Osteoarthritis is a leading cause of disability with no cure. The incidence of
osteoarthritis is sexually dimorphic: women have a higher rate of
osteoarthritis than men after the age of 50. Research has investigated the contribution of
sex hormones, reproductive factors and
hormone supplementation to
osteoarthritis. It has been recognized that different joints are susceptible to different risk factors for
osteoarthritis. We reviewed the evidence for the effect of endogenous
sex hormones, reproductive factors and
hormone supplementation on joint-specific
osteoarthritis of the knee, hip and hand. Although the role of these hormonal factors in the pathogenesis of
osteoarthritis is complex, data suggest that endogenous
hormones and reproductive factors have a role in the pathogenesis of
osteoarthritis, especially
knee osteoarthritis, with uncertainty for the effect of exogenous
hormones. From the available data, it is hard to conclude whether this is a direct effect of hormonal factors, or whether other factors related to these hormonal factors, i.e.
obesity and
inflammation, have a role in this association. Further studies should consider the mediation effect of
body weight and
inflammation, change in
body weight throughout life, circulatory levels of all endogenous
hormones and circulatory levels of
hormones after
hormone supplementation in this complex relationship.