Hormone therapy may reduce risk of carpal tunnel syndrome

USA: A new study in the journal Plos One finds that menopausal hormone therapy (HT) may reduce the risk of carpal tunnel syndrome (CTS) in postmenopausal women.

CTS is the most common compressive mono-neuropathy that commonly affects postmenopausal women. It represents an important cause of functional hand impairment and disability. The condition is often associated with living and working with pain, a physical disability that may lead to compensation claims, loss of work and inability to perform family and social roles.

Although small case series have suggested that severe CTS unresponsive to traditional non-surgical treatments may benefit from HT prescribed for menopausal symptom. However, the association between HT and CTS remains uncertain.

To investigate the association between CTS and HT, Tala Al-Rousan, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, US, and colleagues conducted a secondary analysis of the Women's Health Initiative (WHI) hormone therapy trials. Separate intention-to-treat analyses were performed for the 2 trials: the conjugated equine estrogens alone (CEE alone) and the trial of CEE plus medroxyprogesterone acetate (MPA) trial," they explained.

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The study involved 16,053 patients ≥65 years old who were enrolled in Medicare. The participants were divided into 2 groups; those who had a hysterectomy received either CEE 0.625mg/day or placebo, while patients without hysterectomy were randomized to CEE + MPA (2.5mg/day) or placebo.

Key Findings:

• After a mean follow-up of 4.5 years in the CEE only trial (N=6,833), there were 203 incident cases of carpal tunnel syndrome in the intervention group vs 262 cases in the placebo arm.


• In the CEE + MPA trial, which followed participants for a mean of 3.7 years, 173 incident cases of carpal tunnel syndrome were observed in the intervention group compared with 203 cases with placebo.

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"To our knowledge, this is the first large-scale observational analysis in a randomized trial population where CTS risk, a common and chronic problem that affects functioning and productivity, is suggested to be decreased by hormonal intervention," write the authors.

"CTS could be added to the list of outcomes that may inform the decision-making process for women considering menopausal HT, particularly those who have other risk factors for CTS," they added.

They concluded that a potential therapeutic role for other forms of estrogen therapy in the management of CTS warrants future research.

For further reference follow the link: https://doi.org/10.1371/journal.pone.0207509