Department of Rheumatology, Barzilai University Medical Center, Ashqelon, Israel.
Climacteric. 2024 Apr;27(2):115-121. doi: 10.1080/13697137.2023.2276201. Epub 2023 Nov 22.
Abundant research has been published describing the effects invoked during menopause across different organ systems. Changing levels of estrogen and progesterone result in bidirectional alterations of immune cell pathways. Overall, the net trend dampens immunoregulation and promotes inflammation. In paradigmatic rheumatologic diseases, the combined effect is far from predictable. While some features may abate during menopause, studies have shown a general increased frequency toward disease exacerbation. Similarly, while impossible to isolate the ramifications of menopause in women with fibromyalgia, a tendency toward enhanced symptoms is unquestionably apparent. Furthermore, the comorbidities accrued by increasing age and the consequences of long-term medication use may also confound this picture. Periodic rheumatologic visits are warranted, with clinical assessments directed toward a multi-disciplinary approach. Ultimately, while an arsenal of effective tools is available for caring for these women and their underlying conditions, more studies are needed to better clarify how the different stages surrounding perimenopause affect subpopulations with rheumatic diseases and fibromyalgia-related disorders so that clinical course can be predicted and addressed prior to the emergence of symptomatology.
大量研究已经发表，描述了更年期在不同器官系统中引起的影响。雌激素和孕激素水平的变化导致免疫细胞途径的双向改变。总的来说，净趋势抑制免疫调节并促进炎症。在典型的风湿性疾病中，综合效应远非可预测的。虽然一些特征在更年期可能会减轻，但研究表明，疾病恶化的频率普遍增加。同样，虽然不可能将纤维肌痛患者更年期的影响孤立起来，但症状明显增强的趋势是毫无疑问的。此外，随着年龄的增长而积累的合并症以及长期药物使用的后果也可能使这种情况复杂化。需要定期进行风湿病就诊，临床评估针对多学科方法。最终，虽然有大量有效的工具可用于照顾这些妇女及其潜在疾病，但仍需要更多的研究来更好地阐明围绝经期周围的不同阶段如何影响患有风湿性疾病和纤维肌痛相关疾病的亚群，以便在出现症状之前预测和处理临床病程。
