Is osteoarthritis common in women aged 40 and above?

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Last updated: November 28, 2025View editorial policy

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Yes, osteoarthritis is extremely common in women aged 40 and above

After age 40, the incidence of osteoarthritis increases dramatically in women, with prevalence reaching approximately 70% in women over 65 years, compared to 60% in men of the same age. 1

Age-Related Prevalence Pattern

  • It is rare for osteoarthritis to develop before age 40, but after this threshold the incidence increases dramatically, especially in women. 2

  • Women have a slightly greater prevalent risk of hand osteoarthritis than men, with a relative risk of 1.23 (95% CI 1.11 to 1.34) for prevalence. 2

  • The prevalence of osteoarthritis affects approximately 50% of persons aged 65 and older, increasing to 85% in those 75 and older. 2

  • When using a cut-off of 40 years, age has a likelihood ratio of 3.73 (95% CI 2.69 to 5.18) as a diagnostic criterion for hand osteoarthritis. 2

Gender-Specific Pattern After Age 40

The gender difference in osteoarthritis is distinctly age-dependent: women have lower incidence before age 40 but significantly higher incidence after this age compared to men. 2, 3

  • This dramatic shift at age 40 is attributed to hormonal changes, particularly the reduction in estrogen associated with menopause. 2

  • Menopausal status is recognized as an independent risk factor for hand osteoarthritis. 2, 3

  • The hormonal influence is so significant that sex hormones may directly influence the development of osteoarthritis in women, though hormone replacement therapy studies have not consistently shown protective effects. 2

Clinical Implications for Women Over 40

With typical features of osteoarthritis (pain on usage, mild morning stiffness, characteristic joint involvement), a confident clinical diagnosis can be made in adults aged over 40. 2

  • Risk factors particularly relevant to women over 40 include: female sex, increasing age, menopausal status, obesity, higher bone density, greater forearm muscle strength, and joint laxity. 2

  • Hand osteoarthritis commonly targets distal interphalangeal joints, proximal interphalangeal joints, and thumb base joints in this population. 2

  • Nearly 12% of people aged 65 and older report activity limitations specifically due to arthritis. 2

Common Pitfall to Avoid

Never dismiss osteoarthritis symptoms as "just part of normal aging"—this is explicitly rejected by expert consensus. 2 The fact that osteoarthritis prevalence increases with age does not mean it is an inevitable or untreatable consequence of aging; it represents a disease process requiring active management through exercise, weight control, and appropriate interventions.

References

Research

Osteoarthritis: an overview of the disease and its treatment strategies.

Seminars in arthritis and rheumatism, 2005

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Osteoarthritis in Women

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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