What is the impact of menopause on women with autoimmune disease?
As women age, a natural physiological process called menopause occurs that marks the end of a woman's reproductive years. Many women with autoimmune diseases experience an intensification of symptoms during perimenopause (the transition period between a woman's reproductive years and menopause) and menopause. Although some studies show that declining estrogen levels during menopause can worsen autoimmune symptoms for many women, other research examining the impact of menopause has conflicting results, and symptoms may vary from woman to woman.
Estrogen plays a crucial role in women's health. For example, estrogen helps lubricate the joints to maintain function. When estrogen levels decrease, it can increase joint pain and stiffness in women with rheumatoid arthritis (RA), lupus, and psoriatic arthritis. Yet, lower estrogen levels may not always trigger an increase in symptoms. Some women with systemic lupus erythematosus (SLE) may experience a decrease in disease activity levels after menopause.
Menopause doesn’t only affect symptoms, but also complicates treatment. While menopause itself doesn’t directly alter the effectiveness of autoimmune medications, the natural progression of disease during midlife often requires changes in treatment plans. For example, women with MS may shift from a relapsing to a progressive phase in their 40s or 50s, which may coincide with hormonal changes and require medication adjustments. Understanding whether new or worsening symptoms are due to menopause or the autoimmune condition itself involves tracking symptoms and active communication with healthcare providers.
Many women report that their concerns about hormonal changes are overlooked by specialists focused only on the autoimmune condition. This highlights the need for better communication between providers and for women to advocate for themselves. For many, understanding this overlap can lead to more informed care and better health outcomes.
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