Table of ContentsView AllTable of ContentsHormones and Joint PainPsA and MenopausePsA and Bone DensityManagementFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Hormones and Joint Pain
PsA and Menopause
PsA and Bone Density
Management
Frequently Asked Questions
Menopause can affect other health conditions, includingpsoriatic arthritis(PsA). PsA is a type ofautoimmune diseasein which the immune system malfunctions and attacks healthy tissues. It affects about 30% of the people with the skin conditionpsoriasis, although psoriasis may develop after the onset of PsA.
People who menstruate eventually stop experiencing periods, usually in their 40s and 50s. This natural part of life is calledmenopause, defined as a point in time 12 months after your last period.The time before that is known asperimenopause. The perimenopause transition begins between ages 45 and 55 and lasts around seven to 14 years.
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The connection between PsA and menopause is hormones—mainly droppingestrogenlevels from menopause. These decreased levels might lead to increasedPsA flares(periods of high inflammation and pain),menopausal symptoms, bone density changes, andosteoporosis(bone thinning).
This article will cover the connection between PsA and menopause, the effect of chronic inflammation, and how to manage hormonal changes and inflammation.
The list of menopausal symptoms is extensive. Symptoms range from mood swings to hot flashes and even joint pain. And while swollen, achy joints are a sign of aging or even autoimmune arthritis, achy joints can also be a symptom of menopause.
For people with PsA and other types of autoimmune arthritis, joint pain from both PsA and menopause can be extra challenging. Studies suggest that hormonal changes throughout a person’s life—the menstrual cycle, during pregnancy, and during menopause—can lead to periods of increased inflammation, which could eventually result in joint damage and disability.
Effect of Estrogen
The effect of decreased estrogen is wide-ranging. Estrogen loss can lead to weight gain, weak and achy bones, painful intercourse, increasedurinary tract infections, depression,cardiovascular disease, and so much more.
Estrogen andprogesterone, both alone and together, play a significant role in sexual and reproductive health. For example, both help to regulate menstrual cycles and help the pregnancy to get started.
Estrogen also has other functions, including:
Additional functions of progesterone include:
Estrogen FunctionsBuilds up uterine liningRegulates thyroid hormoneIncreases blood clottingProtects bone healthRegulates cholesterolProgesterone FunctionsThickens the uterine lining to prepare it for pregnancyProtects against breast cancer and high blood pressureRegulates moodInduces libidoStimulates blood vessels to the endometrium during pregnancy
Estrogen FunctionsBuilds up uterine liningRegulates thyroid hormoneIncreases blood clottingProtects bone healthRegulates cholesterol
Builds up uterine lining
Regulates thyroid hormone
Increases blood clotting
Protects bone health
Regulates cholesterol
Progesterone FunctionsThickens the uterine lining to prepare it for pregnancyProtects against breast cancer and high blood pressureRegulates moodInduces libidoStimulates blood vessels to the endometrium during pregnancy
Thickens the uterine lining to prepare it for pregnancy
Protects against breast cancer and high blood pressure
Regulates mood
Induces libido
Stimulates blood vessels to the endometrium during pregnancy
Estrogen Changes
Studies on inflammation show that it increases during menopause because of declining estrogen. This theory makes sense because estrogen has anti-inflammatory benefits.
One study reported in 2020 concluded that postmenopausal people had higher white blood cell counts, indicating increased systemic (whole-body) inflammation.Here, researchers suggest that both visceral body fat (hidden fat inside the belly and wrapped around the stomach organs) and declining hormone levels might be to blame for increased inflammation.
There has been very little research on an estrogen-PsA connection. However, researchers have looked at the effect of estrogen on psoriasis, which is linked to PsA, and the role of hormones in other types of autoimmune arthritis, includingrheumatoid arthritis(RA).
Research shows hormone fluctuations can cause psoriasis to flare up during puberty, after giving birth, and during menopause.Also, symptoms of psoriasis can improve during pregnancy when hormone levels are higher.
Risk Factors of Rheumatoid Arthritis
During Menstrual Period
The connection between inflammatory arthritis and menstrual cycles isn’t one that researchers understand well. Some research studies suggest variations in hormones during menstrual cycles influence autoimmune arthritis activity and increase symptoms.
