Menopause is emerging as a significant risk factor for osteoarthritis, a debilitating disease that affects millions of people worldwide. Recent research highlights the role of two key sex hormones—17beta-estradiol and progesterone—in maintaining cartilage health. The loss of these hormones post-menopause increases cartilage vulnerability, contributing to the aging and degeneration of cartilage.
A recent study using murine models found that menopause leads to a drop in 17beta-estradiol and progesterone, which in turn accelerates cartilage aging, degeneration, and disassembly of the extracellular matrix. While these findings provide crucial insights, they do not fully replicate the human body, highlighting a gap between laboratory discoveries and real-world applications.
“Murine models of research, while enlightening, don’t fully replicate the human body. [The findings] thought-provoking as to potential therapeutics, but certainly more research need be done.” – Kecia Gaither, MD, MPH, MS, MBA, FACOG
Hormone replacement therapy (HRT) emerges as a potential avenue for regenerating cartilage. The study suggests HRT reduces markers of senescence and promotes chondrogenic markers, indicating its potential to reverse cartilage damage. However, human evidence supporting the use of HRT for osteoarthritis remains insufficient.
“The study suggests that hormone replacement reduced markers of senescence and promoted chondrogenic markers suggesting potential for regeneration. I think this is entirely conceivable but not yet proven in humans and these results should increase research activity in the fields of endocrinology, women’s health and [osteoarthritis] to understand these relationships better in translational human studies.” – Fiona Watt, MBBS, BMedSci, PhD
Experts call for fully powered human randomized clinical trials to determine the efficacy of HRT in preventing or treating osteoarthritis in postmenopausal populations. Such trials are essential to validate these preliminary findings and develop effective treatment strategies.
“The question arises of whether we should consider use of hormone replacement therapy, either to prevent osteoarthritis or try to treat it if it occurs in post menopausal populations. This would be outside of its existing licenses. We lack evidence in humans to support this currently and fully powered human randomised clinical trials in populations at risk of or with osteoarthritis are needed to better understand whether [hormone replacement therapy] or similar agents would be efficacious.” – Fiona Watt, MBBS, BMedSci, PhD
Understanding the disproportionate impact of osteoarthritis on postmenopausal women is crucial for designing interventions that can slow or even prevent the onset of this condition. Such strategies could significantly enhance the quality of life for those affected by osteoarthritis.
“Understanding why postmenopausal women are disproportionately affected by osteoarthritis is a critical step toward designing effective interventions,” she pointed out. “Our findings lay the groundwork for strategies we hope will eventually slow, mitigate, or even prevent the onset of this debilitating disease, improving the quality of life for millions of individuals.” – Ambrosio
Advancing knowledge about the link between menopause and osteoarthritis is vital. This understanding could lead to innovative treatments that bridge the gap from lab-based discoveries to tangible solutions for individuals living with osteoarthritis.
“these findings provide valuable insights into the underlying mechanisms of osteoarthritis and offer a foundation for bridging the gap between lab-based discoveries and real-world solutions for individuals living with this condition.” – Ambrosio
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