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Menopausal Oestrogen Deficiency Linked to Rheumatoid Arthritis
A DGReview of :"Menopausal syndrome in female patients with rheumatoid arthritis"
Modern Rheumatology
10/05/2001
By Mark Greener
Menopausal estrogen deficiency influences symptoms and inflammation in patients with rheumatoid arthritis.
In some cases, estrogen-driven joint symptoms mimic rheumatoid arthritis.
Researchers from the Kyushu Rosai Hospital and Kyushu University in Japan reviewed five patients with stage I and monocyclic-type rheumatoid arthritis an average of 5.4 years following their menopause. The women experienced at least seven menopausal syndrome symptoms.
In all patients, first joint symptoms coincided with onset of menopause. The mean age of onset was 51.0 years.
The two women who had gynecologically confirmed menopausal syndrome received hormone replacement therapy (HRT). This resolved polyarthralgia in one case.
The authors comment that the estrogen deficiency that underlies menopausal syndrome accounts for all American College of Rheumatology (ACR) criteria, except subcutaneous nodules.
They note that estrogen regulates production of inflammatory cytokines, including interleukin (IL) 1, IL-6 and Tumour Necrosis Factor (TNF) alpha. Production of these cytokines rises as estrogen levels decline.
They conclude that estrogen deficiency at menopause influences both joint symptoms and inflammation in patients with rheumatoid arthritis. In some cases, estrogen deficiency in menopausal syndrome might lead to joint symptoms similar to those of rheumatoid arthritis, they add.
Modern Rheumatology 2001;11:230-233
"Menopausal syndrome in female patients with rheumatoid arthritis"
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