> Health and Disease > Bones, Joints, and Muscles > arthritis (osteo-)

An estimated 2.7 million Canadians (one in 10 people) are affected by osteoarthritis. Eighty-five per cent of the population will be affected by osteoarthritis by age 70. It is the single most common cause of lost time from work and leisure activity.

Under the age of 45, osteoarthritis is more common in men but after the age of 45, it is 10 times more common in women! Surveys have indicated that 80 percent of people over 50 have osteoarthritis.

There are many factors that can cause and contribute to osteoarthritis. Increasing age, obesity, history of joint injuries and trauma, genetic conditions, hormonal factors, nutritional deficiencies and maldigestion can all cause or exacerbate suffering. Since osteoarthritis of the knee is twice as common in women as men, researchers investigated the impact high-heeled shoes have on knee osteoarthritis. They concluded that the altered forces at the knee caused by walking in high heels may in fact predispose degenerative changes in the joint. Does that mean high-heeled shoes are the only reason more women have osteoarthritis than men? Of course not. It is just one piece of the puzzle.

The Post-45 Puzzle

The most curious fact regarding osteoarthritis is that the number of women affected by this disease increases greatly after the age of 45. This is the time most women are either beginning menopause (perimenopause) or are already menopausal. Increased aches and pains are the common complaints of menopausal women. This is the time in a woman’s life where estrogen, progesterone, dehydroepiandrosterone (DHEA) and other hormones are declining. Low thyroid function has even been implicated as a possible contributing cause to osteoarthritis.

It is not clear how or why the declining levels of estrogen and progesterone affect joint pain but it is clear that natural progesterone, with or without natural estrogen therapy, provides almost immediate relief from joint pain for some women. Some doctors say it is due to natural progesterone’s anti-inflammatory properties. Others feel high levels of estrogen (using hormone replacement) have an immunosuppressive effect that blocks arthritic responses. We do know that hormones affect circulation in the body and have a direct effect on the immune system.

If you are going to use hormone replacements, I recommend natural hormone therapy. Natural hormones are formulated with natural estrogen, natural progesterone and occasionally natural testosterone in a cream or pill form. These natural hormones are the closest thing to that found in a woman’s body and are different from synthetic hormones, which are not bio-identical and possess serious side effects. You can purchase natural progesterone at health food stores in the United States. It is not allowed in Canada; however, naturopathic doctors in Canada are familiar with it. Ask your health practitioner or your health food store for alternative sources.

Interestingly, recent studies have suggested that synthetic hormone replacement therapy may contribute to arthritis. Canadian researchers found that the odds of arthritis incidence for current synthetic hormone replacement users who had used hormones for five years or longer were twice as high as for non-users. Another study showed an increased risk of arthritis by 30 per cent with hormone use for one to four years; 96 percent with hormone use for four to 10 years; and 104 percent with hormone use for more than 10 years. The results suggest that users of estrogen replacement therapy are at higher risk of developing arthritis and the longer the use of the hormone, the higher the risk.

Preventative Practices

With all of this information, what is a woman to do? Natural approaches include maintaining an ideal body weight; exercising; optimizing digestion; eating a whole foods diet and eliminating foods that exacerbate pain and inflammation.

A well-known herb used for relieving menopausal symptoms, black cohosh, is also helpful in relieving arthritic symptoms. This herb has not only been proven to help with the symptoms of menopause such as hot flashes, but it also has anti-inflammatory properties, which can be helpful to menopausal women suffering from osteoarthritis.

If nutritional recommendations and supplements don’t resolve pain, I recommend that women have a salivary hormone profile done to determine estrogen, progesterone, testosterone and DHEA levels. Talk to your natural health care provider about natural hormones to decide if this option is right for you.

Dr Stengler is a practising naturopath and author in California.

Source: alive #214, August 2000

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