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Can Menopause Trigger Autoimmune Conditions?

Learn about the connection between menopause and autoimmune conditions, examining hormonal impacts on immunity.
Can Menopause Trigger Autoimmune Conditions?
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Have you ever wondered whether menopause could serve as a catalyst for the onset of an autoimmune disease?

Menopause is a natural biological process that marks one year since the last menstrual period. Menopause brings about significant hormonal shifts, particularly a decline in progesterone and estrogen levels, that can affect various bodily functions.

Among these, the immune system undergoes notable changes, and menopause is considered a risk factor for the new onset of autoimmune conditions.

This article will delve into the intriguing connection between menopause and autoimmune conditions.

What are autoimmune conditions?

Autoimmune diseases occur when the immune system mistakenly attacks healthy tissues or organs, leading to symptoms such as headaches, dizziness, and pain. There are over 80 known autoimmune diseases, including rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, and Hashimoto’s thyroiditis.

Autoimmune diseases are the third most commonly occurring disease in the United States, among which 78% are women. The exact cause of autoimmune diseases remains unknown.

The common symptoms of autoimmune conditions include:

These symptoms may vary depending on the type and location of the immune response.

Menopause and immune system changes

During menopause, the levels of hormones such as estrogen and progesterone may fluctuate, which affects the immune system. Research has established that estrogen stimulates specific immune cells to increase the production of inflammatory substances, two key aspects in modulating the immune system. Several research studies also demonstrate that when estrogen levels drop, the thymus shrinks, which similarly affects how T cells function.

Lower estrogen levels may also result in more inflammation because estrogen has properties that reduce inflammation. Estrogen has been found to have protective effects against autoimmune conditions, but during menopause, changes in the immune function have implications for autoimmune diseases. Therefore, the fluctuations in hormones, such as drops in estrogen levels during menopause, play a significant role in influencing the onset and progression of autoimmune diseases, along with shaping the immune function in women.

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Immune system and estrogen receptor connections

The connection between the immune system and estrogen receptors is important because estrogen can alter the ability of the immune responses. According to research, immune cells, such as T and B cells, can help increase the body’s ability to fight infections and diseases. For this reason, estrogen will likely regulate or modify the defense response.

There is a direct relationship between estrogen and the immune system because estrogen receptors are found on the immune cells. Estrogen attaches to these estrogen receptors and activates the signals controlling cell functions. It also affects the production of cytokines that are responsible for regulating immune responses.

During menopause, the levels of estrogen decline due to hormonal fluctuations and affect the functioning of estrogen receptors. With less estrogen available, immune cells might not get the same level of signaling they are accustomed to getting. This can result in increased inflammation or weaker immune responses, explaining why women are more likely to develop autoimmune diseases after menopause.

Autoimmune conditions associated with menopause

During menopause, hormone levels can fluctuate, affecting the immune system. The imbalance of hormones in menopausal women can influence the development, severity, and worsening of symptoms. Here are some of the autoimmune diseases that can be affected by menopause.

Hashimoto’s thyroiditis

Hashimoto’s thyroiditis is a chronic autoimmune condition where the body mistakenly attacks the thyroid gland. This results in a thyroid gland that is incapable of producing enough thyroid hormone, a condition known as hypothyroidism. Estrogen may have a direct effect on thyroid function. This is because estrogen increases the production of thyroxine-binding globulin (TBG) and affects the thyroid peroxidase (TPO) enzyme involved in producing thyroid hormone. Due to low estrogen levels during menopause, these processes are disrupted, leading to worsening of hypothyroidism symptoms.

Estrogen also modulates T-helper cell subsets that are responsible for immune response. Still, during menopause, a low estrogen level disrupts the balance and increases the risk of developing Hashimoto’s thyroiditis.

Additionally, estrogen has anti-inflammatory properties, but during menopause, this effect is reduced. In this way, low estrogen levels can increase the risk of thyroid inflammation.

