Table 2.

Effects of estrogen on joint tissues

Drug name	Type of study	Effects on joint tissues	Reference
Estradiol	In-vivo OVX + OA rabbits	Cartilage degeneration	[16]
β-estradiol	In-vivo OVX rabbits	Loss of glycosaminoglycans and collagen	[17]
17β-estradiol	In-vivo OVX rats	Decrease of CTX-II; prevention of cartilage lesions	[20]
17β-estradiol	In-vivo postmenopausal OA women	Decrease of 17β-estradiol after menopause	[21]
Estrogen	In-vivo postmenopausal OA women	Estrogen deficiency may lead to increase of serum IL-6	[22]
17β-estradiol	In-vivo murine with knee OA	Inhibition of tibial and patellar subchondral cortical thinning and tibial cartilage damage	[23]
17β-estradiol	In-vivo OVX + OA mice	Inhibition of bone resorption; decreased ADAMTS-4 and ADAMTS-5 expression	[19]
β-estradiol	In-vivo OA + OVX murine	Reduction of cartilage and bone turnover	[18]
β-estradiol	In-vivo OVX + ACLT murine	Regulation of intraarticular neurogenic inflammation	[24]
17β-estradiol	In-vivo OA + OVX murine	Potentiation of cartilage degradation and subchondral bone erosion and mRNA expression of Fas, FasL, caspase 3, and caspase 8	[25]
17β-estradiol	In-vitro rabbit chondrocytes	Upregulation of type II collagen gene	[26]
17β-estradiol	In-vitro cow mature joint cartilage	Prevention injury-related cell death and GAG release	[27]
17β-estradiol	In-vitro rabbit chondrocytes	Inhibition of doxorubicin-induced apoptosis	[28]
17β-estradiol	In-vitro rat OA chondrocytes	Promotion of chondrocyte proliferation	[29]
Oral estrogen	CSS osteoporotic white women	Reduction of risk of any hip OA	[31]
HRT	CSS women around menopause	Inverse association of current HRT use and radiological OA of the knee	[35]
Oral estrogen	CSS women with OA	No positive association of estrogen use with radiographic knee OA	[36]
ERT	CSS older women	Protection moderately against worsening of radiographic knee OA, but not statistically significant	[37]
ERT	CSS women	Nonsignificant protective effect for incident knee osteophytes	[38]
CEE	RCT community-dwelling women	Lower rates of any arthroplasty	[32]
Estrogen	CSS women	Lower subchondral bone attrition and bone marrow edema-like abnormalities	[33]
Estrogen	CSS, older women	No significant correlation with knee replacement of OA	[39]
HT	Prospective study, women around menopause	Correlation highly with the hip or knee replacement rates of OA	[40]
17β-estradiol	RCT postmenopausal OP women	Decrease of levels of COMP	[34]

OA osteoarthritis, OP osteoporosis, OVX ovariectomy, CTX-II C-terminal cross-linked telopeptide type II collagen, HRT hormone replacement therapy, ERT estrogen replacement therapy, COMP cartilage oligomeric matrix protein, ACLT anterior cruciate ligament transaction, CEE conjugated equine estrogens, HT hormonal therapies, CSS cross-sectional study, RCT randomized controlled trial