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Rheumatoid Arthritis Hormonal Imbalance and Its Treatment Options

Rheumatoid Arthritis Hormonal Imbalance and Its Treatment Options

By Mike Kocsis | 7 minutes read | Last updated: July 24, 2023 |
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    Rheumatoid arthritis is a chronic disease that causes inflammation of body joints. The exact cause of this illness has not been discovered, but experts believe that hormonal imbalance (low levels of estrogen and progesterone) may play a part in causing the disease or worsening its symptoms.

    This article explains how hormonal imbalance affects rheumatoid arthritis in women and how they can reduce its symptoms through different treatment options.

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    Rheumatoid arthritis

    Rheumatoid arthritis is an inflammatory disease in which swelling of joints occurs, which leads to pain and some degree of disability of the affected joint. It is an autoimmune disease which means your body’s immune system, whose role is to protect you from foreign invading particles, starts attacking healthy body cells. In the case of rheumatoid arthritis, it is the joint cells that are attacked.

    When the condition gets severe, it changes the shape of the joint and affects more joints in the body. It can also affect other body organs and tissues. The exact cause behind this activation of an autoimmune response is not clear yet. However, experts believe some environmental and genetic factors may cause it.

    In the UK, more than 400,000 people have this illness. It mostly affects menopausal females, and it usually starts when they are 40 to 50 years old. Women have three times more risk of developing it compared to men. Unfortunately, there is no cure for this illness. However, there are some treatments that can help you reduce its symptoms and limit its impact.


    Symptoms of rheumatoid arthritis

    Rheumatoid arthritis symptoms are symmetrical. It means they will occur on both sides of the body equally. This disease first affects small joints like finger joints. Then it moves to the other joints like the hip joint, shoulder joint, etc.

    The basic symptoms of rheumatoid arthritis are given below.

    • Pain in more than one body joint
    • Swelling of joints
    • Stiffness and immobility of joints
    • Formation of lumps under the arm skin
    • Loss of weight
    • Weakness and tiredness
    • Fever


    Can hormonal imbalance cause rheumatoid arthritis?

    Experts have been studying the relationship between hormones and rheumatoid arthritis for many years. The exact effect or relationship has not yet become clear. However, they believe that women with healthy levels of sex hormones (progesterone and estrogen) are less likely to develop this illness. It is because their hormones have a protective effect on joints.

    In one research, scientists discovered that women going through pregnancy and the postovulatory stage (a menstrual stage that occurs before menses start) reported having very few joint symptoms. The reason they described was the high levels of sex hormones. Your body naturally produces these hormones more than usual during these phases.

    In the same research, it is also reported that the same women reported having more joint symptoms after pregnancy and when the second week of the menstrual cycle started. They experienced more symptoms because the female body produces less sex hormone during these stages.

    Naturally, women experience fluctuation of reproductive hormones with age. During menopause, these hormones reach their lowest points. Experts believe that it might be the reason why menopausal women are at a higher risk of developing rheumatoid arthritis.

    Similarly, non-menopause women experience fewer rheumatoid arthritis symptoms compared to menopause women. It shows the role of estrogen and progesterone in the protection of joints. Women who maintain their estrogen levels even after developing rheumatoid arthritis experience less severity of the disease.


    Why are joints affected due to the low levels of estrogen and progesterone?

    The hormonal imbalance can have a direct effect on different body joints. There are receptors of estrogen present in your joint tissues. These receptors maintain the function and structure of joints. They also keep the levels of lubricant normal to avoid friction between joints. In this way, they have a protective effect.

    Progesterone and estrogen can also act as anti-inflammatory compounds. Although they cannot cure the disease, they certainly can reduce swelling, pain, and inflammation. That is why increasing and maintaining their levels can reduce the symptoms of arthritis.


    How to treat rheumatoid arthritis hormonal imbalance?

    This disease has no cure, but it still has several treatment options. These treatments are particularly used to reduce flare-ups and prevent further damage by maintaining a healthy hormonal balance. Increasing the levels of estrogen and progesterone naturally should be the first option that one should consider. For this purpose, you can eat foods that boost the production of these hormones.

    It is also important to maintain a healthy weight and avoid stress. Women with excessive weight often develop an imbalance between progesterone and estrogen. Their estrogen levels increase while progesterone levels stay the same. Similarly, stress can also trigger your body to change hormones, including progesterone to cortisol. It also leads to hormonal imbalance, which can trigger rheumatoid arthritis flare-ups.

