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Symptoms of rheumatoid arthritis get worse after menopause

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Women with rheumatoid arthritis (RA) suffer a greater decline in physical function after the menopause, according to a study published in Rheumatology.

For the study, researchers examined data on 8,189 women in a US-wide observational cohort who developed RA before menopause.

They found that women who were pre-menopausal had less physical decline compared with women who were post-menopausal, even after adjusting for other significant factors. Those who had ever used hormonal replacement therapy, or had a pregnancy, and those with a longer length of reproductive life, were associated with less physical decline.

After menopause, the physical decline worsened and accelerated in women with RA.

The results suggest 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.

It’s important to learn more about physical function in rheumatoid arthritis patients as it impacts quality of life, explained Oxford University Press, publisher of Rheumatology. 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.

“Further study is needed as to why women with rheumatoid arthritis are suffering a greater decline in function after menopause,” said Elizabeth Mollard from the University of Nebraska Medical Center, lead author of the paper. “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.”