Do Menopause and Aging Affect the Onset and Progression of Rheumatoid Arthritis and Systemic Lupus Erythematosus?

Abstract

Rheumatoid arthritis and systemic lupus erythematosus (SLE) are autoimmune diseases that are commonly seen in the female population. Rheumatoid arthritis mainly consists of distal symmetrical deforming polyarthritis. SLE patients have immune complexes that damage the organs and systems of the body, and this can present with one or more symptoms including the characteristic malar rash, serositis, lupus nephritis, photosensitivity, and arthritis of large joints. The onset and progression of the diseases are affected by physiological processes that occur in the body such as menopause and aging. The studies used as evidence were found in the PubMed, ScienceDirect, ProQuest, Taylor & Francis Online, Wiley Online Library, Ovid, and Oxford Academic databases. By analyzing these studies, the effects of aging and menopause on rheumatoid arthritis and SLE were revealed. In relation to menopause and aging, it was found that there was a progression of disease in women who had rheumatoid arthritis. However, aging and menopause caused the progression of SLE to decrease in women. An earlier age of onset of menopause was correlated with an increased chance of developing rheumatoid arthritis and SLE. Furthermore, while some studies showed that a later onset of SLE caused an increase in the progression of the disease, other studies showed that a later onset of SLE led to a decrease in the progression of the disease. Due to the prevalence of rheumatoid arthritis and SLE in females, we believe that the effects of menopause, age, and other factors on these two diseases should be examined in future studies.

Exploratory Analysis of Outpatient Visits for US Adults Diagnosed with Lupus Erythematosus: Findings from the National Ambulatory Medical Care Survey 2006–2016

“…Although an older population likely with more comorbidities may be conducive to a greater number of medical visits, it only partially explains the increase observed in 2011–2016. Previous literature has reported late-onset lupus in women, which may be triggered by menopause or age-related changes to the immune system that impact cellular functions and may contribute to the development of lupus in older women [ 26 , 27 ].…”

Female Health Amidst the Covid-19 Pandemic

“…A number of autoimmune diseases such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjögren syndrome (SS), and multiple sclerosis (MS) seem to be prevailing in females compared to males [5,27]. Early menopause has been shown to correlate with the incidence of RA and SLE development in women [28]. Estrogen receptors (ERα/β) are being expressed in numerous cells affecting innate and adaptive immunity.…”

Sex differences in musculoskeletal injury and disease risks across the lifespan: Are there unique subsets of females at higher risk than males for these conditions at distinct stages of the life cycle?

“…As many autoimmune diseases affect more females than males, this means that such conditions that affect joints and other connective tissues are mainly females. An example of such a scenario is rheumatoid arthritis (RA) which can be initiated pre-puberty (i.e., Juvenile Idiopathic Arthritis; Juvenile Inflammatory Arthritis; JIA) ( Glass and Giannini, 1999 ; Cattalini et al, 2019 ), as an adult, or even in post-menopausal females ( Serhal et al, 2020 ; Shah et al, 2020 ; Sugihara, 2022 ). JIA exhibits sex differences in incidence with a predilection for females compared to males of 3-6.6/1 ( Cattalini et al, 2019 ).…”