My RA has got worse with onset of menopausal symptoms - is this normal?

[CLANCASTER]

I am also suffering from fatigue to the extent that I have no energy at the end of the day to exercise (too stiff in the morning to do it) and now I am putting on weight and not fit any more....how have others overcome this? I have asked for further treatment with a more effective DMARD but my specialist has said no and offers no other help eg physio, occupational therapy etc. I want to remain self-employed for as long as possible and am trying to forward plan to avoid further joint and cardiovascular problems but the help from my specialist is not very forthcoming

[trace65]

Hi Clancaster, welcome to the site. Lots of people on here feel there is a connection between the Menopause and RA. I think it may well be one of those triggers that can make things worse or even start things off in the first place.

Regarding exercise, have you tried swimming? I find that even if I'm stiff or tired i still go , telling myself I'll just have a float about in the water and everytime I end up having a decent swim and feel better for it.

Sorry to hear you aren't getting much help with your treatment, does your specialist give any reasons for not moving on to something else?

Tracy

[Hidden]

I've been to see my Professor Rheumy today and asked the question is there any connection between onset RA and the menopause.... he said no he's seen no real evidence of this but mmmm I'm not convinced???? but he's the expert!!! He said there Is more evidence of RA making itself known after recently giving birth, which after reading some blogs on here makes sense. X

[helixhelix]

well my GP (female) says that although the scientific lot haven't proved it she's seen too many patients where things have got worse joint-wise with menopause to believe that there's absolutely no link. Personally I'd ask your GP to refer you for a second opinion, as it doesn't sound as if the rheumy is listening to you or explaining things properly. Maybe there's a good reason not to give you other drugs, but if so then they should tell you! Polly

[Hidden]

That's interesting Polly that your GP is aware of a possible link with RA and the menopause, every health professional that I've mentioned it to Poo poo's it.. I'm no expert but if you look at the facts there's got to be something in it?? My Rheumy today said he believed there was some evidence to believe there is a link between ladies that have recently given birth and RA... But the menopause or giving birth means that our hormones are all over the place? I know in here there's been a few comments about this but surely there has to be something in it?

[earthwitch]

I thought it was quite commonly understood that most autoimmune disorders can be influenced by hormones, with for example some getting better during pregnancy and some getting worse. With AS, I am sure I've heard theories that the reason that women can have less radiological damage (but the same disease burden) is that female hormones give some protection somehow. Also if there isn't a hormonal influence, then how do you explain the major difference in incidence between men and women with pretty much all the autoimmune diseases?

The problem with asking doctors about whether there is a link or not, is that they take it too literally. A doctor will only believe something if there is documented research evidence on it. If the reason there isn't research evidence is because no one has actually done enough research, then it still doesn't exist as far as they are concerned..

[helixhelix in reply to earthwitch]

I thought the male/female difference was put down to genetic links rather than hormones (ie XY related)?

[CLANCASTER]

Thanks for your views and help. I am toying with idea of getting a second opinion. So far I've only been given MTX and offered plaquenil. Which has made me violently ill in the past so I refused (is also in my medical notes) but cos I refused the specialist doesn't offer any other options. I don't get it. There are drugs available that all but stop the joint damage but we can't have them until we fail other things and are in a state where these drugs will them just maintain the state we are in. I hate the fatigue and uncertainty of the flare ups.

[jeanabelle]

I think on this subject the sufferers know better. I had just turned 60 and was still having palpitations and 'flushes'. I was with my GP with my first complaint about joint pain. I happened to say to him that I have been in the menopause for over seven years and was wondering just when it was going to end. That was in January by March I had been diagnosed withRA. The flushes were due to inflamitation and the mountain of medication I was suddenly on.

I am one hundred percent sure that as my menopause was ending the RA was just starting to take over..... I had no space inbetween.....from one misery to another!

Hope this helps. X

[nottsexsportfanatic]

I saw my gp yesterday to ask for gynae referral as its gone haywire since my ra diagnosis last feb. I have kept a diary which shows my joints worsen when I have a period due. If it doesnt start my nausea levels also increase. But both gp and rheumy say ra is not linked to hormones so blood tests r all they will offer.

