Menopausal hormone therapy for rheumatic diseases (gout)

DOI

https://dx.doi.org/10.18565/aig.2021.9.36-41

Panevin T.S., Yureneva S.V.
1) V.A. Nasonova Research Institute of Rheumatology, Ministry of Science and Education of the Russian Federation, Moscow, Russia; 2) Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation, Moscow, Russia

The perimenopausal and postmenopausal period is characterized by the development of many diseases of great sociomedical significance, as well as metabolic disorders, including those of purine metabolism. Despite the fact that gout is traditionally considered to be a disease that predominantly affects males, the prevalence of hyperuricemia (HU) and gout significantly increases in females when menopause occurs. The available data on the association of gout with the postmenopausal period, as well as its frequent combination with other metabolic syndrome components actualize the possible additional positive effects of menopausal hormone therapy (MHT) for GU and gout in females during perimenopause and postmenopause. The review considers the results of prospective versus large retrospective studies of the impact of MHT on changes in uric acid (UA) levels and on the risk of gout. The biological mechanism underlying the relationship between menopause, estrogen action, MHT, and serum UA levels is assumed to be an inhibitory effect of estrogens on UA reabsorption in the renal tubules. In addition, estrogen deficiency favors the development of metabolic disorders, such as abdominal obesity, insulin resistance, and dyslipidemia. The anti-inflammatory effect of estrogens may be the basis for reducing the risk of gout when using MHT.
Conclusion: MHT can lead to a decrease in the level of UA and in the risk of gout. However, the decrease in the production of estrogens and progestogens only partially explains the higher risk of HU and gout. The protective effect against gout is probably due not only to the estrogenic, but also progestogenic component of MHT. It may be promising to study the impact of MHT not only on the risk, but also on the course of gout.

estrogens

menopause

menopausal hormone therapy

uric acid

gout

hyperuricemia

joints

Full text (in Russian)

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Received 17.05.2021

Accepted 01.06.2021

Taras S. Panevin, Ph.D., endocrinologist, V.A. Nasonova Research Institute of Rheumatology, Ministry of Health of Russia, +7(914)207-43-67, tarasel@list.ru,
https://orcid.org/0000-0002-5290-156X, 115522, Russia, Moscow, Kashirskoye Shosse, 34A.
Svetlana V. Yureneva, Dr. Med. Sci., Leading Researcher at the Department of Gynecological Endocrinology, NMRC for OG&P, Ministry of Health of Russia,
syureneva@gmail.com, https://orcid.org/0000-0003-2864-066X, 117997, Russia, Moscow, Ac. Oparina str., 4.

Authors' contributions: Panevin T.S. – pilot study; writing and editing the text; Yureneva S.V. – writing and editing the text; final approval of the manuscript.
Conflicts of interest: The authors declare that there are no possible conflicts of interest.
Funding: The pilot and analytical study has not been sponsored.

For citation: Panevin T.S., Yureneva S.V. Menopausal hormone therapy for rheumatic diseases: Gout.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 9: 36-41 (in Russian)
https://dx.doi.org/10.18565/aig.2021.9.36-41

Menopausal hormone therapy for rheumatic diseases (gout)

Panevin T.S., Yureneva S.V.

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