A study reported in 2022suggests people with RA may experience fluctuations in their joint symptoms linked to their menstrual cycles.The study looked at the case of a 49-year-old perimenopausal woman who experienced recurrent flares that started 10 days before her period and spontaneously resolved after her period ended.
In this study, researchers treated the person with agonadotropin-releasing hormone agonistin an estradiol gel to prevent low estrogen and alevonorgestrel-releasing intrauterine system(a device to release levonorgestrel, a hormone).
The treatment plan was found to reduce RA symptoms the person experienced before and during her period. The researchers concluded hormonal therapy might be a beneficial option for people who have increased symptoms of inflammatory arthritis during their monthly cycles.
Research also shows that psoriasis can flare around the time of a person’s period. One 2015 review of immunological changes and hormone fluctuations found that increased estrogen levels, especially during pregnancy, could be linked to lower inflammation in the body.But the opposite could occur around the time of a monthly period.
During Pregnancy
Research on PsA and pregnancy is mixed. Some studies demonstrate improvement, while others show worsening disease activity, particularly in the postpartum period (after childbirth).
One study reported in 2017 found improvement or stabilization occurred in 58% of pregnancies, and skin symptoms improved in 88% of cases.This study also found that PsA could also worsen, as demonstrated in 32% of the study participants.
Pregnancy might also trigger PsA in people who have psoriasis. A 2015 report found up to 40% of study participants with psoriasis went on to develop symptoms of PsA in the weeks following childbirth.
PsA might worsen after childbirth in someone with previously diagnosed PsA. A study reported in 2019 inArthritis Care and Researchfound PsA could get worse at any time during the first six months after childbirth.
Interestingly, this study also reported that about 75% of the study participants had experienced remission (little or no disease activity) during pregnancy and shortly after giving birth. Here, disease activity did not increase until weeks or months later.
During Menopause
Hormonal changes duringperimenopauseand menopause might increase psoriatic arthritis flares. Research on psoriatic symptoms (skin and joint) shows that hormone fluctuations can trigger PsA and psoriasis flare-ups.Reduced estrogen can also contribute to flares.
PsA and menopause have overlapping symptoms, which makes it harder to distinguish which of the two conditions is causing the symptoms. For example, you might experience fatigue, sleep problems, and mood swings resulting from PsA and menopause or perimenopause. In addition, symptoms of menopause, such as sleep disturbances, might trigger PsA flares.
PsA Can Intensify Menopause
Most people who menstruate stop getting periods around ages 45 to 55.That transition from perimenopause to post-menopause takes between seven and 14 years. However, people with PsA and other types of inflammatory arthritis might experience menopause even earlier.
According to a 2015 report in the journalRheumatic Disease Clinics of North America, rheumatic inflammatory diseases can lead to an underlying decreased ovarian reserve (total number of healthy, immature eggs in the ovaries).In addition, some of the therapies used to treat these conditions can also induceearly menopause.
PsA Can Change Bone Density
Osteoporosis causes bones to become weak and brittle. Bones become so soft that mild stressors can lead to fractures, such as bending over or coughing.
In the United States, osteoporosis affects around 10 million people—the majority of whom are female.Also, over 43 million Americans have low bone mass, which increases their risk for osteoporosis.
Estrogen is vital for protecting your bone health, and reduced estrogen levels during menopause could increase your risk for osteoporosis. Chronic inflammation can also increase the risk for osteoporosis.
Research shows having PsA or psoriasis puts you at a greater risk forosteopenia(low bone density) and osteoporosis. A 2020 study suggests both inflammation and medications used to treat both conditions might be to blame.
The study’s authors conclude the value of screening people with PsA and psoriasis for osteoporosis, especially those treated with methotrexate or cyclosporin. Chronic steroid use, as may be given for inflammatory arthritis such as PsA, can also lead to osteoporosis.
Managing Hormonal Changes and Inflammation
There is plenty you can do to manage hormonal changes and inflammation. These include both lifestyle tips and medications that can help.
Lifestyle Tips
Lifestyle changes can be beneficial for managing both PsA and menopause.
Diet: Eat a healthy diet that includesanti-inflammatory foods—fruits, vegetables, lean proteins, healthy fats, and whole grains.You may wish to avoidfoods that increase inflammation, such as refined carbohydrates (white bread and pasta), fried foods, sugary beverages, red meat, and saturated fats (margarine and other shortenings).
