Does Menopause Affect Rheumatoid Arthritis?

Aging is a natural part of life. Now that I can no longer say that I’m slowly approaching that age, I am interested in learning about what happens during the transition time to that age as a 52-year-old woman.

What age am I talking about? I’m talking about the age at which women begin to notice changes in their body that signify a transition from reproductive years to menopause.

What is menopause?

According to the National Institute on Aging, menopause is a point in time 12 months after a woman's last period. In the years leading up to that point, women may experience changes in their monthly cycles, hot flashes, or other symptoms.1 This transitional time period is called perimenopause and most often begins between the ages of 45 and 55 but can begin for women in their 30s as well.1 Perimenopause can last between 7-14 years.

Am I experiencing perimenopause?

If you’ve wondered whether you are experiencing perimenopause, you are not alone. I’ve questioned it more with increased night sweats that totally soak my pajamas and sheets. Yuck!

In recent years, any symptoms of hot flashes I may have experienced during the day, I’ve probably blamed on heat-intolerance associated with multiple sclerosis (another disease I have in addition to RA and OA).

Does menopause have any affect on RA?

This is the question I asked my rheumatologist last week. Her answer was something as noncommittal as — for some, maybe; for some, maybe not. I had hoped for a more direct answer and that she could share what some of her patients had experienced in general.

She asked me if I was still having periods. The answer is no because I have an IUD, but I have been experiencing more spotting that seems to act like a period complete with cramping on occasion. Without the IUD maybe I would be experiencing irregular and heavier periods, the type that can occur during perimenopause.

The night sweats dilemma

I told her that I get night sweats which have been occurring on and off for years now. She tells me that gabapentin sometimes helps with night sweats. “So that is good,” she concludes since I’m already using gabapentin. I looked into it and found that much higher doses of gabapentin than I take reduced nighttime awakenings and sweats in 3 case studies.2

What does the research say?

In my search for answers, I found little satisfactory scientific evidence that could answer my question. Here is some of what I did discover.

Hormonal changes in pre- and post-menopausal stages can contribute to the development of RA.3 (But I already have RA.)

RA's effect on hormones

Rheumatoid arthritis can affect sex and thyroid hormones, so “reproductive and menopausal conditions should be taken into consideration when sex and thyroid hormones studies are carried out in RA women.”4 My interpretation of the research summary is that basically RA can alter expected hormonal test results such that they do not reflect menopausal status as compared to women without RA.

Although estrogens are known to have an anti-inflammatory effect, there is a lack of solid research that suggests hormone replacement therapy might be effective in improving the quality of life in women with RA.5

Menopause and disease risk

A later onset of menopause for women in the general population (not specifically women with RA) has been associated with longer life expectancy, reduced risk of cardiovascular disease, and reduced risk of osteoporosis. However, later menopause is associated with an increased risk of breast, endometrial, and ovarian cancers.6

What was your experience?

Even after reading on the subject for several hours, there is no clear answer to what I thought was a simple question. So I’d like to ask members of the community to share their own stories and anecdotal evidence.

Has perimenopause and/or menopause had any effect on your RA? If so, how?

Be well,
Lisa

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