Menopause and Autoimmune Disease: What You Should Knowby Robin Elise Weiss, Ph.D. Health Professional
The combination of menopause and autoimmune disease can produce a range of issues for women. Some women will find that going through menopause results in relief from their autoimmune disease symptoms, while others find menopause makes their symptoms worse. How you are affected largely depends on which autoimmune disease you have, when you were diagnosed, and when you reach menopause.
Read on to learn what you need to know about menopause and autoimmune disease.
What is menopause?
Menopause is a fact of life. It’s defined as the cessation of the menstrual cycle, which follows a period of time when your hormonal production slows. The average age women go through menopause is 51, according to the American College of Obstetricians and Gynecologists.
What is autoimmune disease?
Autoimmune disease is a group of almost 100 diseases that alter the immune system. A healthy immune system is one way to predict your life span. As you age, the risks of autoimmune disease increase. This is particularly true for women. Additionally, there are 50 million Americans with autoimmune disease, and 75 percent of those are women.
Your immune system and menopause: Aging of the thymus
To understand some of the issues surrounding menopause and autoimmune disorders, you first have to understand the thymus. The thymus is a small organ located behind your breastbone. It’s small when you are born and grows until you hit puberty. Then, it will start to shrink as you age, eventually weighing as little as 5 grams when you’re elderly.
The thymus is the backbone of your immune system. It produces progenitor cells, which morph into T-cells. T-cells work to kill of infection and cancer cells in your body. As you age and your thymus decreases the production of the T-cells, you are more susceptible to illness and disease and experience an increase in inflammation. You also experience an increase in the production of autoimmune cells as you age, which doesn’t mean that you’ll definitely have an autoimmune disease, but rather means you carry an increased risk.
How hormones affect menopause and autoimmune disease
The hormone estrogren can boost the immune system for women, and for some it can also increase the risk of autoimmune disease. And then for others, it can increase the risk of menopause while estrogren levels are decreasing.
That means that while estrogen typically plays some role, the outcomes can vary. For example, if you have systemic lupus erythematosus (SLE), you will typically have flares in pregnancy, a time of high estrogen activity, but have less disease activity in perimenopause and menopause. Estrogen can also cause the thymus to shrink, decreasing the number of T-cells and other functions related to the immune system.
How genetics and environmental factors impact autoimmune disease
There is a genetic component to autoimmune disease, and the environment can also play a role. Environmental factors can include everything from social choices like smoking and diet to where you physically live and work.
Menopause symptoms and autoimmune disease
During menopause, it can become difficult to tease out what symptoms are normal parts of menopause and which are related to your autoimmune disease.
There is a laundry list of typical menopause symptoms that we tend to think of as annoying but not necessarily as physical ailments. These include:
Lack of physical activity or a decrease in the amount of exercise and movement you have
Issues with your diet
These are problems that happen frequently with aging, but can be attributed to many factors, only some of which you control. For example, stress can increase your levels of the stress hormone cortisol, and a lack of sleep, poor diet, and lack of exercise can all add to a decrease in the functioning of your immune system.
How does menopause impact my specific condition?
Wondering how your particular autoimmune disease may interact with aging and menopause? Here are some of the most common autoimmune diseases and what you may be able to expect. If you have an autoimmune disease (listed here or not), discussing the impact of menopause on your condition is always a good idea, too.
After menopause, there is an increase in the diagnosis of RA. The decrease in estrogen during the postmenopausal years may play a role in the development of RA.
Menopause has an effect on sceleroderma (systemic sclerosis), namely in skin thickening. There are studies that show an increased skin thickening in patients with scleroderma who are menopausal. It is also suspected that the development of pulmonary arterial hypertension (PAH) is more common after menopause.
Menopause, like the postpartum period, can have a harmful effect on the symptoms associated with multiple sclerosis (MS). One very small study showed that 54 percent of women reported a worsening of their MS symptoms after menopause.
Future research on autoimmune disease and menopause
We don’t know the complete interplay of menopause with other diseases, hormone replacement therapy (HRT), and other disease pathways. For example, some autoimmune diseases get better after menopause, while others get worse. Menopause, in general, can alter disease risk and quality of life. When menopause is combined with autoimmune diseases, some women may have a greater disease risk than others in categories like cardiovascular disease. More study on the various diseases and menopause would be helpful, not only for those who suffer from the diseases but for the economic burden of the problems.
Despite the number of people who have autoimmune disorders, there is a lot less money spent researching it. This is particularly true of the effect of menopause and other hormonal shifts on these disorders, despite the fact they overwhelmingly occur in women and affect their quality and quantity of life.
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