Menopause and Hormonal Replacement Therapy in Women with Rheumatic Diseases

Women are more prone to many autoimmune rheumatic diseases (AIRDs), and the change in the disease activity of these diseases at puberty and pregnancy reflects the hormonal influence on the immune system. Menopause is characterized by immunosenescence, contributing to a pro-inflammatory shift leading to a variety of AIRDs. In addition, menopause also increases the risk of cardiovascular diseases and osteoporosis. The impact of hormones, especially estrogen, on the causation and impact on existing AIRDs is complex, and the knowledge on these concepts is evolving over the years. The understanding of the effects of menopause and hormone replacement therapy on AIRDs and vice versa is essential in their effective management.