Early menopause, removing uterus linked with increased risk of rheumatoid arthritis: Study

Early menopause—before the age of 45—taking hormone replacement therapy (HRT), and having 4 or more children are among several hormonal and reproductive factors linked to a heightened risk of rheumatoid arthritis in women.

New Delhi:Early menopause before turning 45, surgical removal of uterus and/or ovaries, and having four or more children heighten the risk of rheumatoid arthritis in women, a research published in British Medical Journal's RMD Open.

Starting to menstruate after turning 14, and having fewer reproductive years than 33 were also linked with an enhanced risk of the chronic autoimmune disease that affects joints and is known to impact women more than men, researchers from China found after analysing data of more than 2.2 lakh women in the United Kingdom (UK).

Factors like taking hormone replacement therapy (HRT) and oral contraceptive pills too were found to be important, according to the study by the Anhui Medical University. HRT is used to treat symptoms in postmenopausal women, such as hot flashes, decreased muscle mass and complications like osteoporosis or bone loss.

While it is known that hormonal and reproductive factors contribute to women's increased vulnerability to the disease, the research team wanted to find out exactly which factors were "particularly influential".

They said that the findings suggested the importance of evaluating hormonal and reproductive factors in women diagnosed with rheumatoid arthritis, even as they could not establish a cause-and-effect relationship in this observational, albeit long-term, study.

For the study, the researchers drew on the data of 2,23,526 women from the UK Biobank, whose health was tracked for an average of 12 years. Of these women, 1.5 per cent (3,313) were found to develop rheumatoid arthritis, or RA.

Using statistical tools, the researchers found that experiencing menopause before turning 45 years old was associated with 46 per cent increased risk of developing the chronic condition than experiencing menopause at or after 50 years of age.

Further, having fewer than 33 reproductive years - duration starting from having the first period till menopause - was linked with a heightened risk of 39 per cent, the team found.

Surgical removal of reproductive organs like uterus (hysterectomy) and one or more ovaries (oophorectomy) was associated with 40 and 21 per cent increased RA risks, despite only a few women in the study group having had these procedures, the researchers said.

The team also found that getting the first period after turning 14 rather than 13, and having four or more children were associated with an enhanced risk of 17 and 18 per cent, respectively, of developing the autoimmune condition.

"The findings of this study are significant and form a basis on which novel and target-specific intervention measures to curb the risk of (rheumatoid arthritis) in women may be developed," they wrote. Future studies should investigate how female hormones are involved in the development of RA, they said.

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