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Understanding the impact of menopause and age-related androgen decline on the onset and course of autoimmune diseases, as well as the potential for hormonal interventions, is critically important [1]. In women, the course of systemic lupus erythematosis (SLE) and rheumatoid arthritis (RA) with onset after the age of menopause differs from that with onset before menopause. Early age at menopause is associated with increased disease risk and, after menopause, disease course changes in SLE and RA. This article summarizes what is known about the relationship between reproductive aging and autoimmune diseases in men and women, and highlights areas for further investigation.


  • Amos Pines
    Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel


  1. Bove R. Autoimmune diseases and reproductive aging. Clin Immunol 2013 Feb 28. Epub ahead of print
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  5. Fernández M, Calvo-Alén J, Bertoli AM, et al. Systemic lupus erythematosus in a multiethnic US cohort (LUMINA L II): relationship between vascular events and the use of hormone replacement therapy in postmenopausal women. J Clin Rheumatol 2007;13:261-5.
  6. Sánchez-Guerrero J, González-Pérez M, Durand-Carbajal M, et al. Menopause hormonal therapy in women with systemic lupus erythematosus. Arthritis Rheum 2007;56:3070-9.
  7. Pikwer M, Bergström U, Nilsson JÅ, Jacobsson L, Turesson C. Early menopause is an independent predictor of rheumatoid arthritis. Ann Rheum Dis 2012;71:378-81.
  8. Pikwer M, Nilsson JA, Bergström U, Jacobsson LT, Turesson C. Early menopause and severity of rheumatoid arthritis in women older than 45 years. Arthritis Res Ther 2012;14:R190.
  9. Hall GM, Daniels M, Huskisson EC, Spector TD. A randomised controlled trial of the effect of hormone replacement therapy on disease activity in postmenopausal rheumatoid arthritis. Ann Rheum Dis 1994;53:112-16.
  10. Walitt B, Pettinger M, Weinstein A, et al. Effects of postmenopausal hormone therapy on rheumatoid arthritis: the Womens Health Initiative randomized controlled trials. Arthritis Rheum 2008;59:302-10.
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