Clinical studyDisease activity during the premenopausal and postmenopausal periods in women with systemic lupus erythematosus☆
Section snippets
Patients and methods
From an SLE register of 157 postmenopausal patients, 30 women were identified who fulfilled inclusion criteria: a clinical diagnosis of SLE, development of natural menopause, and regular follow-up at our center at least 2 years before and after menopause. A woman was excluded if she developed SLE after menopause; had surgical, drug-induced, or premature menopause before the age of 35 years; received estrogens, progestins, or danazol at any time; had an estimated creatinine clearance ≤20 mL/min;
Results
The 30 women included in the study were a mean (± SD) of 7.2 ± 5.3 years from menopause (Table 1). They were studied for a mean of 6.4 ± 1.7 years (range, 4 to 8 years). The mean premenopausal period was 3.3 ± 0.9 years (range, 2 to 4 years), and the mean postmenopausal period was 3.2 ± 0.9 years (range, 2 to 4 years). Thirteen patients were seen during the fourth years before and after menopause, 19 patients during the third years, and all 30 patients during the second years.
Discussion
We found that women with SLE had relatively mild disease activity during the premenopausal and postmenopausal periods. There was a modest decrease in maximum disease activity after natural menopause, especially when the disease activity in the fourth year before menopause was compared with the fourth year after menopause. These findings suggest that natural menopause has a mild protective effect on SLE activity, as has been found following cyclophosphamide-induced ovarian failure (17).
Although
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Sex Bias and Autoimmune Diseases
2022, Journal of Investigative DermatologyCitation Excerpt :Polymorphisms of the different estrogen receptor genes have been shown to be associated with different ages of disease onset of SLE as well as varied clinical severity of lupus nephritis (Lee et al., 2004; Liu et al., 2002). In addition, SLE disease activity has been documented to be moderately diminished after natural menopause (Sánchez-Guerrero et al., 2001). Exogenous estrogen treatment has also been shown to increase the risk of autoreactivity.
Impact of menopause on women with systemic lupus erythematosus
2021, MaturitasCitation Excerpt :For women diagnosed with SLE prior to the MT, menopause brings both beneficial and detrimental effects on SLE disease activity. Following menopause, either natural menopause or due to hysterectomy, women with SLE report decreased frequency of flares [31,56–59] and less disease activity [57]. However, the improvement in disease activity appears to be constant over the time period from pre- to post-menopause and not necessarily due to the MT [57].
Chapitre 7: Prise en charge continue des femmes ménopausées et de celles qui présentent des considérations particulières
2019, Journal of Obstetrics and Gynaecology CanadaPregnancy and autoimmune disease, reproductive and hormonal issues
2018, Dubois' Lupus Erythematosus and Related SyndromesMenopause and Rheumatic Disease
2017, Rheumatic Disease Clinics of North America
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Supported by Grants 3367P-M and 25556-M from Consejo Nacional de Ciencia y Teconologiá (CONACYT) México.