Is early menopause increasing the risk of rheumatoid arthritis? Expert explains – India TV

Early menopause is defined as menopause before the age of 45 years. Early menopause is associated with a series of hormonal changes which occur years before they usually should. Estrogen & Progesterone are the two principal female hormones. The levels of these two hormones decline significantly as menopause sets in. 

What happens when menopause hits early?

With menopause setting in early, the decline in hormones earlier than it physiologically should. Estrogen affects the immune response of the body and that gets affected as early menopause sets in. Autoimmune diseases are likely to come up at this time. A decline in estrogen causes changes in the cellular mechanisms, which has an association with the development of seronegative RA, a milder form of arthritis. The signals and the functions from the higher centres in the brain to the ovaries decline during menopause. 

When we spoke to Dr Nidhi Sharma Chauhan, consultant obstetrician and gynaecologist, at Saifee Hospital, Mumbai, she said that this begins to happen much earlier in the case of early menopause. Evidence has shown an association of mild seronegative rheumatoid arthritis with the onset of early menopause. Some of the symptoms of menopause such as joint pains, body aches, and muscle fatigue could mimic the symptoms of rheumatoid arthritis. Do women with early menopause need treatment to avoid a lot of problems that could arise due to a premature decline in estrogen & progesterone? The answer is “yes”! There is now enough evidence to show that women who undergo premature ovarian failure ( menopause before 40 years) & those having early menopause ( before 45 years), benefit by taking Hormone replacement therapy ( now known as Menopause Hormone Therapy) till the age of average physiological menopause ( 51-52 yrs). 

There must of course be a consultation done before starting the therapy and a follow-up at regular intervals is recommended. It is also true that having an autoimmune disease, like rheumatoid arthritis can lead to premature ovarian insufficiency and early menopause. A recent study by the British Menopause Society, published in the British Medical Journal ( Jan 2024) has evidence to state that the risk of rheumatoid arthritis increases in girls with the age of menarche beyond 14 years of age and age of menopause before 45 years.

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