Boost calcium and vitamin D:Calciumandvitamin Dare both critical for bone health, and your diet is the first place you can start improving your intake.Great sources of vitamin D include spinach, kale, okra, white beans, some fish (sardines, salmon, and perch, for instance ), and calcium-fortified foods (such as orange juice and breakfast cereal).
Foods that provide vitamin D include fatty fish (tuna, mackerel, and salmon), egg yolks, cheese, beef liver, and dairy and plant milk fortified with vitamin D. Check with your healthcare provider before you start taking vitamin D or calcium supplements.
Benefits of Vitamin D for Women in Menopause
Exercise: Reduced estrogen can make it easier to gain weight. Increased weight on the joints can trigger PsA symptoms and joint damage.You will want to stay as active as you can to manage both PsA and counter the stress effects of menopause.
Different exercises, includingweight-bearingones (walking, stair climbing, dancing, etc.), can promote bone health and reduce your risk for osteoporosis.
Manage stress: Stress can trigger PsA flares and systemic inflammation.Trystress-reduction techniques, like yoga, meditation, and deep breathing, to manage stressors in your life, especially in the years leading up to menopause.
Try to get restful sleep:Symptoms of menopause, including night sweats and mood changes, can disrupt your sleep. Poor sleep can contribute to PsA flares.
To improve your sleep quality, try sticking to a sleep schedule, avoid caffeine too close to bedtime, keep your bedroom and bed comfortable, and leave the electronics out of the bedroom. Talk to your healthcare provider if you have improvedsleep habitsand still have difficulty getting a good night’s sleep.
8 Natural Remedies for Hot Flashes
Hormone Replacement Therapy
Hormone replacement therapy(HRT) might be an option for managing both inflammation and the effects of menopause. Increased estrogen might also prevent bone loss.
But the research on HRT in psoriatic arthritis is limited and mixed. For example, research on HRT inpsoriatic diseaseshowed no symptom improvement.Other studies mention a potential benefit but don’t detail information about participants, dosing, and adverse effects.
When deciding whether HRT is right for you, you should consider all the benefits and risks.
The main benefit of HRT is to reduce symptoms of menopause, includinghot flashes, night sweats, mood swings, reduced sex drive, and vaginal dryness. HRT might also help to prevent bone thinning and osteoporosis.
Side effects of HRT might include:
Risks of HRT might include:
Your healthcare provider is in the best position to advise you on the potential benefits of HRT, whether it be for managing menopausal symptoms, reducing inflammation, or another health condition. They will take specific factors into consideration, such as:
Once you and your healthcare provider have discussed these issues, you can decide whether HRT is a viable option for managing inflammation and hormonal changes.
Why Hot Flashes Happen and How to Get Relief
You Have Options
Your healthcare provider is in the best position to help you manage the effects of PsA during menopause. If you find your PsA has worsened since entering your 40s, your healthcare provider can help you find solutions or treatments to make you feel more comfortable and reduce inflammation.
You will want to make sure your PsA is as managed as possible, which can minimize risks associated with both PsA and menopause. You might also consider discussing with your healthcare provider when to startbone density screeningsto check your bones for signs of osteopenia or osteoporosis.
If you find you are experiencing frequent flares, especially around the time of your period, reach out to your healthcare provider to find ways to better manage PsA during those times.
If your healthcare provider doesn’t bring up issues related to menopause, it is OK to speak up. You and your healthcare provider are partners in your healthcare, and they will want to know about health issues that are important to you.
Summary
Estrogen works to reduce inflammation in the body, offering a proactive effect for people with psoriatic arthritis and other types of autoimmune arthritis. But during the years leading to menopause, reduced estrogen could mean more inflammation and increased PsA flares. People with PsA might also be at an increased risk for osteoporosis and low bone density during menopause.
Fortunately, there is plenty you can do to manage hormonal changes and inflammation. Steps to take include eating a healthy diet that promotes bone health, staying active, managing stress, and getting a good night’s sleep.
Hormone replacement therapy might also be an option for managing symptoms of menopause, but it likely won’t improve PsA symptoms. Talk to your healthcare provider if you think HRT might be beneficial to you. You will also want to make sure your PsA is well-managed.
A Word From Verywell
The emotional effects of PsA and menopause can be just as complex as the physical, and both can lead to stress, mood swings, and mood disorders like anxiety and depression. You need to find the best ways to cope and manage stress. Activities like yoga, meditation, and rhythmic breathing can be helpful.
