Comparative Study on The Impact of Pre-and Postmenopausal Status in Women With Rheumatoid Arthritis

Abstract

Rheumatoid arthritis (RA) is among the most common rheumatic diseases and an important women's health problem, particularly in Middle Eastern women, where rheumatism and metabolic disorders are prevalent. The current study aimed at evaluating clinical, inflammatory and hormonal changes in Iraqi women during the pre- to postmenopausal transition stage with and without RA. In this cross-sectional study conducted from March to September 2025, a total of 64 women with rheumatic arthritis (RA) specifically recruited by patients' age (32 premenopausal and 32 postmenopausal subjects) and 60 matched controls were enrolled from Nasiriyah city, Iraq. ANOVA and correlation were used to test disease response and laboratory biomarkers (p < 0.05). Background Postmenopausal RA patients had elevated DAS28, ESR, CRP, RF, anti-CCP and IL-6 and TNF-? levels compared with premenopausal RA patients, consistent with the disease, while oestradiol was lower, but FSH and LH were higher. Oestradiol levels harboured inverse correlations, while gonadotropins had positive associations with inflammatory markers concerning disease activity. Hormonal changes in menopause play a key role in the increased inflammatory response and disease severity of RA after menopause, underscoring the importance of appropriate menopause-directed management.