Menopausal hormone therapy for rheumatic diseases: osteoarthritis

Panevin T.S., Yureneva S.V., Zotkin E.G.

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
Osteoarthritis (OA) is one of the diseases of great sociomedical importance. Primary OA generally develops between the ages of 40–45 years, 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.


menopausal hormone therapy


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Received 17.08.2021

Accepted 01.12.2021

About the Authors

Taras S. Panevin, Ph.D., Endocrinologist, V.A. Nasonova Research Institute of Rheumatology, +7(914)207-43-67,,
115522, Russia, Moscow, Kashirskoye Shosse, 34A.
Svetlana V. Yureneva, Dr. Med. Sci., Leading Researcher at the Department of Gynecological Endocrinology, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia,, 117997, Russia, Moscow, Ac. Oparina str., 4.
Evgeniy G. Zotkin, Dr. Med. Sci., First Deputy Director, V.A. Nasonova Research Institute of Rheumatology,,
115522, Russia, Moscow, Kashirskoye Shosse, 34A.

Authors' contributions: Panevin T.S. – pilot study; writing, editing the text; Yureneva S.V. – writing, editing the text and final approval of the manuscript; Zotkin E.G. – writing, editing the text and final approval of the manuscript. All the authors have made a significant contribution to the preparation of the article, read, and approved the final version of the article before publication.
Conflicts of interest: The authors declare that there are no possible conflicts of interest.
Funding: The pilot and analytical study has been conducted without sponsorship.
For citation: Panevin T.S., Yureneva S.V., Zotkin E.G.
Menopausal hormone therapy for rheumatic diseases: osteoarthritis.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 12: 50-57 (in Russian)

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