It is also helpful to build a social support network to help you deal with the effects PsA and menopause on your daily life. That way, when you feel overwhelmed, you can reach out to a family or friend.
You might also consider joining a support group for PsA. Chances are you will meet people who are coping with the effects of both conditions. And if you find yourself struggling to cope or feel anxious and depressed frequently, ask your healthcare provider for a referral to a mental health counselor.
Women with psoriatic arthritis might experience more frequent flare-ups due to hormonal shifts during menopause. They might also struggle with overlapping symptoms of both conditions, including fatigue, sleep problems, and mood changes.
Learn MoreJoint Pain Causes and Treatment Options
PsA and menopausal symptoms are managed separately. With PsA, the goal is to manage symptoms, reduce disease progression, and treat and prevent disease flare-ups.Healthcare providers can prescribe hormone replacement therapy to manage the effects of decreased estrogen, such as mood swings, hot flashes, and sleep troubles. PsA and menopause are often manageable with healthy lifestyle practices, including eating a balanced diet, managing stress, and staying active.
PsA and menopausal symptoms are managed separately. With PsA, the goal is to manage symptoms, reduce disease progression, and treat and prevent disease flare-ups.
Healthcare providers can prescribe hormone replacement therapy to manage the effects of decreased estrogen, such as mood swings, hot flashes, and sleep troubles. PsA and menopause are often manageable with healthy lifestyle practices, including eating a balanced diet, managing stress, and staying active.
25 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Psoriasis Foundation.About psoriatic arthritis.National Institute on Aging.What is menopause?Watt FE.Musculoskeletal pain and menopause.Post Reprod Health. 2018;24(1):34-43. doi:10.1177/2053369118757537Marder W, Vinet É, Somers EC.Rheumatic autoimmune diseases in women and midlife health.Womens Midlife Health. 2015;1:11. doi:10.1186/s40695-015-0012-9Dalal PK, Agarwal M.Postmenopausal syndrome.Indian J Psychiatry. 2015;57(Suppl 2):S222-S232. doi:10.4103/0019-5545.161483Reed BG, Carr BR.The normal menstrual cycle and the control of ovulation. [Updated 2018 Aug 5]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-.The Endocrine Society.Reproductive hormones.Villa A, Rizzi N, Vegeto E, Ciana P, Maggi A.Estrogen accelerates the resolution of inflammation in macrophagic cells.Sci Rep. 2015;5:15224. doi:10.1038/srep15224Abildgaard J, Tingstedt J, Zhao Y, Hartling HJ, Pedersen AT, Lindegaard B, Dam Nielsen S.Increased systemic inflammation and altered distribution of T-cell subsets in postmenopausal women.PLoSOne. 2020;15(6):e0235174. doi:10.1371/journal.pone.0235174Ceovic R, Mance M, Bukvic Mokos Z, Svetec M, Kostovic K, Stulhofer Buzina D.Psoriasis: female skin changes in various hormonal stages throughout life–puberty, pregnancy, and menopause.Biomed Res Int. 2013;2013:571912. doi:10.1155/2013/571912Ueno A, Yoshida T, Yamamoto Y, Hayashi K.Successful control of menstrual cycle-related exacerbation of inflammatory arthritis with GnRH agonist with add-back therapy in a patient with rheumatoid arthritis.J Obstet Gynaecol Res. 2022 May 20. doi:10.1111/jog.15287.Danesh M, Murase JE.The immunologic effects of estrogen on psoriasis: A comprehensive review.Int J Womens Dermatol. 2015;1(2):104-107. doi:10.1016/j.ijwd.2015.03.001Polachek A, Li S, Polachek IS, Chandran V, Gladman D.Psoriatic arthritis disease activity during pregnancy and the first-year postpartum.Semin Arthritis Rheum. 