study identifies potential avenue for treating osteoarthritis after menopause
there are several reasons why, as females age, they are more likely to develop osteoarthritis—with one main reason being the drop in estrogen that occurs during menopause.
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osteoarthritis affects 25 per cent of canadian women. it can develop as young as 20, but risk and prevalence rates grow significantly as a person ages.
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females are three and a half times more likely to develop osteoarthritis between the ages of 50 and 60 than any other demographic. those numbers also increase with age. during this time, females also typically go through, or have already experienced, menopause. while there is already a long-known link between the two, the mechanisms that drive the connection haven’t been well understood.
now, a new study conducted by researchers with spaulding rehabilitation has opened the door to better understanding in the hopes that it can improve treatment avenues for those who experience the debilitating symptoms of the condition.
osteoarthritis development during aging in females
osteoarthritis affects 25 per cent of canadian women. it can develop as young as 20, but risk and prevalence rates grow significantly as a person ages. for example, roughly 11 to 18 per cent of canadian women between the ages of 50 and 59 have osteoarthritis. those between the ages of 60 and 69 develop osteoarthritis at a rate of 25 to 33 per cent, and those 70 and above do so at a rate of 40 to 60 per cent, with the highest prevalence rates being seen in those aged 90 and above.
there are several reasons why, as females age, they are more likely to develop osteoarthritis—with one main reason being the drop in estrogen that occurs during menopause.
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when the body begins to produce estrogen at much lower levels, the tasks it’s meant to perform begin to falter. estrogen works to protect joints and reduce inflammation, but once there is less of the hormone, those protective efforts are hindered.
it also affects the cartilage between bones, leading to disintegration over time. when that cartilage wears down, osteoarthritis may not be far behind because of the damage caused by bones rubbing together without that tissue to protect them.
when these things happen, it can lead to the development of osteoarthritis and its hallmark symptoms, including joint pain, fluid buildup in the joint, limited mobility, weakness and stiffness in the muscles, and bone spurs.
as of writing, no disease-modifying treatments are available for osteoarthritis, so symptom management is all that’s available for those who develop the condition.
the study findings
to determine why the loss of estrogen during menopause plays such a major role in the development of osteoarthritis, the researchers examined two primary components of cartilage that disintegrate in joints: the surrounding proteins that give it its structure, known as the extracellular matrix and the cell population in the cartilage, known as chondrocytes.
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the study, which examined “a mouse model of menopause,” looked at changes that occurred in the knee joint and how it was connected to the entire organism to see how the changes that are similar to those that occur in females during menopause affect osteoarthritis risk, development, and progression. in mice, cartilage quality loss occurs at the start of menopause, which is also typically seen in female humans.
to get to their results, they had to utilize a specific type of framework that would show how cartilage protein changes occur in osteoarthritis, and in the process, found that a loss of estrogen and progesterone fosters the perfect environment for deterioration of both the extracellular matrix and the cells.
understanding of this process allowed them to try to treat and reduce cartilage loss in osteoarthritis in the mice by reintroducing estrogen and progesterone to levels that are found before a person goes through menopause. this ended up ultimately showing them that when hormone therapy is implemented in osteoarthritis, it can protect the cartilage from breaking down further.
“our findings reveal novel pathways that may represent promising new therapeutic targets,” said senior study author fabrisia ambrosio, phd, mpt, director of the discovery center for musculoskeletal recovery of the schoen adams research institute at spaulding rehabilitation, in a press release. “by understanding how menopause-induced changes in sex hormone levels contribute to joint degeneration, our hope is that this will pave the way for researchers to develop novel strategies that slow or prevent the progression of oa, which could lead to a better quality of life for millions of women worldwide.”
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what this means for postmenopausal females with osteoarthritis
the results of the mouse-model study show a new and promising direction in the treatment of post-menopausal osteoarthritis, but research in humans still needs to occur to take it from a clinical study into patient treatment. but there is new hope on the horizon for those living with osteoarthritis.
“this research provides insights into why the long-observed sex differences in osteoarthritis rates may occur. we hope that since we were able to protect against cartilage degeneration in our models, we are laying the foundation for pursuing effective treatments for older female humans,” said lead study author gabrielle gilmer, phd, a graduate student researcher at spaulding rehabilitation in a press release.
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