Psoriatic Arthritis and Menopause

Psoriatic Arthritis and Menopause

Psoriatic arthritis is a chronic autoimmune disorder that is integrally associated with psoriasis, another autoimmune disorder.(1,2,3) Psoriatic arthritis is a progressive condition, meaning it tends to get worse with time. Common symptoms of psoriatic arthritis include joint stiffness, joint pain, swelling of the toes and fingers, skin lesions, and nail deformity. While psoriatic arthritis can also happen as a standalone condition, but it has been found that it is usually preceded by psoriasis in nearly 85 percent of cases.(4,5)

In most women, menopause begins between the ages of 45 and 55 years, though the symptoms tend to start at least four years before a woman gets her final period. This phase is known as perimenopause.(6) Many hormonal changes occur in the body during this time, which may cause uncomfortable symptoms like mood swings, hot flashes and sleep disruptions.

In women with underlying health conditions like psoriatic arthritis, menopause can begin earlier. A study from 2011 done on more than 1.7 million women who were all of the reproductive age found that participants who had chronic inflammatory diseases like psoriasis were nearly five times more likely to have menopause before the age of 45. They were also more likely to experience premature ovarian failure before they turn 40.(7)

Here’s how psoriatic arthritis can affect women who are experiencing menopause.

Psoriatic Arthritis and Psoriasis Flares

As mentioned above, a majority of people who have psoriatic arthritis also have psoriasis. There are certain common triggers for both psoriasis and psoriatic arthritis flare-ups. These triggers can include trauma to the skin, smoking, alcohol use, stressful situations in life, and infections. Research has found that the fluctuations in hormones in women during menopause can also act as a trigger that causes psoriatic arthritis and psoriasis flare-ups to worsen.(8)

Other studies have also found that a decrease in estrogen levels after menopause is responsible for aggravating psoriasis symptoms.(9)

Many times, the symptoms of psoriatic arthritis and menopause can overlap, making it difficult to determine the exact source of your discomfort. For example, you may find you are having trouble sleeping or experiencing mood swings that eventually lead up to a psoriatic arthritis flare-up. These same symptoms are also likely to occur when you are experiencing perimenopause.

In fact, the usual symptoms of menopause can also worsen the flares of psoriatic arthritis. For example, sleep disruptions associated with menopause may increase your fatigue, which, in turn, increases your perception of pain caused by psoriatic arthritis.

By tracking your diet, sleep, stress levels, and your symptoms, you can try to narrow down and pinpoint the exact triggers for psoriatic arthritis and psoriasis. Keeping track of these triggers will also help you manage any flare-ups. If you find that you are experiencing more severe or more frequent flares of psoriatic arthritis during menopause, you should let your doctor know. They may adjust your medication or advice you to make certain modifications to your lifestyle o help reduce the severity of your symptoms.

Psoriatic Arthritis, Menopause, and an Increased Risk of Osteoporosis

Osteoporosis is a condition that causes brittle and weak bones that break easily. Globally, it is estimated that 1 in 3 women over the age of 50 will experience osteoporosis-related fractures. The estimate is slightly lower in men – estimated at 1 in 5 men will go on to have osteoporotic fractures.(10) Another set of statistics show that a staggering 80 percent of 10 million Americans who have been diagnosed with osteoporosis are all women.(11)

It is believed that the sudden reduction in estrogen levels in women once they reach menopause increases the risk of developing osteoporosis. Estrogen has a vital role to play in protecting bone.(12)

Chronic inflammation caused by psoriatic arthritis increases this risk manifold. There are numerous pro-inflammatory proteins involved in both psoriatic conditions that are also found to be involved in osteoporosis.

Research shows that women with psoriatic arthritis are probably at an even higher risk of developing osteoporosis once they reach menopause.(13) A review of 21 studies done in 2016 found that people with psoriatic arthritis had lower bone mineral density than those who did not have this medical condition.(14) Another study also found that people with psoriasis and psoriatic arthritis had a significantly higher risk of experiencing bone fractures.(15)

If you have psoriatic arthritis, it is best to talk to your doctor and come up with strategies to lower your risk of osteoporosis. Your doctor may recommend that you undergo regular bone density screenings at an earlier age than usual.(16) They may also advise you to starts supplements of vitamin D and calcium, as well as recommended certain weight-bearing exercises.

Hormone Therapy and Psoriatic Arthritis Flares – Can It Help?

Hormone therapy has been found to be effective in providing relief from menopause symptoms like hot flashes and mood swings. It has also been shown to help prevent bone loss in menopausal women that could cause osteoporosis.(17,18)

Research has shown that there is a link between decreased levels of estrogen in menopausal women and flare-ups of psoriatic arthritis. While some research indicated that hormone therapy would not improve the symptoms of psoriatic arthritis, but other studies suggest that the complexity of an autoimmune disease like psoriasis makes it challenging to find out the exact impact of hormone therapy. This is why more research is still needed to determine if hormone therapy can help in reducing the severity and frequency of psoriatic arthritis flares.(19,20) Your doctor can help you determine if hormone therapy could be a potential treatment option for your condition.

Managing Psoriatic Arthritis Symptoms with Menopause

Managing the symptoms of psoriatic arthritis while also experiencing the symptoms of menopause can be challenging and frustrating for most women. However, by reducing your exposure to potential triggers for your flare-ups, and by controlling your menopause symptoms, you can still continue to experience a good quality of life. If you are experiencing severe menopause symptoms along with psoriatic flares, you can talk to your doctor about how to manage your condition. Here are some tips that can help:

Important To Remain Physically Active: Doing regular physical activity can help alleviate your psoriatic arthritis symptoms and may even keep them at bay. It is recommended that you indulge in some weight-bearing and resistance training exercises such as walking. This will enhance bone health and also reduce the chances of developing osteoporosis as you reach menopause.(21)

Have a Healthy Sleeping Routine: Getting enough sleep is crucial for your health, especially when you have a medical condition like psoriatic arthritis. Sleep disruptions are common when you have menopause and are also associated with psoriatic flares. Following a sleep schedule, avoiding caffeine from the afternoon itself, avoiding using mobile phones or watching TV before bedtime, and keeping your bedroom cool and comfortable can help boost the chances of having a good night’s sleep.(22)

Reduce Your Stress Levels: Stress is a known trigger for psoriatic arthritis and psoriasis. You should practice stress-reducing techniques like meditation and yoga, especially in the years leading up to menopause.

Conclusion

The years and months leading up to menopause may cause your psoriatic arthritis symptoms to worsen. You may also experience an increase in the severity and frequency of your flare-ups. Women with psoriatic arthritis are also at a higher risk of developing osteoporosis during menopause. Furthermore, women with psoriatic arthritis are more likely to experience menopause at an earlier age than women who don’t have this condition.

You should talk to your doctor to find out what you can do to manage the symptoms of psoriatic arthritis during menopause. Your doctor may recommend adjusting or switching your medications. You may also need to make healthy lifestyle changes to reduce the discomfort of your symptoms.

References:

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