Menopause in Women With RA: A New Study

Not so lucky for the ladies out there, more women experience RA than men. And if that weren’t enough of a bummer fact, women with RA also experience a greater loss of function and more disability than men with RA. There could be many reasons why there is a large difference between how men and women experience RA, including differences in how men and women are built, and the fact that women have more active immune systems than men. But researchers have also wondered if the explanation for this variation in numbers might also be linked to the difference in male and female hormones.

Researchers have observed that RA symptoms in women change around several hormonal events such as pregnancy, the time after giving birth and menopause. It is well known that menopause has many effects on a woman’s health1, including bone loss and increased cardiovascular risks. You can read more about RA and Menopause here. There have also been studies that have shown that there are associations between increased risk of RA in women who have experienced early menopause.

A new study2 shows that women going through menopause who are already diagnosed with RA may be more likely to suffer an increased decline in physical abilities. This study looked at women with RA who are pre-menopausal, experiencing menopause and postmenopausal and was based on patient-reported outcomes (a health assessment questionnaire or HAQ), over an extended period of time. The researchers looked at questionnaires that had already been done (between 2003 and 2017) and gathered the questionnaires from the National Data Bank for Rheumatic Diseases.

Further information on the link between menopause and RA activity in women

The purpose of the study is to see if there was enough evidence to make a connection between RA and menopause and to see if there should be further studies about female hormones and the effect on RA. The study did show that women who were pre-menopausal reported less functional decline per year than women who had already experienced menopause, but that women with greater over-all hormonal exposure had less physical decline.

This study had some flaws, such as self-reported answers, without matching clinical information, meaning what a person says they are experiencing on a given day may be different than their overall health picture. Additionally, menopause can be associated with depression, as well as a general reduction of quality of life. Finally, most of the participants who answered the questionnaires tend to be from higher income communities, so they may have better access to care and may be able to comply better with treatments. However, even with these shortcomings, the study still shows many significant factors associating change of functional status (on a HAQ) with menopause.

The study suggests a relationship between menopause and worsening physical decline in RA sufferers and discusses the need for further scientific study. Studies like this pave the way for more funding for researchers to find out why female hormones and menopause may affect RA. This funding can lead to better treatment of RA in all women, including those who are post-menopausal, and better ways to prevent the effects of RA as hormonal changes occur.

View References
  1. https://rheumatoidarthritis.net/women-health/ra-and-menopause/
  2. Elizabeth Mollard, Sofia Pedro, Eliza Chakravarty, Megan Clowse, Rebecca Schumacher, Kaleb Michaud; The impact of menopause on functional status in women with rheumatoid arthritis, Rheumatology, , kex526, https://doi.org/10.1093/rheumatology/kex526

Comments

View Comments (3)
  • Lawrence 'rick' Phillips
    12 months ago

    It will be interesting to know if this proves out.

    I wonder as men age and testosterone declines if they have a similar, different or no change in symptoms?

  • Richard Faust moderator
    12 months ago

    Hi Rick. These are interesting questions. There are studies that show that low testosterone may be a predictor for RA in men. However, there also was a study finding men with RA receiving testosterone therapy showed no significant effect on disease activity compared to those receiving a placebo (https://www.ncbi.nlm.nih.gov/pubmed/8670579). A study of T levels of men with RA as they age and disease progression could certainly be interesting, but given the significantly higher number of women with RA probably further down the research ladder. Best, Richard (RheumatoidArthritis.net Team)

  • Lawrence 'rick' Phillips
    12 months ago

    Richard, I understand that women are thought to have about 70% of the known cases of RA. However a more fundamental question might exist. Is the rate of RA in men and women actually as different as we think or are men more under reported? I believe that someday, research on that question and the degree of AS in women will be yield some interesting results. .

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