis is ambiguous and requires further investigation; however, the appearance of joint pain with the onset of menopause may be another argument in favor of considering the prescription of MHT.

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About the authors

Taras S. Panevin

V.A. Nasonova Research Institute of Rheumatology, Ministry of Science and Education of the Russian Federation

Email: tarasel@list.ru
Ph.D., Endocrinologist

Svetlana V. Yureneva

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation

Email: syureneva@gmail.com
Dr. Med. Sci., Leading Researcher at the Department of Gynecological Endocrinology

Evgeniy G. Zotkin

V.A. Nasonova Research Institute of Rheumatology, Ministry of Science and Education of the Russian Federation

Email: ezotkin@mail.ru
Dr. Med. Sci., First Deputy Director

References

  1. Felson D.T., Lawrence R.C., Dieppe P.A., Hirsch R., Helmick C.G., Jordan J.M. et al. Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann. Intern. Med. 2000; 133(8): 635-46. https://dx.doi.org/10.7326/0003-4819-133-8-200010170-00016.
  2. Zhuo Q., Yang W., Chen J., Wang Y. Metabolic syndrome meets osteoarthritis. Nat. Rev. Rheumatol. 2012; 8(12): 729-37. https://dx.doi.org/10.1038/nrrheum.2012.135.
  3. Sokolove J., Lepus C.M. Role of inflammation in the pathogenesis of osteoarthritis: latest findings and interpretations. Ther. Adv. Musculoskelet. Dis. 2013; 5(2): 77-94. https://dx.doi.org/10.1177/1759720X12467868.
  4. Lievense A.M., Bierma-Zeinstra S.M., Verhagen A.P., van Baar M.E., Verhaar J.A., Koes B.W. Influence of obesity on the development of osteoarthritis of the hip: a systematic review. Rheumatology (Oxford). 2002; 41(10): 1155-62. https://dx.doi.org/10.1093/rheumatology/41.10.1155.
  5. Felson D.T. Epidemiology of hip and knee osteoarthritis. Epidemiol. Rev. 1988; 10: 1-28. https://dx.doi.org/10.1093/oxfordjournals.epirev.a036019
  6. Multanen J., Heinonen A., Hakkinen A., Kautiainen H., Kujala U.M., Lammentausta E. et al. Bone and cartilage characteristics in postmenopausal women with mild knee radiographic osteoarthritis and those without radiographic osteoarthritis. J. Musculoskelet. Neuronal Interact. 2015; 15(1): 69-77.
  7. Юренева С.В., Комедина В.И., Кузнецов С.Ю. Прибавка массы тела у женщин в перименопаузе: методы оценки композиционного состава тела и тактика ведения. Акушерство и гинекология. 2020; 2: 56-61. [Yureneva S.V., Komedina V.I., Kuznetsov S.Y. Weight gain in perimenopausal women: methods for assessing the body composition and maintenance tactics. Akusherstvo i ginekologiia/ Obstetrics and Gynecology. 2020;2:56-61. (in Russian)]. https://dx.doi.org/10.18565/aig.2020.2.56-61.
  8. Ding C., Cicuttini F., Blizzard L., Scott F., Jones G. A longitudinal study of the effect of sex and age on rate of change in knee cartilage volume in adults. Rheumatology (Oxford). 2007; 46(2): 273-9. https://dx.doi.org/10.1093/rheumatology/kel243.
  9. Шабалова О.В., Юренева С.В., Ермакова Е.И., Хохлова С.В., Гарданова Ж.Р., Якушевская О.В. Хирургическая менопауза как фактор риска раннего развития коморбидных состояний у женщин репродуктивного возраста. Акушерство и гинекология. 2021; 6: 54-9. [Shabalova O.V., Yureneva S.V., Ermakova E.I. et al. Surgical menopause as a risk factor for the early development of comorbid conditions in reproductive-aged women. Akusherstvo i ginekologiia/ Obstetrics and Gynecology. 2021;6:54-9. (in Russian)]. https://dx.doi.org/10.18565/aig.202L6.54-59.
