Intensive care medicine

Joint pain

Clinical trial

Environmental health

Rheumatoid arthritis

Alternative medicine

Menopause

Comorbidity

Osteoarthritis

Arthritis

Physical therapy

Population

Internal medicine

Epidemiology

Medicine

Randomized controlled trial

Pathology

Maturitas

Arthritis is more common in women and often presents around the time of the menopause or in later life. Common causes of arthralgia (joint pain in the absence of arthritis) and arthritis in this population are discussed, notably osteoarthritis and rheumatoid arthritis. The clinical assessment, investigation and management of women presenting with arthralgia or arthritis will be reviewed. The epidemiological and trials evidence for the effects of menopausal hormonal therapy (MHT) on joint pain, osteoarthritis and rheumatoid arthritis will be discussed. There have been few interventional studies of MHT specifically including those with arthritis, and most of the randomized control trial (RCT) evidence comes from post-hoc analysis of large MHT clinical trials for typical symptoms of menopause, such as WHI. There is also no current evidence to support MHT preventing or delaying the onset of arthritis. Currently MHT is not recommended as part of any international guidelines for the management of arthritis. Hand osteoarthritis frequently presents around the time of menopause. A new study in post-menopausal women with hand osteoarthritis which seeks to test the feasibility of an RCT investigating whether MHT has therapeutic effect on pain and other symptoms will be outlined. Finally, considerations on the prescription of MHT in individuals with arthritis who wish to take it for other reasons will be overviewed.

Comorbidity: arthritis