Could Menstrual Cycles Hold Lupus Clues?

The link between estrogen and lupus has been intensely studied, with most research seeing a link between higher estrogen levels and accelerated lupus development. But how about when estrogen is at an all time low, like during the menstrual cycle could there be a correlation there? This article will investigate how the fluctuating hormone levels and other factors during menstruation may affect lupus symptoms.

*Disclaimer:

The information provided in this article is for general informational purposes only and is not intended as medical advice. It should not be used as a substitute for professional diagnosis, treatment, or advice from a qualified healthcare provider. Reliance on any information provided in this article is solely at your own risk.

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Estrogen and progesterone levels will begin to fall when a woman begins a healthy menstrual cycle, and at about two weeks when ovulation occurs, they will continue to fall until they hit their lowest point. Progesterone will be at a low point before ovulation, but spike briefly during ovulation before dropping once more when pregnancy does not occur. In contrast, estrogen will rise before ovulation, remain at its peak during ovulation, and then drop sharply when pregnancy does not occur.

These changing hormone levels worsen lupus symptoms. Since high amounts of estrogen have been linked to increased immune system activity in those with lupus, when estrogen remains at a high during ovulation, inflammation and autoantibody production is worsened. Some women even experience flare ups that sync with their menstrual cycle.

On top of the rising estrogen levels during ovulation being a concern for women with lupus, many find they already have a low amount of progesterone, and thus lack the immune-regulating benefits progesterone provides. In contrast, they may find that they instead have an increased amount of estrogen metabolites that can certainly exacerbate symptoms.

Additionally, women with lupus are at a higher risk of developing menstrual irregularities or disorders resulting from the hormone imbalance. Shannon C., who was diagnosed with lupus at age 50, says that she “experienced extremely painful periods and menorrhagia, leading to a complete hysterectomy” as a result of an onset of lupus in 2009. Menorrhagia is heavy and prolonged bleeding during a menstrual cycle that can trigger anemia and is common in women with lupus who may already suffer from low blood levels due to their immune system destroying their red blood cells.

Women with lupus suffering from hormone imbalances are also at risk of:

• Oligomenorrhea: light or infrequent bleeding, which is one of the most common menstrual irregularities that can develop in women with lupus

• Polymenorrhea: bleeding that occurs frequently, but briefly, often with cycles less than 21 days

• Amenorrhea: absence of menstruation for at least three cycles or menstruation that starts later than 15 years of age

• Dysmenorrhea: painful cramps resulting from uterine contractions or other underlying reproductive system issues

Menstrual cycles provide a helpful glimpse into how estrogen’s role, and many women certainly report symptoms worsening with the fluctuating hormones, yet there are still gaps in our knowledge of how estrogen specifically plays a role.

For example, many studies have found that the removal of estrogen leads to a diminishing of lupus traits such as autoantibody production and renal injury, but these are studies conducted with experimental animal models of lupus. When it comes to how estrogen actually affects humans? The data are much less clear. For example, studies that use hormone contraceptives for lupus in humans don’t always reach a firm positive or negative conclusion. Additionally, hormones are not the only factor playing a role in exacerbated symptoms inflammation alongside other diseases and disorders can affect your body negatively too. Thus why we cannot establish a casual relationship between estrogen levels and lupus just yet.

However, the menstrual cycle still provides a very helpful clue on just how hormonal shifts, especially when it comes to estrogen, can change the way lupus interacts with our body.

The link between estrogen and lupus has been long researched, and the menstrual cycle is a window into that relationship as hormone levels fluctuate wildly and negatively impact lupus symptoms. However, research gaps still remain, and a casual correlation between estrogen and lupus symptoms has not yet been established.

The Role of Estrogen Membrane Receptor (G Protein-Coupled Estrogen Receptor 1) in Skin Inflammation Induced by Systemic Lupus Erythematosus Serum IgG | Frontiers

Menstruation and Lupus | LupusCorner

Lupus and the Menstrual Cycle | Kaleidoscope Fighting Lupus

The Role of Hormones in Lupus: Why It’s More Common in Women | Rupa Health

Shannon C. - Diagnosed Age 50 | Lupus Foundation of America

Estrogen in Cardiovascular Disease during Systemic Lupus Erythematosus | National Library of Medicine