Rheumatoid arthritis (RA)

Rheumatoid arthritis is a chronic inflammatory disease that typically affects joints and organs. It can cause symptoms including pain, swelling, stiffness of joints, and decreased mobility. Research suggests that there is a link between estrogen levels and the development or progression of RA. During menopause, declining estrogen levels can disrupt immune responses and inflammation regulation, potentially exacerbating RA symptoms or increasing the risk of its onset in women.

Studies suggest that early menopause in women is linked to an increased risk of developing rheumatoid arthritis. The effects can vary in pre- and post-menopausal women according to the time of estrogen exposure.

Systemic lupus erythematosus (SLE)

Systemic lupus erythematosus is a chronic inflammatory disease affecting the skin, joints, kidneys, and other organs. Estrogen can affect the immune response and inflammatory processes, and a decline in estrogen levels during menopause may influence SLE activity. Two studies have suggested that overall severity and frequency of flares decreases in post-menopausal women compared to premenopausal women with SLE.

Multiple sclerosis (MS)

Multiple sclerosis is a chronic autoimmune disease of the central nervous system that affects the brain and spinal cord, resulting in muscle weakness and vision changes. Studies suggest that while menopause doesn’t directly trigger MS, it can influence its course in women already diagnosed with MS. After menopause, women with MS may experience reduced inflammation but increased disability, potentially signaling a shift to a more progressive disease phase. This might occur due to hormonal, immunological, and aging effects on the immune system during menopause.

Factors influencing the relationship between menopause and autoimmune conditions

The relationship between menopause and autoimmune conditions is complex and influenced by various factors. Here are some of the factors:

Hormonal changes

Estrogen and progesterone are hormones that play a role in regulating the immune system. During menopause, levels of estrogen can decrease, which affects the immune function and leads to the onset or increased risk of autoimmune conditions.

Genetic predisposition

Genetic factors heavily influence the development of autoimmune diseases. Certain people may have a genetic tendency towards autoimmune conditions, and the onset or progression of these conditions in susceptible individuals can be triggered by menopause.

Age-related changes

Aging is associated with changes in the immune system, including alterations in immune cell function and cytokine production. These age-related changes can influence the risk and course of autoimmune diseases, particularly as women transition through menopause.

Environmental factors

Environmental factors such as diet, stress, and exposure to toxins may interact with hormonal changes during menopause to influence the development or progression of autoimmune conditions.

Hormone replacement therapy (HRT)

HRT involves the use of hormones estrogen and progesterone to alleviate menopausal symptoms and may influence the risk of autoimmune diseases. Research studies suggest that estrogen therapy may modulate the immune system in ways that either increase or decrease the risk of autoimmune conditions. This depends on various factors, such as the type of hormone therapy or the dose.

Understanding these factors is crucial for determining the relationship between menopause and autoimmune conditions and developing prevention, management, and treatment strategies.

Medications for autoimmune conditions and menopause

For some women, hormone replacement therapy (HRT) can help alleviate menopausal symptoms, such as hot flashes and vaginal dryness, by balancing reproductive hormones. However, HRT may not be suitable for everyone, especially those with certain autoimmune conditions.

If you have Hashimoto’s hypothyroidism, treatment with thyroid hormone replacement medication can improve your thyroid health and, in some cases, may improve menopausal symptoms as well.