2017;46(6):740-745. doi:10.1016/j.semarthrit.2017.01.002Kurizky PS, Ferreira Cde C, Nogueira LS, Mota LM.Treatment of psoriasis and psoriatic arthritis during pregnancy and breastfeeding.An Bras Dermatol. 2015;90(3):367-375. doi:10.1590/abd1806-4841.20153113Talsania M, Scofield RH.Menopause and rheumatic disease.Rheum Dis Clin North Am. 2017;43(2):287-302. doi:10.1016/j.rdc.2016.12.011Wright NC, Looker AC, Saag KG, et al.The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine.J Bone Miner Res. 2014;29(11):2520-2526. doi:10.1002/jbmr.2269Xia J, Xie SY, Liu KQ, et al.Systemic evaluation of the relationship between psoriasis, psoriatic arthritis and osteoporosis: observational and Mendelian randomisation study.Ann Rheum Dis. 2020;79(11):1460-1467. doi:10.1136/annrheumdis-2020-217892Briot K, Roux C.Glucocorticoid-induced osteoporosis.RMD Open. 2015;1(1):e000014. doi:10.1136/rmdopen-2014-000014National Psoriasis Foundation.What’s the deal with the anti-inflammatory diet?National Institute of Arthritis and Musculoskeletal and Skin Diseases.Calcium and vitamin D: important at any age.Arthritis Foundation.How fat affects PsA.National Institute of Arthritis and Musculoskeletal and Skin Diseases.Exercise for your bone health.Zhao SS, Miller N, Harrison N, Duffield SJ, Dey M, Goodson NJ.Systematic review of mental health comorbidities in psoriatic arthritis.Clin Rheumatol. 2020;39:217-225. doi:10.1007/s10067-019-04734-8Arthritis Foundation.Psoriatic arthritis and sleep.Gambacciani M, Levancini M.Hormone replacement therapy and the prevention of postmenopausal osteoporosis.Prz Menopauzalny. 2014;13(4):213-220. doi:10.5114/pm.2014.44996
25 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Psoriasis Foundation.About psoriatic arthritis.National Institute on Aging.What is menopause?Watt FE.Musculoskeletal pain and menopause.Post Reprod Health. 2018;24(1):34-43. doi:10.1177/2053369118757537Marder W, Vinet É, Somers EC.Rheumatic autoimmune diseases in women and midlife health.Womens Midlife Health. 2015;1:11. doi:10.1186/s40695-015-0012-9Dalal PK, Agarwal M.Postmenopausal syndrome.Indian J Psychiatry. 2015;57(Suppl 2):S222-S232. doi:10.4103/0019-5545.161483Reed BG, Carr BR.The normal menstrual cycle and the control of ovulation. [Updated 2018 Aug 5]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-.The Endocrine Society.Reproductive hormones.Villa A, Rizzi N, Vegeto E, Ciana P, Maggi A.Estrogen accelerates the resolution of inflammation in macrophagic cells.Sci Rep. 2015;5:15224. doi:10.1038/srep15224Abildgaard J, Tingstedt J, Zhao Y, Hartling HJ, Pedersen AT, Lindegaard B, Dam Nielsen S.Increased systemic inflammation and altered distribution of T-cell subsets in postmenopausal women.PLoSOne. 2020;15(6):e0235174. doi:10.1371/journal.pone.0235174Ceovic R, Mance M, Bukvic Mokos Z, Svetec M, Kostovic K, Stulhofer Buzina D.Psoriasis: female skin changes in various hormonal stages throughout life–puberty, pregnancy, and menopause.Biomed Res Int. 2013;2013:571912. doi:10.1155/2013/571912Ueno A, Yoshida T, Yamamoto Y, Hayashi K.Successful control of menstrual cycle-related exacerbation of inflammatory arthritis with GnRH agonist with add-back therapy in a patient with rheumatoid arthritis.J Obstet Gynaecol Res. 2022 May 20. doi:10.1111/jog.15287.Danesh M, Murase JE.The immunologic effects of estrogen on psoriasis: A comprehensive review.Int J Womens Dermatol. 2015;1(2):104-107. doi:10.1016/j.ijwd.2015.03.001Polachek A, Li S, Polachek IS, Chandran V, Gladman D.Psoriatic arthritis disease activity during pregnancy and the first-year postpartum.Semin Arthritis Rheum. 