  10. Szoeke C.E., Cicuttini F.M., Guthrie J.R., Dennerstein L. The relationship of reports of aches and joint pains to the menopausal transition: a longitudinal study. Climacteric. 2008; 11(1): 55-62. https://dx.doi.org/10.1080/13697130701746006.
  11. Sievert L.L., Goode-Null S.K. Musculoskeletal pain among women of menopausal age in Puebla, Mexico. J. Cross Cult. Gerontol. 2005; 20(2): 127-40. https://dx.doi.org/10.1007/s10823-005-9087-3.
  12. Ho S.C., Chan S.G., Yip Y.B., Cheng A., Yi Q., Chan C. Menopausal symptoms and symptom clustering in Chinese women. Maturitas. 1999; 33(3): 219-27. https://dx.doi.org/10.1016/s0378-5122(99)00056-0.
  13. Bardel A., Wallander M.A., Wedel H., Svardsudd K. Age-specific symptom prevalence in women 35-64 years old: a population-based study. BMC Public Health. 2009; 9: 37. https://dx.doi.org/10.1186/1471-2458-9-37.
  14. Протасова А.Э., Юренева С.В., Байрамова Н.Н., Комедина В.И. Менопауза, ожирение и коморбидность: возможности менопаузальной гормональной терапии. Акушерство и гинекология. 2019; 5: 43-8. [Protasova A.E., Yureneva S.V., Bairamova N.N., Komedina V.I. Menopause, obesity, and comorbidity: possibilities of menopausal hormone therapy. Akusherstvo i ginekologiia/ Obstetrics and Gynecology. 2019;5:43-8. (in Russian)]. https://dx.doi.org/10.18565/aig.2019.5.43-48.
  15. Юренева С.В., Ермакова Е.И. Менопауза и климактерическое состояние у женщины. Акушерство и гинекология. 2018; 7: 32-8. [Yureneva S.V., Ermakova E.I. Menopause and menopausal status in a woman. Akusherstvo i ginekologiia/ Obstetrics and Gynecology. 2018;7:32-8. (in Russian)]. https://dx.doi.org/10.18565/aig.2018.7.32-38.
  16. Сухих Г.Т., Сметник В.П., Андреева Е.Н., Балан В.Е., Гависова А.А., Григорян О.Р., Ермакова Е.И., Зайдиева Я.З., Ильина Л.М., Касян В.Н., Марченко Л.А., Подзолкова Н.М., Роговская С.И., Сметник А.А., Чернуха Г.Е., Юренева С.В. Менопаузальная гормонотерапия и сохранение здоровья женщин в зрелом возрасте: Клинические рекомендации (протокол лечения). М.; 2015. 30c.
  17. Российское общество акушеров-гинекологов. Менопауза и климактерическое состояние у женщины. Клинические рекомендации. М.; 2021. 85с.
  18. Couse J.F., Korach K.S. Estrogen receptor null mice: what have we learned and where will they lead us? Endocr. Rev. 1999; 20(3): 358-417. https://dx.doi.org/10.1210/edrv.20.3.0370.
  19. Pettersson K., Gustafsson J.A. Role of estrogen receptor beta in estrogen action. Annu. Rev. Physiol. 2001; 63: 165-92. https://dx.doi.org/10.1146/annurev.physiol.63.1.165.
  20. Martin-Millan M., Castaneda S. Estrogens, osteoarthritis and inflammation. Joint Bone Spine. 2013; 80(4): 368-73. https://dx.doi.org/10.1016/j.jbspin.2012.11.008.
  21. Riancho J.A., Garci'a-Ibarbia C., Gravani A., Raine E.V., Rodn’guez-Fontenla C., Soto-Hermida A. et al. Common variations in estrogen-related genes are associated with severe large-joint osteoarthritis: a multicenter genetic and functional study. Osteoarthritis Cartilage. 2010; 18(7): 927-33. https://dx.doi.org/10.1016/j.joca.2010.04.002.
  22. Ushiyama T., Ueyama H., Inoue K., Nishioka J., Ohkubo I., Hukuda S. Estrogen receptor gene polymorphism and generalized osteoarthritis. J. Rheumatol. 1998; 25(1): 134-7.