If you have an autoimmune disease, your doctor may recommend medications to treat your autoimmune condition and prevent flare-ups. The medications prescribed for other autoimmune diseases vary depending on the specific condition and its severity. Here are some common types:

  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These drugs, like ibuprofen and naproxen, help reduce inflammation and relieve pain.
  • Corticosteroids: Prednisone and other corticosteroids are potent anti-inflammatory medications that can help control inflammation in autoimmune diseases.
  • Disease-Modifying Antirheumatic Drugs (DMARDs): These drugs slow down the progression of autoimmune diseases by suppressing the immune system. Examples include methotrexate, hydroxychloroquine, and sulfasalazine.
  • Biologic Response Modifiers (Biologics): These are a newer class of medications that target specific immune system components involved in autoimmune diseases. Examples include TNF inhibitors (e.g., adalimumab, etanercept), interleukin inhibitors (e.g., tocilizumab), and B cell inhibitors (e.g., rituximab).
  • Immunosuppressants: Drugs like azathioprine, cyclosporine, and mycophenolate mofetil suppress the immune system, reducing inflammation and controlling autoimmune responses.
  • Janus Kinase (JAK) Inhibitors: These medications block the action of certain enzymes involved in the immune response. Examples include tofacitinib and baricitinib.
  • Monoclonal Antibodies: These antibodies target specific proteins involved in the immune response. Examples include belimumab, which targets B cells in systemic lupus erythematosus.
  • Interferons: These medications regulate the immune system and are used in conditions like multiple sclerosis.

The choice of medication depends on factors such as the type and severity of the autoimmune disease, the patient’s overall health, and potential side effects. Treatment plans often involve a combination of medications and may need to be adjusted over time. Patients need to work closely with their healthcare providers to find the most effective and safest treatment for their condition.

Other ways to manage autoimmune conditions during menopaus

Managing autoimmune conditions during menopause requires a multifaceted approach beyond prescription medications. Lifestyle modifications can improve your overall well-being, hormonal balance, and immune function. Consider incorporating stress reduction and management, dietary changes, physical activity, and other complementary approaches. Consulting with healthcare professionals knowledgeable in integrative approaches to health management can help you craft a personalized treatment plan that optimizes quality of life during menopause while managing autoimmune conditions effectively. Some of these factors include the following.

Maintain a healthy lifestyle

Eating a balanced, anti-inflammatory diet, engaging in regular exercise and physical activity, managing stress, and getting adequate sleep are essential for managing both menopause and autoimmune conditions. In addition, the Autoimmune Protocol (AIP) diet can help reduce inflammation, improve gut health, and minimize the symptoms of autoimmune diseases.

Monitor symptoms

Keep track of your symptoms, including any changes or flare-ups, and promptly communicate with your healthcare provider. Adjustments to medications or treatment plans may be necessary to manage symptoms during menopause effectively.

Alternative therapies

Some women find relief from menopausal symptoms and autoimmune conditions through complementary and alternative therapies such as acupuncture, yoga, massage, and herbal supplements.

Managing autoimmune conditions during menopause may require patience and persistence. Seeking consultation from gynecologists or rheumatologists can help develop a personalized management plan tailored to your autoimmune condition. In addition, adopting healthy lifestyle habits can help you optimize your well-being and quality of life during this transitional period.

A note from Paloma Health

Menopause marks a significant milestone in a woman’s life, signaling the end of her reproductive years. During menopause, fluctuations in hormone levels, particularly estrogen, can impact the immune system. For some women, this time also coincides with the onset or exacerbation of autoimmune conditions.

At Paloma Health, we understand the complexities of menopause and its potential impact on immune health. That’s why we’re dedicated to providing comprehensive care and support to women navigating this phase of life. As a Paloma Health member, you’ll have access to a range of resources tailored to your needs, including convenient and painless at-home blood test kits, virtual consultations with experienced healthcare professionals, personalized treatment plans, health coaches, and a supportive community to help you reach your health and wellness goals.


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‌Chakraborty B, Byemerwa J, Krebs T, Lim F, Chang CY, McDonnell DP. Estrogen Receptor Signaling in the Immune System. Endocrine Reviews. Published online June 16, 2022. doi:

Lorefice L, Maurizio Nicola D’Alterio, Davide Firinu, Fenu G, Cocco E. Impact of Menopause in Patients with Multiple Sclerosis: Current Perspectives. International Journal of Women’s Health. 2023;Volume 15:103-109. doi:

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