Menopause and Autoimmune Disease
Hot flashes, bone loss, and heart risk: how the decline of reproductive hormones intersects with lupus, RA, and Sjögren's syndrome.
When we are young girls, the biggest news of childhood is getting your first menstrual period. Some women dread that monthly cycle, which may come with PMS symptoms of bloating, cramps, increased appetite, fatigue, and mood changes. Then, in our 40s and 50s, we dread the absence of the cycle, because it may signify menopause.
Menopause is the period when reproductive hormones decline and menstrual periods end. The ovaries stop releasing eggs, estradiol (estrogen) decreases, and follicle-stimulating hormone levels increase. Symptoms may include night sweats, sleep disturbances, mood changes, weight gain, hair loss, vaginal dryness, and hot flashes.
Menopause can follow a hysterectomy, the natural decline of hormones, autoimmune diseases that keep the ovaries from producing normal hormone levels, or treatments such as chemotherapy or radiation therapy.
How does menopause relate to autoimmune disease? Cardiovascular risk increases in women after estrogen levels decline, and some autoimmune diseases, such as lupus (SLE) and RA, already carry an increased risk of heart disease. Postmenopausal women need to be very attentive to reducing blood pressure and cholesterol.
When menopause hits, bone density decreases rapidly, leading to bone loss and osteoporosis, which puts women at risk for fractures. Women with autoimmune diseases may have bone loss around the joints, and necessary therapies such as steroids can accelerate bone loss even in women in their 30s and 40s.
Menopause can also reduce secretions and cause vaginal dryness. In Sjögren's syndrome, an autoimmune disease where proteins attack moisture-secreting glands, vaginal dryness can occur as well.
Please speak to your primary care physician, OB/GYN, or endocrinologist about this period of life.
Dr. Maggie Cadet, MD