Why do autoimmune conditions flare during menopause?

(Peri-)menopause and autoimmunity

Many people will notice that their autoimmune condition has surfaced or flared during perimenopause and / or menopause.

It is also common for those with pre-existing autoimmune conditions to find the transition through menopause harder.

During perimenopause, our hormones fluctuate wildly, which is why testing hormone levels on just one specific day is not necessarily useful. Our bodies are designed to operate best when hormones stay within fairly small ranges, so we find it hard to deal with these extreme fluctuations that can occur in perimenopause.

Our livers play a huge role in supporting us through these fluctuations. They recycle the hormones and so work particularly hard at those times when levels are peaking and troughing dramatically, often on a day-to-day basis at times.

If our livers are already struggling due to high levels of inflammation and the knock-on effects that come with autoimmune conditions, then we can struggle more than the average person to deal with our fluctuating hormones.

When our livers are struggling to cope, inflammation can build. As we know, when inflammation levels are high, our immune systems become less tolerant. We start reacting to things in our environment that we weren’t reacting to before, such as pollens, foods, chemicals, etc.

This creates even more inflammation and we can reach a point where our immune systems start reacting to our own tissues. This is autoimmunity.

Problems can continue into menopause. Progesterone, our anti-inflammatory hormone, remains low. Lower levels of oestrogen disrupt all sorts of processes in our bodies, including sleep. Poor sleep has all sorts of inflammatory knock-on effects, such as affecting our blood sugar control, our gut microbes, and our ability to detoxify. Of course all of these problems create further inflammation and increase the risk of autoimmune flares.

What natural steps can we take?

Working with people in perimenopause and menopause is similar to working with thyroid clients. Hormones are extremely responsive to diet and lifestyle changes and there is lots we can do.

It is helpful to look at our health as a point on a spectrum. Instead of looking for a magical cure, instead we look at ourselves holistically and strategise a combination of evidence-based steps that we can put together to help ourselves.

For example, we may look at whether our progesterone levels can be supported by optimising B6 levels, reducing histamine, and influencing our nervous systems to spend more time in parasympathetic mode (‘rest and digest’).

We may look at whether we have certain gut issues that our affecting our microbes, our mood, our energy, and blood sugar control and our sleep.

We may look at whether certain nutrient deficiencies are affecting our ability to detoxify toxins, including certain hormones.

Testing

Testing is particularly useful in perimenopause and menopause. If you are experiencing symptoms of perimenopause, you may want to consider a test that maps your entire cycle. This allows you to get a complete picture of the hormonal fluctuation pattern that is happening across the cycle, rather than looking at just one day.

Basic hormonal testing often just tells us whether our oestrogen levels are ‘in range’ or not on one specific day. Yet in reality, this can be misleading.

In perimenopause, it is likely to be the fluctuations that are causing the problem. People tend to find that taking steps to help them to manage the fluctuations better naturally is the most effective thing to do at this stage.

This contrasts with medical support, which is more binary and tends to dictate that the individual either should or shouldn’t take hormonal medication based on results from just one day in their cycle.

In menopause, which starts 12 months after our final period, hormones stabilise and are more predictable, For many people at this stage, hormonal testing over 1-3 days is sufficient.

Additional markers can be included in testing, such as looking at key nutrient levels, as well as assessing stress levels (cortisol patterns), which can be very useful in menopause.

(Peri-)menopause testing and one-to-one sessions

Please contact me if you’d like to know more about getting some support as you go through perimenopause and menopause. Testing costs start at £249. The hormone profiling tests use urine samples, so they are easy to carry out at home.

My online autoimmune program also works really well if you want help with easing yourself through the menopause while looking after your autoimmune health.