Decline in physical function among post-menopausal women with rheumatoid arthritis
- Menopause may worsen symptoms of rheumatoid arthritis.
- Women with rheumatoid arthritis may experience a functional decline after menopause.
- Functional decline may involve decline in physical functions, lack of independence due to decline in self-care capabilities.
After studying 8189 women with rheumatoid arthritis, a research team found that pre-menopausal women experienced a slower physical decline than those that were post-menopausal.
Physical function is an important aspect of study in patients with rheumatoid arthritis as it impacts their quality of life.
‘Menopause is associated with a worsening progression of functional decline, which means a loss of independence in self-care capabilities.’
Women experience rheumatoid arthritis at a rate three times greater than men, and also have more severe decline and increased disability, yet the sex-based differences in the condition remain poorly understood.
Relationship between hormones and rheumatoid arthritis
Previous studies have shown that women with rheumatoid arthritis experience shifts in their disease surrounding reproductive and hormonal life events, such as childbirth. During pregnancy, women have decreased incidence of rheumatoid arthritis, yet they have an increased incidence of disease development and flare during the post-partum period. Similarly, women who experience early menopause are more likely to develop rheumatoid arthritis compared to those who experience normal or late menopause.
Since there are connections between hormonal or reproductive life events and rheumatoid arthritis in women, the research team conducted an observational study to investigate the association of menopause with functional status in women with the disease.
The participants were women who developed rheumatoid arthritis before menopause.
The results indicate that menopause has a significant impact on the level and rate of functional decline in women with rheumatoid arthritis. Women with rheumatoid arthritis who were pre-menopausal have less functional decline compared with women who were post-menopausal.
"Further study is needed as to why women with rheumatoid arthritis are suffering a greater decline in function after menopause," said the paper's lead author, Elizabeth Mollard. "Not only is this decline causing suffering for women, it is costly to both individuals and the healthcare system as a whole. Research is specifically needed on the mechanism connecting these variables with the eventual goal of identifying interventions that can maintain or improve function in postmenopausal women with rheumatoid arthritis."
- Elizabeth Mollard, Sofia Pedro et al. The Impact of Menopause on Functional Status in Women with Rheumatoid Arthritis, Rheumatology https://doi.org/10.1093/rheumatology/kex526