Hormone changes caused by menopause make rheumatoid arthritis symptoms worse in women, according to a study.

After studying 8189 women with rheumatoid arthritis, researchers 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. 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.

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. Given these connections between hormonal or reproductive life events and rheumatoid arthritis in women, researchers conducted an observational study to investigate the association of menopause with functional status in women with the disease.

The results indicate that menopause has a significant impact on the level and rate of functional decline in women with rheumatoid arthritis and is associated with a worsening progression of the effects of the disease. “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.” The findings have been published in the journal Rheumatology.