Women who take HRT to help them through the menopause are almost 50% more likely to get arthritis, finds study

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  • Researchers tracked more than 200,000 Brits for an average of 12 years
  • They found women on HRT were associated with a 46% higher risk of condition

Women using hormone replacement therapy (HRT) are almost half more likely to suffer arthritis than those who don’t, a study suggests.

Starting menopause early and having four or more children were also linked to higher chances of developing rheumatoid arthritis risk, researchers found.

Experts say the increased risk of the autoimmune disease is likely due to lower levels of naturally occurring hormones oestrogen and progesterone during menopause, which are known to have anti-inflammatory effects.

They suggest the ‘significant’ findings should be used to look at targeting treatment for those women most at risk.

Experts say the increased risk of the autoimmune disease is likely due to lower levels of naturally occurring hormones oestrogen and progesterone during menopause, which are known to have anti-inflammatory effects

Experts suggest the 'significant' findings should be used to look at targeting treatment for those women most at risk. Official figures show hormone replacement therapy (HRT) prescriptions have risen 47 per cent compared to 2021/22

Experts suggest the ‘significant’ findings should be used to look at targeting treatment for those women most at risk. Official figures show hormone replacement therapy (HRT) prescriptions have risen 47 per cent compared to 2021/22

NHS data shows about 400,000 people have rheumatoid arthritis in the UK, with about three times as many women affected than men.

It typically causes joint pain and inflammation in areas such as the hands, knees and ankles, as a result of a person’s immune system attacking its own body cells.

While hormonal and reproductive factors are thought to contribute to women’s heightened susceptibility, researchers wanted to test which factors might be particularly influential.

They studied data from 223,526 UK Biobank participants whose health was tracked for an average of 12 years.

WHAT IS THE MENOPAUSE? 

Menopause is when a woman stops having periods naturally and is no longer able to get pregnant naturally.

It is a normal part of ageing and usually happens between the ages of 45 and 55 when a woman’s levels of the sex hormone oestrogen drop. 

Eight in ten women will experience menopausal symptoms including hot flushes, night sweats, vaginal dryness, difficulty sleeping, low mood or anxiety and problems with memory.

Women are advised to see their GP if their symptoms are difficult to manage.

Treatments doctors can provide include hormone replacement therapy, such as tablets, skin patches and gels that replace oestrogen. 

Source: NHS

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During the period, 3,313 women developed rheumatoid arthritis, according to the findings published in the journal RMD Open.

Going through the menopause before the age of 45 found to have a 46 per cent heightened risk compared to those at the age of 50-51, they found.

Being on HRT, which helps ease menopause symptoms, was associated with a 46 per cent higher risk, researchers said.

Those with fewer than 33 reproductive years — the time between starting periods and menopause — had a 39 per cent higher risk, while starting periods after the age of 14 was linked to a 17 per cent higher risk than at 13.

Women with four or more children carried an 18 per cent higher risk compared to women with two children, they said, again likely due to differences in hormone levels.

GP and menopause specialist Dr Louise Newson said the findings should not unduly concern women on HRT, with ‘body-identical hormones’, such as patches, gel or spray more common these days.

She said it was likely the findings include women prescribed older, synthetic types of HRT, rather than the more natural types of hormones prescribed now.

She said: ‘We have known for decades that our natural sex hormones oestradiol — the main type of oestrogen — and progesterone, which decline during menopause, are anti-inflammatory.

‘Women who go through an earlier menopause – that is, before the age of 45 – are without these natural hormones for longer and are therefore at greater risk of inflammation and autoimmune diseases, including rheumatoid arthritis.’

She added: ‘Older tablet oestrogen can be converted to oestrone which is an inflammatory type of oestrogen, while older synthetic progestogens do not have the same anti-inflammatory effects of body-identical progesterone.’

MenopauseNHS

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