Sex Difference in OA: Should We Blame Estrogen?

Area of Science:

• Rheumatology and Endocrinology
• Investigating the biological basis of osteoarthritis (OA) and hormonal influences.

Background:

• Osteoarthritis (OA) is a major global cause of chronic pain and disability, disproportionately affecting women.
• The role of estrogen in sex-based differences in OA remains unclear.
• Existing research presents conflicting findings regarding estrogen's impact on OA.

Purpose of the Study:

• To review and synthesize findings from studies examining estrogen, estrogen depletion, and hormone replacement therapy in relation to knee, hip, hand, and spine osteoarthritis.
• To identify gaps and inconsistencies in current research on estrogen and OA.

Main Methods:

• A targeted literature review was conducted using the PubMed database.
• Studies investigating estrogen's effects on various joints affected by OA were analyzed.

Main Results:

• Evidence regarding the protective effects of estrogen therapy on OA is inconsistent, varying by joint, outcome measure, and study design.
• Some studies suggest a potential protective role for hormone replacement therapy in certain joints, while others indicate no benefit or even adverse effects.
• The literature lacks high-quality experimental research, and study incomparability hinders definitive conclusions.

Conclusions:

• The definitive role of estrogen in the development of osteoarthritis across different joints remains inconclusive.
• Inconclusive evidence is attributed to variations in diagnostic criteria, methodologies, populations, and outcome measures across studies.
• Further high-quality research is essential to clarify estrogen's role in OA, especially considering demographic trends like aging and obesity.