Menopause and axSpA

What is menopause?

Menopause is a natural part of a woman’s life cycle. When a woman goes through menopause, her menstruation (period) stops, and she can no longer conceive naturally. Menopause usually occurs during the ages of 45 and 55. A woman may experience hot flushes, night sweats, fatigue, joint pain, and mood changes during menopause. Some symptoms of menopause are like arthritis. This can make it confusing to know whether you are having menopause or an arthritis flare.

How does menopause affect arthritis?

Menopause may worsen axSpA symptoms. This is thought to be due to a change in hormones. During menopause, the hormone oestrogen (used for sexual and reproductive development) drops. This drop may increase inflammation which can increase disease activity and arthritis symptoms.

There is a lack of research on the effect of menopause on axSpA. Studies show the effect of changing estrogen levels (during menstruation, pregnancy and menopause) in women with inflammatory arthritis is linked to functional decline and worsening of arthritis symptoms.

Can menopause increase the risk of developing other conditions?

Menopause can increase the risk of osteoporosis and heart disease. Which are already more likely to affect people with inflammatory arthritis, like axSpA.

Osteoporosis is when your bones become weak and brittle increasing the risk of breaks. Although osteoporosis affects men too, post-menopausal women are at higher risk. This is due to the decline in oestrogen which causes rapid loss of bone mass. This loss of bone mass increases the risk of breakage.

Heart disease is a term used to describe different conditions that affect the heart. Oestrogen protects different parts of the body, including your heart, blood vessels, and bones. When oestrogen levels drop during menopause these body parts can be affected by increased inflammation. Low levels of oestrogen can increase cholesterol which can cause fatty deposits to build up in your blood vessels. This can make it difficult for blood to flow through the arteries, increasing your risk of heart disease.

What will happen to me?

Menopause and its symptoms will affect each person differently. Common symptoms of menopause include:

Hot flushes – this is the sudden feeling of heat in your face and neck. Hot flushes can last from 30 secs to 10 minutes and may occur several times a day.
Night sweats – are when hot flushes happen during the night. You may wake up to find that your sheets are damp from sweating.
Difficulty sleeping – this could be due to night sweats, but often women have trouble sleeping during menopause.
Mood changes – due to hormone shifts during menopause you may feel irritable, anxious, sad, or depressed. Lack of sleep may also contribute to mood changes. Speak to your GP if you feel it is impacting your day-to-day life.
Reduced sex drive/libido - shifts in hormones during menopause may also cause you to have less interest in sex. You may also have vaginal dryness, which can make sexual intercourse uncomfortable. Using water-soluble lubricants can help reduce pain during sex. Talk to your GP if you are experiencing a low sex-drive that is impacting your sex life.

What can I do?

Maintain your axSpA treatment plan. Work with your health care team to help keep your axSpA under control.

Move regularly. Physical activity can help to:
- Maintain your heart health and improve your general health.
- Keep your bones healthy and prevent bone density loss. Weight-bearing and strength-training activities are good for maintaining healthy bones
- Maintain good balance and reduce the risk of falls.

Stop smoking. Smoking increases the risk of an earlier menopause. Smoking can also increase the risk of heart disease, osteoporosis, and lung cancer. Call the Quitline on 13 78 48 or visit their website Quitline

Consider menopausal hormone therapy (MHT). MHT can help reduce menopause symptoms, particularly for moderate to severe symptoms. You should talk to your doctor about the benefits and risks of taking MHT and how it might interact with any other medication you are taking.

Keep up to date with your health checks. It is recommended that women who have reached menopause have:
- Cervical screening tests every five years
- A mammogram every two years – BreastScreen Australia offer free, Australia-wide services for women over 40. Contact BreastScreen Australia on 13 20 50.

Understanding how your body changes before, during and after menopause can help you to make informed decisions about your health. Some useful websites are: