Short answer: A little, in the largest trials. In the Women's Health Initiative, 47% of women on estrogen plus progestin reported relief of joint pain or stiffness after a year, compared with 38% on placebo. In the estrogen-alone trial, joint pain was slightly less common on estrogen (76% vs 79%), though joint swelling was slightly more common. After the estrogen plus progestin trial stopped, former users more often reported pain or stiffness.
The WHI estrogen plus progestin trial gave 16,608 women aged 50 to 79 with a uterus either Premarin 0.625 mg plus medroxyprogesterone 2.5 mg a day or placebo. After the first year, among women who had each symptom at the start:
| Symptom | Estrogen + progestin | Placebo |
|---|---|---|
| Hot flashes relieved | 85.7% | 57.7% |
| Joint pain or stiffness relieved | 47.1% | 38.4% |
| General aches or pains relieved | 49.3% | 43.7% |
The authors also reported that the hormone group was less likely to develop new muscle and joint symptoms. In the same trial, women without breast tenderness or headaches at the start more often developed them on hormones.
The WHI estrogen-alone trial included 10,739 women who had had a hysterectomy, given Premarin 0.625 mg a day or placebo. At the start, about 77% reported joint pain and 40% joint swelling. After one year, joint pain was less frequent and less severe on estrogen (76.3% vs 79.2%), and the difference lasted through year 3. Joint swelling was slightly more frequent on estrogen (42.1% vs 39.7%).
This was a post hoc analysis, meaning joint symptoms were not the main question the trial was originally designed to answer. The authors described the drop in joint pain as modest.
When the estrogen plus progestin trial was stopped early, the researchers mailed a survey 8 to 12 months later to 8,405 women who had still been taking study pills. Former hormone users were about twice as likely as former placebo users to report pain or stiffness (adjusted odds ratio 2.16) and far more likely to report moderate or severe hot flashes (adjusted odds ratio 5.82). The women were 69 years old on average and had taken the pills for about 5.7 years.
A survey after stopping shows how symptoms changed, but it cannot separate a return of earlier symptoms from new ones.
Hormone therapy is not approved to treat joint pain, and the WHI used one oral product at one dose in women whose average age was over 60. Joint pain has many causes, including arthritis. Dose Track can log joint pain alongside hormone doses, which gives the prescriber a record of how symptoms change when a medicine starts or stops.
Read more on Dose Track: Joint pain · Menopause · Women's Health Initiative · Vasomotor symptoms