{"id":174508,"date":"2024-12-19T09:40:17","date_gmt":"2024-12-19T08:40:17","guid":{"rendered":"https:\/\/www.erasmusmagazine.nl\/en\/?p=174508"},"modified":"2026-02-11T10:41:45","modified_gmt":"2026-02-11T09:41:45","slug":"sita-bierma-zeinstra-is-investigating-the-link-between-pill-use-and-osteoarthritis-i-have-these-aha-moments-all-the-time","status":"publish","type":"post","link":"https:\/\/www.erasmusmagazine.nl\/en\/2024\/12\/19\/sita-bierma-zeinstra-is-investigating-the-link-between-pill-use-and-osteoarthritis-i-have-these-aha-moments-all-the-time\/","title":{"rendered":"Sita Bierma-Zeinstra is investigating the link between pill use and osteoarthritis. \u2018I have these aha moments all the time\u2019"},"content":{"rendered":"

People used to think that osteoarthritis in women over fifty had to do with the menopause. Sita Bierma-Zeinstra is investigating the link with pill use. \u201cThis research really is at the cutting edge. I enjoy that very much.\u201d<\/p>\n

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Sita Bierma-Zeinstra is professor of Osteoarthritis and Related Disorders and specialises in the causes, prevention and treatment of the condition. She leads the Osteoarthritis research group at the Department of General Practice and is also affiliated with the Department of Orthopaedics and Sports Medicine at Erasmus MC, as well as the Department of Biomechanical Engineering at TU Delft.<\/p>\n\n\t<\/div>\n

The wonder<\/h2>

\u201cWell, I\u2019ll be damned\u201d, I thought, when my patient said he got rid of his tinnitus after my treatment. I\u2019d simply tried a novel approach! As a physiotherapist in the 1980s, I\u2019d treated this patient with some stretch relaxation exercises for the muscle attachments behind his ears. The fact that it worked was good news for him. But something kept gnawing at me. What was known about this condition? What was the treatment based on? Physiotherapy wasn\u2019t evidence-based. That\u2019s not how I wanted to work.<\/p>\n\n\t

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\n\t\t\u2018It was absurd how little was known about osteoarthritis back then when it\u2019s so common\u2019\n\t<\/blockquote>\n\n\t<\/figure>\n\t\t<\/div>\n\t<\/div>\n

\u201cI went back to studying and then doing research, with a focus on osteoarthritis. It was absurd how little was known about osteoarthritis back then when it\u2019s so common. I can\u2019t say I\u2019ve had a single major eureka moment since. I have those eureka moments all the time. For example, after reading a study on shoulder injections, which said that injections into the gluteal muscle also gave good results, I thought: \u2018Hey, maybe this approach will work for osteoarthritis of the hip as well, so GPs can inject patients themselves and reduce the need for referrals.\u2019<\/p>\n

\u201cAlso, I\u2019d been thinking for some time about the phenomenon that the incidence of osteoarthritis increases much faster in women after the age of fifty than in men of the same age. People used to think this had something to do with the menopause, but nobody knew exactly why.\u201d<\/p>\n

The eureka moment<\/h2>
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\u201cIt was then that a rheumatologist in her late fifties told me she\u2019d stopped taking the pill. Within three weeks, she spotted Heberden\u2019s nodes \u2013 bony swellings on her fingers. These are signs of osteoarthritis of the hand.<\/p>\n

\u201cI was surprised that the woman was still on the pill at her age. I talked about it with a GP and he didn\u2019t think it was that crazy. He explained that many women of that age are still on the pill and that GPs advise them to stop around the age of 53.<\/p>\n

\u201cThat\u2019s when I really had a eureka moment. At that age, the pill keeps hormone levels artificially high, even though the woman has already entered menopause. Going off the pill at that point causes a sharp drop in hormone levels. I saw opportunities to study the emergence of disorders due to the menopause.\u201d<\/p>\n

The research<\/h2>

\u201cI started a pilot study with other departments and made a call to pharmacies. When women aged between fifty and sixty picked up a new pill strip, the pharmacy gave them information about my research on the development of osteoarthritis, among other things, and a request to sign up.<\/p>\n

\u201cIn no time, I had enough participants. We followed fifty women for two years, gathering many data points: questionnaires, MRIs, DXA and UTC scans, blood levels of hormones and proteins, and so forth. All of them have now completed the follow-up study after the two-year period.\u201d<\/p>\n

The result<\/h2>
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\u201cThe study is still ongoing. We\u2019re busy analysing the data. I\u2019ve already seen signs of an abrupt change in proteins six weeks after stopping the pill. Using statistical analyses, we\u2019ll examine whether this is also related to the occurrence of certain diseases, and whether it makes sense to start a larger study. This research really is at the cutting edge. I enjoy that very much.\u201d<\/p>\n\n\t

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Read more<\/h2>\n\t\t\t\n\t\t\t