Hormonal changes, such as those that occur during menopause, can trigger psoriasis flares. Therefore, menopause may cause or worsen psoriatic arthritis symptoms in some people.

Psoriatic arthritis (PA), a psoriasis complication, occurs in about 20% of people with psoriasis.

Estrogen drops during menopause, and a fall in estrogen levels is known to trigger psoriasis flares. While some people believe that psoriatic arthritis can cause early menopause, no recent research supports this claim.

Hormone replacement therapy to increase estrogen levels may help reduce psoriatic arthritis symptoms if they worsen during menopause.

Read on to learn more about menopause and psoriatic arthritis.

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Menopause may increase PA symptoms or even trigger psoriatic arthritis in a person with no recent history of the disease.

This is because estrogen reduces inflammation. When estrogen levels drop during menopause, inflammation can increase, triggering or worsening psoriatic arthritis symptoms.

Stress may also trigger psoriatic arthritis flares. Menopause is often accompanied by stress and life changes, which can exacerbate symptoms.

There is also some evidence that PA may increase the risk of some menopause-related health conditions.

Menopause itself is not a disease, but the drop in estrogen increases the risk of health concerns like osteoporosis and bone fractures. For instance, a 2022 systematic review found that psoriatic arthritis increased the risk of vertebral fractures — a complication of osteoporosis.

Hormones are the body’s chemical messengers, and they affect many aspects of health and functioning. Hormonal changes may alter levels of inflammatory chemicals in the body, increasing the risk of joint pain.

Estrogen plays an important role in inflammation. According to a 2022 paper, higher levels of estrogen correlate with lower levels of certain types of inflammation. When estrogen drops, psoriasis symptoms — and the risk of flares and psoriatic arthritis — increase accordingly.

The hormonal changes of menopause may also be stressful, which can trigger additional symptoms. Emotional stress is an important cause of psoriasis flares.

There is no singular menopause experience. For some people, symptoms are almost imperceptible. Others experience a wide range of difficult symptoms and complications.

Similarly, the course of psoriasis and psoriatic arthritis is unpredictable. It is a chronic disease, though. This means it typically worsens with time, especially without treatment.

As estrogen levels drop, a person may notice that their symptoms worsen. Physical and emotional stress are also likely to exacerbate symptoms.

People with psoriasis may develop psoriatic arthritis, especially when it is left untreated.

Psoriatic arthritis may also get worse during menopause. In some cases, the condition can significantly impact mobility, vision, and daily functioning.

People with psoriatic arthritis also have a higher rate of co-occurring conditions like diabetes, cardiovascular disease, and high cholesterol. These also become more prevalent after menopause, so ongoing monitoring and management are key.

Menopause does not require treatment, but estrogen hormone replacement therapy (HRT) may ease symptoms such as hot flashes. Because higher levels of estrogen correlate with lower symptoms of psoriasis and psoriatic arthritis, HRT may also help reduce psoriatic arthritis symptoms.

A wide variety of treatments can help psoriatic arthritis. The right treatment depends on a person’s symptoms, overall health, and tolerance for various side effects. Some general categories of treatments include:

  • disease-modifying antirheumatic agent drugs (DMARD)
  • physical therapy
  • occupational therapy
  • social and emotional support
  • psychotherapy to manage stress
  • non-steroidal anti-inflammatory drugs (NSAID)

If a person visits a doctor about their psoriatic arthritis, they may consider asking:

  • How might estrogen therapy affect or interact with other treatments I am using?
  • What are the risks and benefits of taking estrogen?
  • Can I try a different treatment if my symptoms are getting worse?
  • How will I know the treatment is working?
  • How long will it take for treatment to work?
  • Are there any lifestyle changes I can make to manage symptoms?
  • Do my symptoms put me at risk of any other comorbidities?

Because menopause tends to increase inflammation, it may be a trigger for new or worsening psoriatic arthritis. This is not inevitable, however, and predicting the course of either menopause or psoriasis can be challenging.

With treatment, it is often possible to manage psoriasis and psoriatic arthritis symptoms. While HRT is not a cure, it may help reduce flares in addition to easing menopause symptoms.

People should discuss their symptoms with a doctor and should ask for additional support if treatment stops working during menopause.