  23. Hussain S.M., Cicuttini F.M., Alyousef B., Wang Y. Female hormonal factors and osteoarthritis of the knee, hip and hand: a narrative review. Climacteric. 2018; 21(2): 132-9. https://dx.doi.org/10.1080/13697137.2017.1421926.
  24. Brown M. Skeletal muscle and bone: effect of sex steroids and aging. Adv. Physiol. Educ. 2008; 32(2): 120-6. https://dx.doi.org/10.1152/advan.90111.2008.
  25. Tinti L., Niccolini S., Lamboglia A., Pascarelli N.A., Cervone R., Fioravanti A. Raloxifene protects cultured human chondrocytes from IL-1P induced damage: a biochemical and morphological study. Eur. J. Pharmacol. 2011; 670(1): 67-73. https://dx.doi.org/10.1016/j.ejphar.2011.08.027.
  26. Якушевская О.В., Юренева С.В. Менопаузальная гормональная терапия в условиях пандемии коронавирусной инфекции COVID-19. Доктор.Ру. 2021; 20(1): 78-83. doi: https://dx.doi.org/10.31550/1727-2378-2021-20-1-78-83
  27. Richette P., Dumontier M.F., Franqois M., Tsagris L., Korwin-Zmijowska C., Rannou F., Corvol M.T. Dual effects of 17beta-oestradiol on interleukin 1beta-induced proteoglycan degradation in chondrocytes. Ann. Rheum. Dis. 2004; 63(2): 191-9. https://dx.doi.org/10.1136/ard.2003.006510.
  28. Ito M., Nakamura T., Tsurusaki K., Uetani M., Hayashi K. Effects of menopause on age-dependent bone loss in the axial and appendicular skeletons in healthy Japanese women. Osteoporos Int. 1999; 10(5): 377-83. https://dx.doi.org/10.1007/s001980050243.
  29. Giangregorio L., Blimkie C.J. Skeletal adaptations to alterations in weightbearing activity: a comparison of models of disuse osteoporosis. Sports Med. 2002; 32(7): 459-76. 1 https://dx.doi.org/0.2165/00007256-200232070-00005.
  30. Ham K.D., Carlson C.S. Effects of estrogen replacement therapy on bone turnover in subchondral bone and epiphyseal metaphyseal cancellous bone of ovariectomized cynomolgus monkeys. J. Bone Miner. Res. 2004; 19(5): 823-9. https://dx.doi.org/10.1359/JBMR.040309.
  31. Compston J.E. Sex steroids and bone. Physiol. Rev. 2001 ;81(1): 419-47. https://dx.doi.org/10.1152/physrev.2001.81.1.419.
  32. Bay-Jensen A.C., Tabassi N.C., Sondergaard L.V., Andersen T.L., Dagnaes-Hansen F., Garnero P. et al. The response to oestrogen deprivation of the cartilage collagen degradation marker, CTX-II, is unique compared with other markers of collagen turnover. Arthritis Res. Ther. 2009; 11(1): R9. https://dx.doi.org/10.1186/ar2596.
  33. Garnero P., Conrozier T., Christgau S., Mathieu P., Delmas P.D., Vignon E. Urinary type II collagen C-telopeptide levels are increased in patients with rapidly destructive hip osteoarthritis. Ann. Rheum. Dis. 2003; 62(10): 939-43. https://dx.doi.org/10.1136/ard.62.10.939.
  34. Lovejoy J.C. The influence of sex hormones on obesity across the female life span. J. Womens Health. 1998; 7(10): 1247-56. https://dx.doi.org/10.1089/jwh.1998.7.1247.
  35. Pottie P., Presle N., Terlain B., Netter P., Mainard D., Berenbaum F. Obesity and osteoarthritis: more complex than predicted! Ann. Rheum. Dis. 2006; 65(11): 1403-5. https://dx.doi.org/10.1136/ard.2006.061994.
  36. Blomqvist A. Sex hormones and pain: a new role for brain aromatase? J. Comp. Neurol. 2000; 423(4): 549-51.
