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© 1994 Oxford University Press

other

Non-Contraceptive Hormones and the Risk of Rheumatoid Arthritis in Menopausal Women

THOMAS D KOEPSELL*,**,, CARIN E DUGOWSON*,{dagger}, J LEE NELSON{ddagger}, LYNDA F VOIGT{ddagger} and JANET R DALING*,{ddagger}

* Department of Epidemiology, University of Washington Seattle, WA, USA
** Department of Health Services, University of Washington Seattle, WA, USA
{dagger} Division of Rheumatology, Department of Medicine, University of Washington Seattle, WA, USA
{ddagger} Fred Hutchinson Cancer Research Center Seattle, WA, USA

Reprint requests to: Dr Thomas Koepsell, Department of Epidemiology, SC-36, University of Washington, Seattle, WA 98195, USA

BACKGROUND: Several reproductive factors appear to affect a woman's risk of developing rheumatoid arthritis. This study's purpose was to determine whether use of non-contraceptive hormones is among them.

METHODS: A population-based case-control study was conducted in King County, Washington and Group Health Cooperative of Puget Sound, a prepaid health plan. New cases of rheumatoid arthritis in peri- or postmenopausal women (n = 135) were verified through clinical examination and compared with 592 controls. Both groups were interviewed in person about hormone use and demographic and reproductive factors.

RESULTS: The age-adjusted relative risk (RR) among women who had ever used non-contraceptive oestrogens was 1.04 (95% confidence interval [Cl]: 0.70–1.55), and among women who had ever used progestins it was 0.66 (95% Cl: 0.40–1.08). For current users of oestrogen only, the RR was 0.97 (95% Cl: 0.62–1.53), and among current users of oestrogen plus progestin it was 0.81 (95% Cl: 0.45–1.45). Multivariate analyses yielded similar results. There was little evidence of a dose-response relationship with duration of use or with frequency of progestin use.

CONCLUSIONS: Use of non-contraceptive oestrogens appears to have little effect on the risk of developing rheumatoid arthritis in menopausal women. There may be a modest reduction in risk among progestin users.

Received 1 March 1994


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