Do flares of systemic lupus erythematosus decline after menopause?

Abstract

Objective. To study whether flares of SLE decline after menopause. Method. 34 postmenopausal SLE patients with premenopausal disease onset were studied. The frequency and severity of flares before and after menopause was compared. 17 postmenopausal onset SLE patients were also included for comparison. Result. Flares in postmenopausal SLE patients decreased significantly after menopause (total No. of flares/patient-year before and after menopause were 0.50 ± 0.10 and 0.14 ± 0.05, respectively, p = 0.002). The frequency and proportion of severe flares also dropped significantly. The rate and magnitude of postmenopausal flares in these patients were similar to those of the postmenopausal onset SLE patients, a subset known to run a more benign course. Conclusions. SLE flares less frequently and seriously after menopause. While this may suggest a protective role of hypoestrogenemia against lupus flares, the contribution of other factors like disease duration and effective treatment to this postmenopausal decline of flares cannot be separated from menopause per se. Further studies are needed.