Rheumatoid arthritis (RA) is more common in women, affecting both young ages and menopausal females. Many women wonder about the connection between menopause and RA and if hormonal replacement therapy (HRT) can help with menopausal symptoms and arthritis. This article looks into how menopause affects RA and whether HRT is recommended for these patients.
What Is Menopause?
Menopause is the phase when a woman’s menstrual cycles stop. Changes in the ovaries start in the mid-40s, leading to fewer follicles. Menopause usually brings irregular periods around age 51, with later menopause connected to longer life. Officially, menopause is declared after 12 consecutive months without periods.
Some studies suggest that menopause may increase the chances of developing autoimmune diseases, early artery hardening (atherosclerosis), and osteoporosis, which is when bones become thinner and more prone to fractures.
Rheumatoid Arthritis After Menopause
Women are threefold more likely to develop RA than men. During pregnancy, when estrogen levels increase significantly, many women experience improvement in RA symptoms. However, with menopause, as estrogen levels decrease, there is an increased risk of developing RA. Women who already have a diagnosis of RA may see worsening of their symptoms during menopause, including more.
- Pain
- Joint swelling
- Stiffness, and
- Increased risk of flare-ups.
Research from 2017 on the link between menopause and RA shows mixed results. Some studies suggest RA and menopause symptoms may happen at the same time. In contrast, others propose that early menopause might lead to milder RA symptoms or an association with postmenopausal onset of RA.
Can Menopause Worsen Rheumatoid Arthritis?
A study on rheumatoid arthritis (RA) and menopause suggests that lower hormone levels during menopause might increase inflammatory proteins related to RA, potentially leading to poorer outcomes for postmenopausal RA patients. However, larger studies haven’t consistently shown a clear link between RA and menopause.
Some studies indicate a possible connection between the start of RA symptoms and menopause, while others have inconsistent results. Early menopause may be linked to milder RA, but conflicting findings make it hard to be sure.
Symptoms of Menopause and Rheumatoid Arthritis
Symptoms of menopause and rheumatoid arthritis might be confusing due to their similarities.
Fatigue
The inflammatory aspect of arthritis, particularly rheumatoid arthritis, can trigger a systemic reaction that exacerbates sensations of tiredness and fatigue. Menopausal symptoms, combined with hormonal changes, can lead to mood changes and feelings of anxiety or depression, which in turn can cause fatigue.
Gastrointestinal issues
Various organs, such as the gastrointestinal tract, can be affected by persistent rheumatoid arthritis inflammation. The gastrointestinal tract may also be affected by hormonal changes during menopause, particularly the reduction of estrogen levels. Changes in digestion, such as bloating, constipation, and acid reflux, may occur in some women.
Bone loss
Maintaining bone density requires estrogen. During menopause, estrogen levels significantly decline, leading to accelerated bone loss.
Sleep problems
People with arthritis often experience chronic joint pain and inflammation, making it difficult to get a good night’s sleep. Hot flashes and night sweats may occur due to hormonal fluctuations, especially a decrease in estrogen levels. Sleep may be interrupted, and discomfort may occur due to these sudden bursts of heat.
Seeking professional guidance from a rheumatologist is advised to differentiate between the causes of your symptoms.
Hormonal Replacement Therapy – Does It Help?
Hormone Replacement Therapy (HRT) involves taking estrogen and sometimes progestin to help with menopausal symptoms like vaginal dryness, night sweats, and hot flashes. Recent studies suggest potential benefits for rheumatoid arthritis (RA).
According to the American College of Rheumatology guidelines, HRT is recommended for most postmenopausal individuals with rheumatic conditions but not for those with lupus who have anti-phospholipid antibodies, as it can increase the risk of blood clots. However, women with lupus without these antibodies may consider HRT with caution.
HRT may also affect RA’s inflammation, disease activity, and joint discomfort. Individual responses vary, and it’s crucial to consider risks like increased blood clots and some cancers. While studies show benefits, each woman’s experience may differ.
It’s important to note that although HRT can help with menopausal symptoms and RA, it’s not considered a standalone or a replacement for the standard RA treatment.
Conclusion
The prevalence of rheumatoid arthritis is higher in women, and the decline in estrogen levels during menopause may contribute to increased inflammatory proteins associated with RA, potentially leading to worsened symptoms.
While some studies suggest the benefits of HRT in alleviating menopausal symptoms and RA, it is not considered a standalone treatment for RA. Overall, the understanding of how menopause and hormones relate to RA remains complex, and further research is needed for a clearer understanding of this relationship.
Consulting a Rheumatologist is recommended to tailor your needs. Rheumatologist OnCall’s integrative approach is always ready to help you.
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