Hormone change makes women’s arthritis worse

IT is a miserable enough time for most women, but going through the menopause is particularly tough on those with rheumatoid arthritis, researchers warn.

This is because their symptoms get worse faster, leaving them with a battle to do everyday tasks such as getting dressed, standing up or walking.

Women who have arthritis but have not yet gone through the menopause see a much slower decline in their condition, a study found. The trigger is believed to be a lack of oestrogen, which they no longer need to produce an egg each month when their childbearing years are over.

Oestrogen is thought to play an important role in maintaining the joints, which in arthritis sufferers become painful, swollen and stiff.

US researchers studied more than 8,000 women with rheumatoid arthritis.

They found symptoms were less severe in women who had chosen hormone replacement therapy (HRT) or previously had children.

Lead author Dr Elizabeth Mollard, from the University of Nebraska medical centre, said: ‘Further study is needed as to why women with rheumatoid arthritis are suffering a greater decline in function after menopause.

‘Not only is this decline causing suffering for women, it is costly to both individuals and the healthcare system as a whole.’

Women are up to three times more likely to get rheumatoid arthritis than men, with the disease striking at a younger age.

This has led some experts to think female hormones may contribute to the disease, which causes the immune system to attack the cells which line the joints. The theory is supported by the fact that women are less likely to suffer from arthritis when pregnant, but have flare-ups and increased diagnoses after giving birth, when oestrogen levels decline.

The researchers analysed health questionnaires from 8,189 women with rheumatoid arthritis. Around a quarter had not yet gone through the menopause, more than twothirds were post-menopausal and 7.5 per cent went through the menopause during the study.

The participants answered questions on how difficult they found everyday tasks. People with arthritis can struggle dressing, needing zip pulls, button hooks and shoe horns because their joints make the movements painful. They may need a stick to walk and special chairs to make standing up easier.

Analysing the results, the researchers found post-menopausal women had worse physical problems than pre-menopausal women, particularly with reach, grip and bathing. Their condition also declined more over time.

The study, published in the journal Rheumatology, found women who had HRT experienced a slower decline. Dr Heather Currie, former chairman of the British Menopause Society, said: ‘When people talk about menopausal symptoms, many just think about hot flushes and night sweats.

‘We know that women often notice joint pains which they do not necessarily connect with the menopause. This study provides useful information which adds to our understanding of the effects of oestrogen, and the lack of oestrogen which accompanies the menopause, which is much broader than flushes and sweats.

‘We are not at the point of advising women who have rheumatoid arthritis to have HRT purely to reduce effects of the arthritis. But for those who are considering hormone therapy for menopause symptoms, this is something else to consider.’

Dr Benjamin Ellis, senior clinical policy adviser for Arthritis Research UK, said: ‘Going through the menopause can be daunting, even if you don’t have rheumatoid arthritis, and we recognise these findings may cause worry for women who do.

‘If you’re concerned about the impact that the menopause may have on your condition, please speak to your rheumatologist.’