For many women, the mid- to late-forties is a time of rediscovering who they are and what they want from their lives. I’ve found that I’ve come to understand and respect my individual strengths and weaknesses, and am more secure with myself than ever before. Even though I’ve been dealing with rheumatoid arthritis for years, I finally feel like I have a handle on how to care for myself.
However, as amazing as this time of my life has been mentally and spiritually, physically it’s been total chaos. The problem is menopause. I wake up in the middle of the night certain someone is trying to torture me with heat and realize that putting make-up on in the morning is a wasted effort because it will sweat away before I arrive at work. Despite a fairly healthy lifestyle, I now have more than a muffin top hanging over my pants. No matter what I do, the weight seems to keep piling up in my breasts and abdomen. It makes a gal ask, “Who does this body belong to?”
The time in a woman’s life leading up to menopause (defined as 12 months without a menstrual period) can be marked by all kinds of symptoms related to changing hormone levels. To figure out what was going on with my body, I tackled the research on menopause just as I did when I was diagnosed with rheumatoid arthritis. I visited website after website confirming that what seemed to be very abnormal is actually normal. But I discovered a problem. Many of the symptoms of menopause overlap with those of rheumatoid arthritis. Adding to the confusion is that many women may be changing RA medications as they prepare for menopause. When the symptoms overlap, it’s not always clear what the cause is.
When I see my young female rheumatologist, she admits that menopause isn’t her area of expertise. I’m left to wonder, is what I am experiencing a symptom of menopause or rheumatoid arthritis, and does it even matter? Below are just a few of the overlapping issues.
Up to 90 percent of women will gain 12 to 15 pounds between the ages of 45 and 55 as they head towards menopause, according to the site 34 Menopause Symptoms. While many rheumatologists such as my own claim that the use of biologics to treat rheumatoid arthritis doesn't cause weight gain, other experts disagree, and there is a lot of discussion about this in the patient community. I started a biologic just as my menopausal symptoms were beginning and put on 15 pounds almost immediately.
There are many possibilities for why women in their forties experience fatigue, and looking at lifestyle choices is always a good start. However, up to 80 percent of women heading into menopause experience this common symptom. Add in the intense fatigue caused by rheumatoid arthritis and you may have no other choice than to allow your body to sleep as long as needed.
As hormones change during menopause, the result can be dry eyes that need to be treated. RA can also cause dry eyes, whether as a side effect of medications or as a symptom of the disease itself. Anyone diagnosed with rheumatoid arthritis should also know that dry eyes can indicate a complication called Sjögren’s syndrome.
This is one of the dreaded side effects of medications that treat rheumatoid arthritis. But the hormonal changes occurring with menopause can also cause hair loss.
Here are some ways to make sure you’re distinguishing RA symptoms from those of menopause—and some strategies for weathering all the changes.
- Create a healthcare team. Include your OB/GYN in the conversation. An optometrist might be able to help with dry eyes and a dietitian could help with eating well for both RA and menopause. Keep everyone in the loop and be sure to set goals with your team.
- Do your research and ask questions. Make your appointment work for you. Come with a list of questions to ask, such as:
- Would the treatment be the same whether the cause was menopause or RA?
- Do I need additional lab work run to rule out other complications?
- What lifestyle changes can I make as a patient to better support my body as it makes the natural transition into menopause while also coping with a chronic illness?
- How can I coordinate discussion between my health-care providers to make sure I am being treated for all my conditions?
- Know your body well. You are the number-one expert when it comes to your body. If something doesn’t feel right or you aren’t being helped, speak up.
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