[Jenniferbriers in reply to nottsexsportfanatic]

Hi I thought I’d send you a reply as your symptoms seem similar to mine. In my 20’s the time before my period didn’t affect my RA but when I hit my late 30’s the week before & start of my period was just so incredibly painful on my joints & my body felt like a lead weight. My RA nurse said some woman experienced the same symptoms but offered no advice. A male gp specialising in fertility & women’s health suggested taking very low dose steroids to get over the worst days & it did help when I was working in London commuting but I didn’t overdo the steroids maybe 3 days at 2.5mg . Now I have a cataract problem due to steroid use over the years &

despite knowing steroids would help on the really bad days when I just want to chop my legs off I don’t use steroids. How are you coping with those very painful days. My lead up to periods now I’m approaching menopause is horrendous & I have yet to find a solution. I’m interested to know what you do to get through those painful times & willing to try or accept any advice.

Best wishes

[bruce18]

Hi,

This is all very interesting.

I was on prednisolone and I had to have a hormone test to see if I was going through the menopause - Im NOT. The steriods upset my monthlys, gave terrible cramps and made me think I was going through the menopause at 35 :(.

Im off the prednisolone now and Im fine and going to try for a 2nd child.

I did however become quite ill after giving birth to my 1st child and then 2 years later I got the RA. I think it was always on the cards for me and having a baby is a major strain on ones body so I think it was a catalyst to the inevitable...

I have spoke to my nurse who was very honest with me about the meds. They have to tick boxes and have to be seen to have tried us on all the cheaper meds first. Once we have tried what they say then the good meds will be available.

Hope these facts help. Claire x

[Hidden]

For some people the DMARDs are good meds but not for me I admit. My meno started a few years before RA and I'm sure they are closely linked in my case too. At my first rheumy appointment he said "the change can bring on joint problems and we need to be clear that yours aren't simply hormonal" or something like that. I was looking hard at this link - wondering if mine was all menopausal. I came across a site called Menopause Matters started by a Scottish Gynae called Dr Hazel Currie.

I came across a thread she had started in which she stated that most joint pain experienced during menopause is hormonal and women should just accept it and think about starting HRT if theirs was severe. There was no mention of RA or advice for women to see their gps about arthritis - apart from a sentence saying that OA often starts post menopause. Then there were comments from loads of women, some of which I found very worrying. People saying they were sure it wasn't rheumatoid because their bloods were negative for RF but they were struggling to move in the mornings and had swollen knuckles etc. I wrote to Dr Currie saying I thought she should be more responsible and tell people about sero negative RA - she never replied though.

Meanwhile I saw a gynae up here and it was shortly before I was diagnosed with RA. I was taking Prednisolone and he poo pooed the idea that menopause alone could cause severe joint pain and swelling. I explained that my RA symptoms had disappeared when I had a one off period. He said this could be because oestrogen is a steroid and works similarly to Prednisolone so may well have temporarily eliminated joint problems during a surge. So both consultants and my GPs have all said to me that these things are all closely connected. X

[Sailaway]

As others have said I would be concerned that your consultant isn't treating the worsening of your condition and you could consider changing to another consultant (your GP would do that as a second opinion referral). There are others on here who have benefited from doing that.

On the menopause question, I remember reading about a study by Swedish researchers, I think it's on the RA Warrior blog. From memory there was some sort of link proved.

As it happens I was diagnosed with RA the same year blood tests showed I was starting the menopause and I've heard many similar stories. My GP thinks there's a link but my consultant didn't really pick up on it. I wonder whether it would make any difference to the consultant's decision making on treatment? If not that's maybe why they don't concern themselves with it, like any trigger it's done it's work, for the consultant it's the RA that needs dealing with.

I hope things improve for you soon.

[CLANCASTER]

Thanks al for your thoughts and advice. I am toying with the idea of travelling abroad and getting a second opinion there....see if they have a different approach.

It does make me wonder though if specialists can say oestrogen has a steroid like effect, then why would the fall off of natural oestrogen (menopause) cause an increase in pain and inflammation?

[Gottarelax]

I think that there is a lot of overlap in symptoms, I went through menopause before developing RA and HRT was (and is) fantastic. Then when I suddenly went down with RA, it seemed that many of my 'menopause' symptoms were back. The main difference was joint pain and the fact that I couldn't move anymore with the RA. Fatigue, brain fog and hot flushes were very similar (though there did seem to be a difference in the flush - with menopause it was sudden and any time of day whereas with RA it tended to only at night and slowly getting too hot). If you're not taking HRT, you may find that you feel a lot better if you do.

Edited to add I still take HRT and the RA symptoms are much better with MTX.