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Hormone Replacement Therapy Is Associated with Increased Risk of Carpal Tunnel Syndrome
Travis Kotzur, BS
1; Aaron Singh, BA
1; Lindsey Peng, BS
1; Blaire Peterson, BS
1; Jordan Carter, MD
1; Ryan Rose, MD
1; Christina Brady, MD
21UT Health San Antonio, San Antonio, TX; 2Audie L. Murphy Memorial Veterans' Hospital, San Antonio, TX
Introduction: Hormone Replacement Therapy, consisting of estrogen or estrogen and progesterone, is a commonly prescribed regimen to postmenopausal women to treat symptoms of menopause. While the beneficial effects of HRT, such as reduced hot flashes and improvement of sleep, are well known, the effect on the development of orthopedic specific syndromes such as carpal tunnel syndrome (CTS) are relatively uncharacterized. This study aims to assess the impact of HRT on the development of carpal tunnel syndrome.
Methods: This is a retrospective matched cohort study utilizing the TriNetX platform, years 2009 through 2024. A cohort of women receiving HRT were matched to women not receiving HRT. Risk for the diagnosis of CTS within three years of index (receiving HRT) was calculated. Subanalysis among a secondarily matched cohort of women with CTS was conducted to assess the risk of intervention - both surgical and steroid injection - relative to controls.
Results: A total of 3,338,087 women receiving HRT were matched to women not receiving HRT. Patients receiving HRT had an increased risk of developing CTS (Odds Ratio (OR) 1.15; p<0.001). Subanalysis of 107,255 women with diagnosed CTS demonstrated that patients receiving HRT had a decreased odds of surgical management (OR 0.67; p<0.001) and an increased odds of steroid injection (OR 1.14; p<0.001). Conclusion: This study demonstrates an association of women receiving HRT with an increased risk of CTS development. Women with diagnosed CTS who were also receiving HRT, however, were more likely to receive steroid injections and less likely to have operative intervention.
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