The Intersection of Autoimmunity and the Menopause Transition
Louise Rubic | MPH , BHSc ( Comp Med ), Grad Dip Edu ( Innovation & Change ), Adv Dip NAT . Senior learning facilitator , Torrens University Australia
Abstract
Perimenopause involves complex physiological changes driven by fluctuating reproductive hormones , often complicating health outcomes in women with autoimmune diseases . This paper examines the intersection of the menopausal transition ( MT ) and autoimmunity , highlighting how hormonal fluctuations during this period can aggravate autoimmune symptoms and trigger flares . 1 The MT itself is marked by increased systemic inflammation , with declining oestrogen and progesterone levels disrupting immune regulation , promoting proinflammatory cytokine production , and altering immune cell activity . 2
Autoimmune conditions such as rheumatoid arthritis ( RA ), systemic lupus erythematosus ( SLE ), and Hashimoto ’ s Thyroiditis ( HT ) show heightened prevalence and symptom severity during midlife , presenting challenges in symptom differentiation and management . 3 Additionally , external factors , such as modern lifestyle patterns and exposure to environmental xenoestrogens , further amplify inflammatory states during the MT . 4
This article explores the interplay of oestrogen , the immune system and inflammation , and some of the autoimmune conditions that intersect with the MT . Key nutritional elements , including vitamin D , omega-3 fatty acids , and lignans are reviewed for their potential to modulate inflammation , support immune function , and alleviate MT and autoimmune-related symptoms .
Introduction
Perimenopause , the transitional phase preceding the cessation of menstruation , represents a complex period of physiological transformation driven by fluctuating and gradually declining reproductive hormone levels . The menopausal transition ( MT ) describes the whole journey of this period and includes menopause , which is clinically defined as being one year without menstruation . Symptoms throughout the MT vary in expression and severity and can last an average of 7-10 years , though many people can continue to experience symptoms into their 80s . 5 Researchers have emphasised that early intervention must be considered a priority for the prevention of the consequences associated with the numerous physiological changes in the MT . One researcher went as far to say that MT marks ‘ the decay of women ’ s health ’, which is rather alarming as this transition should not be seen as a barrier to the experience of healthy aging . 6 What can complicate the MT , however , are concomitant health challenges that may mask , be masked by , or aggravate an already turbulent physiological setting . This is especially true for autoimmune diseases . Autoimmune diseases affect women at twice the rate seen in men . 7
200 | vol30 | no4 | JATMS