Going through menopause with PsA can worsen flares and increase your risk of osteoporosis. Having PsA can also mean earlier menopause. But talking with your doctor can help you find the right treatment.

Menopause can interact with other health conditions, such as diabetes and psoriatic arthritis (PsA).

Understanding how menopause and PsA affect each other can help you manage flares and reduce your risk of related conditions, including osteoporosis.

Menopause typically occurs between the ages of 45 and 55, and the average age for menopause in the United States is 52. Symptoms start about 4 years before a woman’s final period.

PsA is a chronic condition involving inflammation of the joints. Most people with PsA also have psoriasis.

A 2011 study of more than 1.7 million reproductive-age women found that participants with chronic inflammatory diseases, including psoriasis, were up to 5 times more likely to experience:

  • menopause before the age of 45
  • premature ovarian failure before age 40

A 2019 study of 492 women with menopause found that sTNFR2 is associated with early menopause. This protein, a soluble fraction of tumor necrosis factor alpha receptor 2, is an inflammatory protein involved in psoriasis.

You might already know some of the most common triggers of PsA and psoriasis flares.

A reduction in estrogen after menopause may also be correlated with worsening psoriasis, according to the National Psoriasis Foundation.

Symptoms of menopause and PsA flares can overlap, making it difficult to pinpoint the source. For example, you may have trouble sleeping or have changes in your mood leading up to a PsA flare. These symptoms may also occur during perimenopause.

Common menopause symptoms can also make PsA flares feel worse. Sleep disruptions linked to menopause may cause fatigue. This may, in turn, increase your perception of pain from PsA.

Tracking your symptoms, diet, sleep, and stress levels can help you pinpoint and manage your potential PsA triggers.

If you notice more frequent or more severe PsA flares during menopause, check in with your doctor about adjusting your medication or lifestyle.

Osteoporosis is a disease that causes weak and brittle bones. Around 80% of the 10 million Americans who have osteoporosis are women.

Estrogen plays an important role in protecting bone. The reduction in estrogen levels during menopause increases a woman’s chances of developing osteoporosis.

Chronic inflammation in PsA may also increase the risk of osteoporosis. Several pro-inflammatory proteins involved in psoriatic disease are also involved in osteoporosis.

Research suggests that women with PsA may be at an even greater risk of osteoporosis after age 50.

However, more research is needed because a 2022 cohort study found that the prevalence of osteoporosis in people with PsA was similar to that of the general population.

Talk with your doctor about strategies to minimize your risk of osteoporosis if you have PsA. They may recommend:

Hormone replacement therapy (HRT), or menopausal hormone therapy, can provide relief from hot flashes and other symptoms of menopause.

It can also help prevent bone loss that could lead to osteoporosis.

Reduced estrogen levels and PsA flares may be linked: High estrogen levels are associated with lessened symptoms of psoriasis. But more studies are needed.

Talk with your doctor to determine whether HRT is right for you.

Managing your PsA, limiting your exposure to potential triggers of PsA flares, and managing your menopause symptoms can help you stay as comfortable as possible.

If you’re experiencing menopause symptoms, talk with your doctor about other ways to manage your PsA. The following tips may help:

  • Limit stress when possible: Stress can trigger a PsA flare. Stress-reduction techniques such as yoga and meditation may be helpful in the years leading up to menopause.
  • Focus on sleep: Sleep disruptions can occur during menopause and have been associated with PsA flares. Try to stick to a sleep schedule, keep your bedroom as comfortable as possible, avoid caffeine in the afternoon, and avoid screen use leading up to bedtime to get a good night’s rest.
  • Keep moving: Staying physically active can help keep your PsA symptoms at bay.
  • Talk with your doctor: Explore what you can do during menopause to improve your PsA symptoms. Your doctor may recommend switching or adjusting your medications or making other lifestyle changes to make you more comfortable.

The months and years leading up to menopause may impact your PsA and increase the frequency and severity of flares.

People with PsA may also be at greater risk of osteoporosis during menopause. You may be more likely to go through menopause earlier than women who don’t have PsA.

HRT doesn’t seem to improve PsA symptoms, but it may help with hot flashes and other menopause symptoms.

Avoiding triggers and making lifestyle changes can help prevent PsA flare-ups. Getting plenty of rest and reducing stress has also been shown to help with PSA.

Check in with your doctor about your medication and your lifestyle to develop a strategy to manage your PsA during menopause.

Check out Healthine’s psoriatic arthritis and menopause resource centers.