2017;46(6):740-745. doi:10.1016/j.semarthrit.2017.01.002Kurizky PS, Ferreira Cde C, Nogueira LS, Mota LM.Treatment of psoriasis and psoriatic arthritis during pregnancy and breastfeeding.An Bras Dermatol. 2015;90(3):367-375. doi:10.1590/abd1806-4841.20153113Talsania M, Scofield RH.Menopause and rheumatic disease.Rheum Dis Clin North Am. 2017;43(2):287-302. doi:10.1016/j.rdc.2016.12.011Wright NC, Looker AC, Saag KG, et al.The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine.J Bone Miner Res. 2014;29(11):2520-2526. doi:10.1002/jbmr.2269Xia J, Xie SY, Liu KQ, et al.Systemic evaluation of the relationship between psoriasis, psoriatic arthritis and osteoporosis: observational and Mendelian randomisation study.Ann Rheum Dis. 2020;79(11):1460-1467. doi:10.1136/annrheumdis-2020-217892Briot K, Roux C.Glucocorticoid-induced osteoporosis.RMD Open. 2015;1(1):e000014. doi:10.1136/rmdopen-2014-000014National Psoriasis Foundation.What’s the deal with the anti-inflammatory diet?National Institute of Arthritis and Musculoskeletal and Skin Diseases.Calcium and vitamin D: important at any age.Arthritis Foundation.How fat affects PsA.National Institute of Arthritis and Musculoskeletal and Skin Diseases.Exercise for your bone health.Zhao SS, Miller N, Harrison N, Duffield SJ, Dey M, Goodson NJ.Systematic review of mental health comorbidities in psoriatic arthritis.Clin Rheumatol. 2020;39:217-225. doi:10.1007/s10067-019-04734-8Arthritis Foundation.Psoriatic arthritis and sleep.Gambacciani M, Levancini M.Hormone replacement therapy and the prevention of postmenopausal osteoporosis.Prz Menopauzalny. 2014;13(4):213-220. doi:10.5114/pm.2014.44996
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Psoriasis Foundation.About psoriatic arthritis.National Institute on Aging.What is menopause?Watt FE.Musculoskeletal pain and menopause.Post Reprod Health. 2018;24(1):34-43. doi:10.1177/2053369118757537Marder W, Vinet É, Somers EC.Rheumatic autoimmune diseases in women and midlife health.Womens Midlife Health. 2015;1:11. doi:10.1186/s40695-015-0012-9Dalal PK, Agarwal M.Postmenopausal syndrome.Indian J Psychiatry. 2015;57(Suppl 2):S222-S232. doi:10.4103/0019-5545.161483Reed BG, Carr BR.The normal menstrual cycle and the control of ovulation. [Updated 2018 Aug 5]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-.The Endocrine Society.Reproductive hormones.Villa A, Rizzi N, Vegeto E, Ciana P, Maggi A.Estrogen accelerates the resolution of inflammation in macrophagic cells.Sci Rep. 2015;5:15224. doi:10.1038/srep15224Abildgaard J, Tingstedt J, Zhao Y, Hartling HJ, Pedersen AT, Lindegaard B, Dam Nielsen S.Increased systemic inflammation and altered distribution of T-cell subsets in postmenopausal women.PLoSOne. 2020;15(6):e0235174. doi:10.1371/journal.pone.0235174Ceovic R, Mance M, Bukvic Mokos Z, Svetec M, Kostovic K, Stulhofer Buzina D.Psoriasis: female skin changes in various hormonal stages throughout life–puberty, pregnancy, and menopause.Biomed Res Int. 2013;2013:571912. doi:10.1155/2013/571912Ueno A, Yoshida T, Yamamoto Y, Hayashi K.Successful control of menstrual cycle-related exacerbation of inflammatory arthritis with GnRH agonist with add-back therapy in a patient with rheumatoid arthritis.J Obstet Gynaecol Res. 2022 May 20. doi:10.1111/jog.15287.Danesh M, Murase JE.The immunologic effects of estrogen on psoriasis: A comprehensive review.Int J Womens Dermatol. 2015;1(2):104-107. doi:10.1016/j.ijwd.2015.03.001Polachek A, Li S, Polachek IS, Chandran V, Gladman D.Psoriatic arthritis disease activity during pregnancy and the first-year postpartum.Semin Arthritis Rheum. 2017;46(6):740-745. doi:10.1016/j.semarthrit.2017.01.002Kurizky PS, Ferreira Cde C, Nogueira LS, Mota LM.Treatment of psoriasis and psoriatic arthritis during pregnancy and breastfeeding.An Bras Dermatol. 