Estrogen alone and joint symptoms in the women's health initiative randomized trial

Rowan T. Chlebowski, Dominic J. Cirillo, Charles B. Eaton, Marcia L. Stefanick, Mary Pettinger, Laura D Carbone, Karen C. Johnson, Michael S. Simon, Nancy F. Woods, Jean Wactawski-Wende

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Objective: Although joint symptoms are commonly reported after menopause, observational studies examining exogenous estrogen's influence on joint symptoms provide mixed results. Against this background, estrogen-alone effects on joint symptoms were examined in post hoc analyses in the Women's Health Initiative randomized, placebo-controlled, clinical trial. Methods: A total of 10,739 postmenopausal women who have had a hysterectomy were randomized to receive daily oral conjugated equine estrogens (0.625 mg/d) or a matching placebo. The frequency and severity of joint pain and joint swelling were assessed by questionnaire in all participants at entry and on year 1, and in a 9.9% random subsample (n = 1,062) after years 3 and 6. Logistic regression models were used to compare the frequency and severity of symptoms by randomization group. Sensitivity analyses evaluated adherence influence on symptoms. Results: At baseline, joint pain and joint swelling were closely comparable in the randomization groups (about 77% with joint pain and 40% with joint swelling). After 1 year, joint pain frequency was significantly lower in the estrogen-alone group compared with the placebo group (76.3% vs 79.2%, P = 0.001), as was joint pain severity, and the difference in pain between randomization groups persisted through year 3. However, joint swelling frequency was higher in the estrogen-alone group (42.1% vs 39.7%, P = 0.02). Adherence-adjusted analyses strengthen estrogen's association with reduced joint pain but attenuate estrogen's association with increased joint swelling. Conclusions: The current findings suggest that estrogen-alone use in postmenopausal women results in a modest but sustained reduction in the frequency of joint pain.

Original languageEnglish (US)
Pages (from-to)600-608
Number of pages9
JournalMenopause
Volume20
Issue number6
DOIs
StatePublished - Jun 1 2013

Keywords

  • Estrogen
  • Joint pain
  • Joint swelling
  • Postmenopausal women
  • Randomized clinical trial
  • Women's Health Initiative

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Chlebowski, R. T., Cirillo, D. J., Eaton, C. B., Stefanick, M. L., Pettinger, M., Carbone, L. D., Johnson, K. C., Simon, M. S., Woods, N. F., & Wactawski-Wende, J. (2013). Estrogen alone and joint symptoms in the women's health initiative randomized trial. Menopause, 20(6), 600-608. https://doi.org/10.1097/gme.0b013e31828392c4