There is a frequent onset of disease around the time of menopause. Recent data demonstrate that the use of hormone replacement therapy is associated with a three-fold reduction in the risk of knee osteoarthritis and a suggestion of a protective effect in hand problems. There is insufficient data to understand the temporal relationship between replacement use and the incidence of the disease. Individuals with osteoarthritis often are not severely disabled, but the high prevalence gives this disease a major impact on the function and cost of care of the elderly. The overall incidence of osteoarthritis is higher in women than in men, especially after the 50 years of age.
Women are more likely than men to experience osteoarthritis in multiple joints.
While there is a genetic disposition to osteoarthritis research has focused on looking at estrogen receptor gene polymorphism as an explanation for the disease process. Furthermore, we have little understanding of the relationship between endogenous hormone levels, the use of exogenous hormones and the function of the receptor subtypes. This is highlighted in this disease process by suggestion that estrogen may contribute to the disease while hormone replacement therapy is protective. While not specifically a gender difference, the discovery of the second estrogen receptor is probably the single most profound observation made with regard to women's biology in the past couple of years. In sum, classic estrogen biology has indicated that estrogen bound with a single receptor, thereby effecting gene expression in the cell.