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Hormones and PsA Flares

Can your menstrual cycle affect psoriatic arthritis symptoms?

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Q: Can my menstrual cycle affect my PsA?

A: Many young women with inflammatory arthritis, including psoriatic arthritis, report flares in their symptoms when they menstruate. While hormones such as estrogen may have an influence on the immune system, the relationship of flares in arthritis symptoms at the time of menstruation may also be due to the effects of pain perception related to estrogen. When estrogen levels are low, women report more pain. In clinical trials, those given a placebo without estrogen have more joint pain than those given estrogen. Thus, the lower levels of estrogen during menstruation may be a cause of the increase in joint pain that many women with arthritis report.

Susan M. Goodman, MD
Rheumatologist
Hospital for Special Surgery, New York

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