    You should also avoid over-exercising. Even though exercise is good for your health as it burns fats and helps you stay fit, doing it excessively can force your body to produce more cortisol and less progesterone. So, do exercise but only in moderation.


    When natural ways are not enough

    There are different treatment options available to reduce the impact of arthritis. Your doctor will suggest these options and then help you choose the one that suits your condition the best. Below are the common treatment options for rheumatoid arthritis.


    This option is suitable for women who have a severe form of rheumatoid arthritis. In it, their damaged joints are replaced to allow the person to start moving them again. It may help with joint pain and swelling. There are many surgical options that you can choose according to your condition.

    Joint fusion

    This surgical option is chosen when the below options are not possible. In it, the damaged joint is fused with the other joint or bone to increase its mobility and reduce pain.

    Tendon repair

    Tendon is a connective tissue that attaches bone to muscles. A damaged tendon can affect your joint’s mobility and pain. So, in this surgical treatment, tendons that have been damaged are repaired.

    Total joint replacement

    As the name indicates, in total joint replacement, the damaged joints are replaced with artificially developed joints. Such joints are called prosthetic joints. They are made up of plastic and metal.

    Physical therapy

    Physical therapy is also effective in reducing the signs of rheumatoid arthritis. Keeping your muscles and bones moving helps them stay fit and flexible. It is one of the easiest options that you can even do on your own or with a little assistance from a professional.


    Some women are prescribed anti-inflammatory drugs to reduce inflammation and its impact. Ibuprofen is an example of such a drug. Some are also prescribed disease-modifying drugs. They relieve pain and also manage the underlying rheumatoid arthritis mechanism.

    Hormone replacement therapy

    In hormone replacement therapy (HRT), FDA-approved bio-identical hormones (hormones that are biologically similar to the hormones that naturally exist in the body) are inserted into the body to help it restore its normal levels. If your estrogen is low, then you will be given only estrogen. But if levels of both hormones (estrogen and progesterone) are down, then you will be given a mixture of these hormones.

    Studies suggest that using this treatment option is very effective in reducing the symptoms of rheumatoid arthritis in women. If you have not developed rheumatoid arthritis, then this treatment can help you prevent the illness. Similarly, if you are a menopausal woman, then this treatment can also help you reduce common symptoms of menopause. If your rheumatoid arthritis is due to hormonal imbalance, then this is the best treatment option you have. It has helped many women relieve pain and increase their activity levels.

    Besides its multiple benefits, it comes with certain risks. For example, it may cause headaches, breast swelling, mood swings, and even increase the chances of a heart attack. That is why it is very important to first discuss this treatment option with your doctor in detail. Evaluate its side effects, then choose it if your doctor suggests it.

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    Summing up

    Rheumatoid arthritis is a chronic disease and has no cure so far. It mostly affects menopausal women who have low estrogen and progesterone levels. That is why hormone replacement therapy, in which a combination of both hormones is used, is very effective and helpful in alleviating rheumatoid arthritis symptoms. Talk to your doctor about the benefits and other effects of HRT before choosing this beneficial option.



    References/Further reading/Bibliography/Scientific studies 

    role of female hormonal factors in the development of rheumatoid arthritis | Rheumatology | Oxford Academic (

    Hormone replacement therapy in rheumatoid arthritis is associated with lower serum levels of soluble IL-6 receptor and higher insulin-like growth factor 1 (

    The Role of Estrogens in Rheumatoid Arthritis Physiopathology | IntechOpen

    Do Hormones Play a Factor in Rheumatoid Arthritis? (

    Rheumatoid Arthritis, Estrogen, and Menopause: What’s the Link? (

    Do female hormones affect the onset or severity of rheumatoid arthritis? – Costenbader – 2008 – Arthritis Care & Research – Wiley Online Library

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    About the Author: Mike Kocsis

    Mike KocsisMike Kocsis has an MBA with a focus on healthcare administration and is an entrepreneur and medical case manager for Balance My Hormones Ltd which offers medical services in the UK and Europe. Mike has over 20 years of experience in the healthcare sector, much of that working with people who have hormone imbalances. Mike has appeared on podcasts and radio and is an expert speaker on the subject of hormone imbalance. He specialises in Testosterone Replacement Therapy (TRT) and Hormone Replacement Therapy (HRT) and has helped thousands of people suffering from hormone imbalances recover and regain control of their lives. You can follow him on LinkedIn and on the Balance My Hormones YouTube Channel.

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