  37. Dawson-Basoa M.E., Gintzler A.R. Estrogen and progesterone activate spinal kappa-opiate receptor analgesic mechanisms. Pain. 1996; 64(1): 169-77. https://dx.doi.org/10.1016/0304-3959(95)00092-5.
  38. Smith Y.R., Stohler C.S., Nichols T.E., Bueller J.A., Koeppe R.A., Zubieta J.K. Pronociceptive and antinociceptive effects of estradiol through endogenous opioid neurotransmission in women. J. Neurosci. 2006; 26(21): 5777-85. https://dx.doi.org/10.1523/JNEUROSCI.5223-05.2006.
  39. Pamuk O.N., Donmez S., Cakir N. Increased frequencies of hysterectomy and early menopause in fibromyalgia patients: a comparative study. Clin. Rheumatol. 2009; 28(5): 561-4. https://dx.doi.org/10.1007/s10067-009-1087-1.
  40. Cecil R.L. Arthritis of the menopause. J. Am. Med. Assoc. 1925; 84: 75-9.
  41. Nelson H.D. Menopause. Lancet. 2008; 371(9614): 760-70. https://dx.doi.org/10.1016/S0140-6736(08)60346-3.
  42. Hays J., Ockene J.K., Brunner R.L., Kotchen J.M., Manson J.E., Patterson R.E. et al. Effects of estrogen plus progestin on health-related quality of life. N. Engl. J. Med. 2003; 348(19): 1839-54. https://dx.doi.org/10.1056/NEJMoa030311.
  43. Barnabei V.M., Cochrane B.B., Aragaki A.K., Nygaard I., Williams R.S., McGovern P.G. et al. Menopausal symptoms and treatment-related effects of estrogen and progestin in the Women's Health Initiative. Obstet. Gynecol. 2005; 105(5, Pt1): 1063-73. https://dx.doi.org/10.1097/01.AOG.0000158120.47542.18.
  44. Балан В.Е., Андреева Е.Н., Юренева С.В., Ткачева О.Н., Илюхин Е.А. Риск и польза менопаузальной гормональной терапии. Акушерство и гинекология. 2020; 3: 33-41. https://dx.doi.org/10.18565/aig.2020.3.33-41.
  45. Welton A.J., Vickers M.R., Kim J., Ford D., Lawton B.A., MacLennan A.H. et al. Health related quality of life after combined hormone replacement therapy: randomised controlled trial. BMJ. 2008; 337: a1190. https://dx.doi.org/10.1136/bmj.a1190.
  46. Hellevik A.I., Nordsletten L., Johnsen M.B., Fenstad A.M., Furnes O., Storheim K. et al. Age of menarche is associated with knee joint replacement due to primary osteoarthritis (The HUNT Study and the Norwegian Arthroplasty Register). Osteoarthritis Cartilage. 2017; 25(10): 1654-62. https://dx.doi.org/10.1016/j.joca.2017.06.010. Correction appears in Osteoarthritis Cartilage. 2017; 25(12): 2148-9. https://dx.doi.org/10.1016/j.joca.2017.10.006.
  47. Wei S., Venn A., Ding C., Martel-Pelletier J., Pelletier J.P., Abram F. et al. The associations between parity, other reproductive factors and cartilage in women aged 50-80 years. Osteoarthritis Cartilage. 2011; 19(11): 1307-13. https://dx.doi.org/10.1016/j.joca.2011.07.020.
  48. Spector T.D., Hart D.J., Brown P., Almeyda J., Dacre J.E., Doyle D.V., Silman A.J. Frequency of osteoarthritis in hysterectomized women. J. Rheumatol. 1991; 18(12): 1877-83.
  49. Inoue K., Ushiyama T., Kim Y., Shichikawa K., Nishioka J., Hukuda S. Increased rate of hysterectomy in women undergoing surgery for osteoarthritis of the knee. Osteoarthritis Cartilage. 1995; 3(3): 205-9. https://dx.doi.org/10.1016/s1063-4584(05)80055-x.
  50. Richette P., Corvol M., Bardin T. Estrogens, cartilage, and osteoarthritis. Joint Bone Spine. 2003; 70(4): 257-62. https://dx.doi.org/10.1016/s1297-319x(03)00067-8.
  51. Spector T.D., Perry L.A., Jubb R.W. Endogenous sex steroid levels in women with generalised osteoarthritis. Clin. Rheumatol. 1991; 10(3): 316-9. https://dx.doi.org/10.1007/BF02208698.
