Search and Hit Enter

Autoimmune Disease and the Menopause

By Dr Ornella Cappellari

We all know someone, perhaps a friend, a relative, or maybe even yourself that has an autoimmune disease.

But what is an autoimmune disease and why it is related to the menopause? By definition, an autoimmune disease is a condition arising from an abnormal immune response to a normal part of the body. Up to now there are approximately 80 known autoimmune diseases meaning that almost any part of the body can be affected. Even if autoimmune diseases also affect men, it is virtually impossible to ignore the fact that they are much more prevalent in women. Scientists believe that estrogen may be the reason behind this.

Estrogen and Autoimmune Disease

The hormone estrogen could interplay with certain immune factors enhancing the action of the body’s inflammatory response, increasing antibodies that attack certain tissues in the body, therefore leading to an autoimmune disease. Other studies have shown that during their reproductive years, when in fact estrogen levels are higher, women tend to have a more vigorous immune response. It is then during the menopause, when estrogen levels decrease, that a woman’s immune system becomes more similar to that of a man’s. This lowered immune response is believed to be caused by changes in the function and activity of certain immune cells. Further interesting evidence supporting the influence of estrogen on the immune system is provided by the observation that the incidence of many autoimmune diseases in women dramatically decreases following menopause whilst some others increases.

Research continues to show that the decreased estrogen level associated with the menopause can affect the immune system. In a review of various studies designed to better understand the relationship between sex hormones such as estrogen and immunity, it has been explained that sex hormones affect and modify the actions of different types of immune cells by modulating their actions. The authors also point out that certain interactions between estrogen and cells of the immune system can also influence other organs of the body that are not directly related to immunity. For example, cardiovascular disease and osteoporosis—health issues that often affect women after menopause—are linked to a decrease in estrogen and a loss in estrogen’s ability to regulate the healthy functioning of other types of immune cells.

Risk Factors

For patients with systemic lupus erythematosus (SLE) for example, disease activity is lower, but damage accrual higher in the postmenopausal years, but the mechanisms responsible may also relate to age, duration of the disease, menopause changes, long-term effects of therapy, and also a combination of these factors. Therapies associated with autoimmune disease in fact, often involve steroids, which are detrimental to bone health and speed up the onset of osteoporosis. It is really pivotal to counteract this effect with prevention (exercise, good level of calcium intake and vitamin D).

Early menopause is a risk factor for Rheumatoid Arthritis (RA), and post-menopausal status in RA is associated with greater damage and disability. Systemic sclerosis and giant cell arthritis may also be adversely affected by the onset of the menopause. It is very important to consider that autoimmune disease and menopause may have an additive effect on risk for common comorbidities such as cardiovascular disease and osteoporosis. For some of these diseases, it may be useful to consider HRT therapy in order to keep the disease progression under control. It is important to always double check symptoms that could indicate the onset of an autoimmune disease as they can be easily masked and confused with some other medical problem. Moreover, a healthy lifestyle is vital in preventing the onset of any autoimmune disease as there is a direct link between stress and the health of our immune system.

Preventative Steps

There are some simple suggestions to keep the immune system as healthy as possible:

  • Avoid exposure to environmental toxins such as mercury, poisons and heavy metals.
  • Diet can influence your immune system, so choose your foods wisely.
  • Sexual activity has been found to have a positive effect on the immune system by activating the hormones regulated by the act of having sex and helps maintain a healthy hormone balance.
  • Engage in physical exercise which helps prevent osteoporosis, keeps you fit and produces endorphins.


Autoimmunity reviews: Menopause in patients with autoimmune diseases. Lisa R. Sammaritano

Expert Review of Obstetrics & Gynecology: Effects of Menopause on Autoimmune Diseases. Miranda A Farage; Kenneth W Miller; Howard I Maibach Expert Rev of Obstet Gynecol. 2012;7(6):557-571.