by author Angela Stengler, ND
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.