2015;90(3):367-375. doi:10.1590/abd1806-4841.20153113Talsania M, Scofield RH.Menopause and rheumatic disease.Rheum Dis Clin North Am. 2017;43(2):287-302. doi:10.1016/j.rdc.2016.12.011Wright NC, Looker AC, Saag KG, et al.The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine.J Bone Miner Res. 2014;29(11):2520-2526. doi:10.1002/jbmr.2269Xia J, Xie SY, Liu KQ, et al.Systemic evaluation of the relationship between psoriasis, psoriatic arthritis and osteoporosis: observational and Mendelian randomisation study.Ann Rheum Dis. 2020;79(11):1460-1467. doi:10.1136/annrheumdis-2020-217892Briot K, Roux C.Glucocorticoid-induced osteoporosis.RMD Open. 2015;1(1):e000014. doi:10.1136/rmdopen-2014-000014National Psoriasis Foundation.What’s the deal with the anti-inflammatory diet?National Institute of Arthritis and Musculoskeletal and Skin Diseases.Calcium and vitamin D: important at any age.Arthritis Foundation.How fat affects PsA.National Institute of Arthritis and Musculoskeletal and Skin Diseases.Exercise for your bone health.Zhao SS, Miller N, Harrison N, Duffield SJ, Dey M, Goodson NJ.Systematic review of mental health comorbidities in psoriatic arthritis.Clin Rheumatol. 2020;39:217-225. doi:10.1007/s10067-019-04734-8Arthritis Foundation.Psoriatic arthritis and sleep.Gambacciani M, Levancini M.Hormone replacement therapy and the prevention of postmenopausal osteoporosis.Prz Menopauzalny. 2014;13(4):213-220. doi:10.5114/pm.2014.44996
National Psoriasis Foundation.About psoriatic arthritis.
National Institute on Aging.What is menopause?
Watt FE.Musculoskeletal pain and menopause.Post Reprod Health. 2018;24(1):34-43. doi:10.1177/2053369118757537
Marder W, Vinet É, Somers EC.Rheumatic autoimmune diseases in women and midlife health.Womens Midlife Health. 2015;1:11. doi:10.1186/s40695-015-0012-9
Dalal PK, Agarwal M.Postmenopausal syndrome.Indian J Psychiatry. 2015;57(Suppl 2):S222-S232. doi:10.4103/0019-5545.161483
Reed BG, Carr BR.The normal menstrual cycle and the control of ovulation. [Updated 2018 Aug 5]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-.
The Endocrine Society.Reproductive hormones.
Villa A, Rizzi N, Vegeto E, Ciana P, Maggi A.Estrogen accelerates the resolution of inflammation in macrophagic cells.Sci Rep. 2015;5:15224. doi:10.1038/srep15224
Abildgaard J, Tingstedt J, Zhao Y, Hartling HJ, Pedersen AT, Lindegaard B, Dam Nielsen S.Increased systemic inflammation and altered distribution of T-cell subsets in postmenopausal women.PLoSOne. 2020;15(6):e0235174. doi:10.1371/journal.pone.0235174
Ceovic R, Mance M, Bukvic Mokos Z, Svetec M, Kostovic K, Stulhofer Buzina D.Psoriasis: female skin changes in various hormonal stages throughout life–puberty, pregnancy, and menopause.Biomed Res Int. 2013;2013:571912. doi:10.1155/2013/571912
Ueno A, Yoshida T, Yamamoto Y, Hayashi K.Successful control of menstrual cycle-related exacerbation of inflammatory arthritis with GnRH agonist with add-back therapy in a patient with rheumatoid arthritis.J Obstet Gynaecol Res. 2022 May 20. doi:10.1111/jog.15287.
Danesh M, Murase JE.The immunologic effects of estrogen on psoriasis: A comprehensive review.Int J Womens Dermatol. 2015;1(2):104-107. doi:10.1016/j.ijwd.2015.03.001
Polachek A, Li S, Polachek IS, Chandran V, Gladman D.Psoriatic arthritis disease activity during pregnancy and the first-year postpartum.Semin Arthritis Rheum. 2017;46(6):740-745. doi:10.1016/j.semarthrit.2017.01.002
Kurizky PS, Ferreira Cde C, Nogueira LS, Mota LM.Treatment of psoriasis and psoriatic arthritis during pregnancy and breastfeeding.An Bras Dermatol. 2015;90(3):367-375. doi:10.1590/abd1806-4841.20153113
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