Menopausal Arthritis?

[Corshamgirl]

Hi I’m recently diagnosed with RA after 4 yrs of misdiagnosis ranging from wrist sprain, tennis elbow, RSI, then positive diagnosis for under active thyroid which i’m medicated for. I asked many times if my joint stiffness was associated with menopause which I have been experiencing for 2yrs now, but none of my menopausal friends had suffered and GP’s we’re clueless.

However, morning swelling and stiffness in fingers and wrists prevailed until I did some research and asked for a Rheumy appt. Finally after ultrasound and bloods they diagnosed RA 1 year ago and I take 10mg Leflunomide daily. I had a negative RA reading, but inflammation was present in bloods and on ultrasound. I was given no support post diagnosis apart from the leaflet on possible side effects of the drug. Of course anxiety set in when I googled my condition and I imagined myself ending up with clawed hands etc. I recently chanced upon a leaflet at the Rheumy hospital about an RA info day run by NRAS which I went along to. What a revelation..! Many of my questions were answered and I finally realised that there is lots of RA support available. At my recent 1 year Rheumy review my consultant admitted his negligence in supporting my emotional well-being, but stressed that I am effectively in remission as my symptoms are mild and confined to finger and wrist stiffness which resolves within 40mins of waking up. This has not improved since starting on the DMARD’s. And I now suffer increased activity induced pain in my wrists throughout the day so he recommended increasing my leflunomide dose to 20mg to alleviate this. I haven’t increased yet as I’m scared of side effects on a higher dose.

My main reason for posting is to question the link between low oestrogen levels in menopause with onset of RA and thyroid symptoms. I read an article by skinmagazine.co.uk which refers to this as a new type of Menopausal Arthritis, suggesting that if female hormone levels are re-balanced, symptoms could go away completely. This makes me wonder whether if I went onto HRT for my night sweats, foggy brain, anxiety this could resolve my RA symptoms and thyroid issues. Could I still have been misdiagnosed with RA?

Has anyone else heard of this new type of ‘Menopausal Arthritis’ and is it safe to take HRT while on DMARD’s?

[helixhelix]

Nope! However you will find that it is very common that RA symptoms appear around the time of the menopause. So yes people are starting to look into that link, but not to identify "special type of RA" which is already a very variable disease. Instead it's about understanding the range within the disease so the treatments can be better targeted. Hormone levels are hugely complex, so it takes real specialist endrocrinologists to judge whether your personal situation needs some attention.

I was either already on HRT when my RA was diagnosed, or started shortly after, and the doctors were quite happy for me to continue within the guidelines. They did not tell me of any negative interactions between the HRT and the drugs I am on for RA.

[Hidden in reply to helixhelix]

But you must be made aware of the risk of Breast Cancer on HRT Corsham Girl. XX

[helixhelix in reply to Hidden]

That's what I meant by within guidelines, i.e. lowest dose for less than 5 years to minimise that risk.

[Corshamgirl]

Thank you so much for your replies I think I will speak to my GP about the possibility of HRT or if he is resistant, try to get a referral to an endocrinologist.

I’m prepared to look at all angles in the hopes that I can minimize the symptoms and avoid joint damage in the future.

[summer32]

Some people get ra in pregnancy, think there could be a hormone link,!!!, I think it is due variation in hormone level, so if you took her it could resurface again on stopping, my symptoms were diagnosed at 45 pre menopause, but I had symptoms first about 27 late, 20 early 30s but were more sporadic, not diagnosed til 45,

[Downtime]

I have taken HRT for years and haven’t stopped since the RA diagnosis 3 years ago, so I don’t know how my hormone levels affected the onset of the disease. Strange actually the RA started after a period when I decided to come off the HRT.

The thinking re breast cancer has changed a lot recently and the extra risk from hormone replacement is considered quite small. I do feel it helps me a lot with general well being and energy levels.

I hope your RA stays stable but if not don’t be afraid to ask for a change in treatment, there are a lot of options available x

[Millysmum]

Hi Corshamgirl,

I have only been diagnosed for 1 week, and was thinking it could be related to the menopause, as I've tested positive for it, although for some reason my doctor thinks I need more blood tests as he thinks 45 is a little early. ( hmmm know people younger!) but when told rheumy he didn't think it was a factor so started the methotrexate last Saturday. All the best.

[Corshamgirl]

Hi, thanks for your reply. Sorry to hear that you have just been diagnosed with RA and I hope that they get your meds worked out quickly.

Do you mean that you've got a positive RA factor? It seems from the responses that I've had that there is strong evidence that hormones may play a part in onset of RA, and indeed other auto-immune conditions such as thyroid issues. I would suggest that you accept any and all blood tests that the GP or Rheumy want to take, so that at least you have some clarity and a benchmark at the start of your diagnosis, to which you can always refer back. Good luck and stay positive.

[Brychni]

Yes I have heard of it too. I know it's an old post but something I was asked about by migraine consultant yesterday made me think about it again. she asked how my Undifferntiated Inflammatory Arthritis was diagnosed, she was implying that my symptoms seemed to coincide with hormonal episodes (pregnancy etc) . It was an ultrasound diagnosis.

Lack of oestrogen causes a degradation of cartilage or something. women who have symptoms find that HRT gets rid of it. There is research and evidence.