  52. Sowers M.R., McConnell D., Jannausch M., Buyuktur A.G., Hochberg M., Jamadar D.A. Estradiol and its metabolites and their association with knee osteoarthritis. Arthritis Rheum. 2006; 54(8): 2481-7. https://dx.doi.org/10.1002/art.22005.
  53. Hanna F.S., Bell R.J., Cicuttini F.M., Davison S.L., Wluka A.E., Davis S.R. The relationship between endogenous testosterone, preandrogens, and sex hormone binding globulin and knee joint structure in women at midlife. Semin. Arthritis Rheum. 2007; 37(1): 56-62. https://dx.doi.org/10.1016/j.semarthrit.2006.12.008.
  54. Hussain S.M., Cicuttini F.M., Bell R.J., Robinson P.J., Davis S.R., Giles G.G. et al. Incidence of total knee and hip replacement for osteoarthritis in relation to circulating sex steroid hormone concentrations in women. Arthritis Rheumatol. 2014; 66(8): 2144-51. https://dx.doi.org/10.1002/art.38651.
  55. Cauley J.A., Kwoh C.K., Egeland G., Nevitt M.C., Cooperstein L., Rohay J. et al. Serum sex hormones and severity of osteoarthritis of the hand. J. Rheumatol. 1993; 20(7): 1170-5.
  56. Sowers M.F., Hochberg M., Crabbe J.P., Muhich A., Crutchfield M., Updike S. Association of bone mineral density and sex hormone levels with osteoarthritis of the hand and knee in premenopausal women. Am. J. Epidemiol. 1996; 143(1): 38-47. https://dx.doi.org/10.1093/oxfordjournals.aje.a008655.
  57. Gao W., Zeng C., Cai D., Liu B., Li Y., Wen X., Chen Y. Serum concentrations of selected endogenous estrogen and estrogen metabolites in pre- and postmenopausal Chinese women with osteoarthritis. J. Endocrinol. Invest. 2010; 33(9): 644-9. https://dx.doi.org/10.1007/BF03346664.
  58. Ockene J.K., Barad D.H., Cochrane B.B., Larson J.C., Gass M., Wassertheil-Smoller S. et al. Symptom experience after discontinuing use of estrogen plus progestin. JAMA. 2005; 294(2): 183-93. https://dx.doi.org/10.1001/jama.294.2.183.
  59. Sestak I., Cuzick J., Sapunar F., Eastell R., Forbes J.F., Bianco A.R. et al.; ATAC Trialists' Group. Risk factors for joint symptoms in patients enrolled in the ATAC trial: a retrospective, exploratory analysis. Lancet Oncol. 2008; 9(9): 866-72. https://dx.doi.org/10.1016/S1470-2045(08)70182-7.
  60. Crew K.D., Greenlee H., Capodice J., Raptis G., Brafman L., Fuentes D. et al. Prevalence of joint symptoms in postmenopausal women taking aromatase inhibitors for early-stage breast cancer. J. Clin. Oncol. 2007; 25(25): 3877-83. https://dx.doi.org/10.1200/JCO.2007.10.7573.
  61. Morales L., Pans S., Paridaens R., Westhovens R., Timmerman D., Verhaeghe J. et al. Debilitating musculoskeletal pain and stiffness with letrozole and exemestane: associated tenosynovial changes on magnetic resonance imaging. Breast Cancer Res. Treat. 2007; 104(1): 87-91. https://dx.doi.org/10.1007/s10549-006-9394-6.
  62. Hussain S.M., Cicuttini F.M., Alyousef B., Wang Y. Female hormonal factors and osteoarthritis of the knee, hip and hand: a narrative review. Climacteric. 2018; 21(2): 132-9. https://dx.doi.org/10.1080/13697137.2017.1421926.
  63. Baber R.J., Panay N., Fenton A.; IMS Writing Group. 2016 IMS Recommendations on women's midlife health and menopause hormone therapy. Climacteric. 2016; 19(2): 109-50. https://dx.doi.org/10.3109/13697137.2015.1129166.

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