Hormone fluctuations — for example, those that occur during adolescence, menstruation, or menopause — may trigger psoriasis flare-ups. Decreased estrogen levels may be important, although more research is necessary.
Psoriasis affects around 8 million people in the United States, all of whom experience hormonal changes throughout life.
This article discusses how hormonal fluctuations, including the menstrual cycle, can affect psoriasis flare-ups.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
Hormones are molecules that send signals throughout the body. They appear to play a role in psoriasis for many people.
Several studies have explored the effects of hormonal changes on psoriasis symptoms. The link between psoriasis symptoms and fluctuating hormones may be particularly noticeable during:
- Pregnancy: A 2016 review found that the significant increase in hormones during pregnancy
can cause psoriasis symptoms to either improve or worsen. - Menopause: The decrease in estrogen levels during menopause could cause psoriasis symptoms to flare, according to the same review.
- Perimenopause: Psoriasis symptoms
may worsen during perimenopause — the period leading up to menopause. - Adolescence: Around one-third of people with psoriasis are under 18 years old when they first experience the condition. Psoriasis flare-ups often begin or worsen during adolescence.
Estrogen seems to play a role in psoriasis flare-ups. Lower levels of estrogen, which females experience during menopause and at certain times during their menstrual cycle, may correlate with psoriasis flare-ups. Higher estrogen levels may make flare-ups less likely.
The National Psoriasis Foundation (NPF) reports that around half of pregnant people see an improvement in their psoriasis during pregnancy. Some people experience no change, and 10–20% experience worsening symptoms. However, it is unclear whether an increase in estrogen is responsible for such changes.
Fully understanding how hormonal changes should influence psoriasis management will require more research.
Hormone levels fluctuate throughout the menstrual cycle. During menstruation and right before it, estrogen levels drop significantly. Hormone levels generally increase later in the cycle. The drop in estrogen around a period may cause psoriasis symptoms to worsen.
If a person experiences worsening symptoms at any point in their cycle, they can talk with a doctor about ways to manage them.
Doctors recommend various treatments for psoriasis based on individual assessments. It may be helpful to keep a record of when flare-ups occur, as, for females, this might tie in with the menstrual cycle.
Doctors sometimes recommend hormonal birth control to improve psoriasis symptoms. Some hormonal birth control increases the amount of estrogen and progesterone in the body, which limits hormonal fluctuations.
Other treatments for psoriasis, such as phototherapy, are available. People can discuss treatment options with a dermatologist.
A person can take steps to avoid psoriasis triggers. According to the American Academy of Dermatology, common triggers include:
- cold, dry weather
- hot conditions and sunburn
- alcohol
- tobacco smoke
- certain medications, including some for heart disease and arthritis
- shaving
- injury to the skin
- infections
Below are answers to some common questions about hormones and psoriasis.
Can psoriasis cause irregular periods?
No studies have directly explored the potential relationship between irregular periods and psoriasis. However, increased stress levels can cause both to occur or worsen.
Older research suggests that stress can affect the area of the brain that releases the hormones needed to regulate the menstrual cycle. When the level of stress reduces, the cycle should return to usual.
Stress can also affect psoriasis symptoms. The NPF explains that stress can cause psoriasis flare-ups. In turn, psoriasis can lead to an increase in stress for some people.
It is a good idea for anyone with psoriasis to practice stress management techniques. Having a strong support network can help.
Could birth control help with psoriasis flare-ups?
Hormonal birth control may help with psoriasis flare-ups, but there is a lack of research to confirm this.
The NPF discusses the theory that the high estrogen oral birth control available in the 1970s may have led to improvements in psoriasis symptoms. However, very little research has looked specifically at its potential to improve psoriasis symptoms.
In the future, conducting studies using estrogen as the primary treatment may help researchers better understand the relationship between this hormone and psoriasis.
Based on the available evidence, there seems to be a connection between psoriasis flare-ups and hormonal fluctuations.
During a monthly menstrual cycle, hormone levels rise and fall, and the decrease in estrogen around the time of a period, in particular, may cause psoriasis symptoms to flare up.
Other life events that involve changes in hormone levels, such as puberty and menopause, can also affect psoriasis symptoms. However, identifying the specific causes and effects will require more research.