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We explain how hormonal fluctuations that induce estrogen decreases, from menstruation to pregnancy to menopause, can cause psoriasis flare-ups.

Approximately once a month, I burst into tears over an insignificant hiccup – a papercut, a parking ticket, or the revelation that I’m missing the onion I need to chop into the spaghetti sauce. Only days later, when my period arrives, do I realize that a hormonal shift was most likely to blame for that strangely strong reaction. People with psoriasis, an autoimmune disorder that often manifests as a dry, scaly rash on the skin, may experience flare-ups during periods of hormonal shift, just as hormones can affect mood and induce acne outbreaks. – according to a patient.

“Psoriasis has a lot of triggers.” “Alcohol, smoking, stress, and certain medications are all things that can cause you to flare,” explains Dr. Adil Moulanchikkal, lead specialist at EliteAyurveda, Bangalore, India. Hormonal changes are also on the list of possible triggers. “Estrogen decreases are often a time when people flare,”. However, the inverse is also true: High levels of estrogen, according to Dr. Adil, are linked to an improvement in psoriasis symptoms.

We asked these specialists to explain how psoriasis worsens or improves with common hormonal changes, such as pregnancy and perimenopause. As Dr. Adil points out, changes in our skin aren’t necessarily the result of a single factor. However, he believes that educating patients on the underlying causes of psoriasis is beneficial. “Is that why it’s getting worse?” “Not always,” he says. “Will you have a flare after pregnancy?” No, not always. But don’t be alarmed if you do get one; it’s quite natural and anticipated.”

How does estrogen affect psoriasis in general?

Psoriatic skin may improve when estrogen levels rise, just as it can lead to stronger hair and healthier nails. “High estrogen levels are associated with lower overall levels of inflammation,” adds Dr. Adil. Psoriasis patients have greater amounts of cytokines, which are small proteins that can stimulate skin-cell proliferation (or overgrowth, as is the case with this illness). High estrogen levels, according to Dr. Adil, have been demonstrated to decrease cytokine synthesis. Psoriasis flare-ups may begin to fade when inflammation and skin-cell proliferation reduce.

What happens to psoriatic skin during the menstrual cycle?

The menstrual cycle advances swiftly, taking an average of 28 days to complete its four phases (menstruation, follicular, ovulation, and luteal). Because the cycle is always changing, any changes to your skin may be modest. Dr. Adil believes that estrogen levels are highest mid-cycle, in the days preceding ovulation. If you keep a watch on your skin during those pre-ovulation days, you might notice an improvement in your psoriasis symptoms. But, regrettably, what goes up must come down, with estrogen levels dropping again after ovulation and at the conclusion of the menstrual cycle, potentially leading to flares.

Is it true that pregnancy causes psoriasis flare-ups?

There’s good news and bad news for pregnant women: “Psoriasis improves during pregnancy,” adds Dr. Adil. (According to the National Psoriasis Foundation, around half of persons with psoriasis will observe an improvement in their disease during pregnancy; 10-20% will experience worsening symptoms, and some pregnant people will see no change at all.) Because of the increased estrogen, your psoriasis symptoms may improve even early in pregnancy, when your hormones begin to adjust. According to Dr. Adil, psoriasis has the best chance of clearing up during the third trimester, when estrogen levels are at their highest. “Many patients will see symptoms reappear and even flare to new extremes when those levels crash postpartum,”.

Is perimenopause associated with psoriasis?

The body begins to shift toward menopause during perimenopause. As the ovaries begin to produce fewer eggs, you will notice irregular menstruation periods and symptoms such as hot flashes and poor libido. Estrogen levels fall during this time, which implies psoriasis will be “likely more consistent,” according to Dr. Adil. Unlike after pregnancy, when estrogen levels stabilize, perimenopause indicates that estrogen production drops and remains low.

These modifications will have an impact on the skin that goes beyond psoriasis flare-ups: Because oil production declines with age, menopausal women have drier skin. “It’s one of the biggest complaints that [older] people have about their skin — it feels like you could never quench that thirst,” said Dr. Adil. Menopausal skin dryness, along with the dry, scaly environment of psoriatic skin, might exacerbate flare-ups. “Anything that reduces the chance of the skin barrier healing and functioning properly,” he adds, will be difficult for someone with psoriasis.

What happens to psoriasis after menopause?

“With larger hormonal life events, like menopause, there’s been pretty clear evidence that there’s a relation between your psoriasis flaring, inflammation as a whole, and the condition,”. And, as Dr. Adil notes, estrogen levels are lowest after menopause. “Many patients will see a worsening of psoriasis symptoms and the severity of their flare-ups,” he said. As a result, menopause is a critical time to maintain your care regimen and regular visits to your doctor. Though psoriasis is a chronic condition, it is manageable, and a little preparation — including mental preparedness and understanding that further flare-ups may occur as you age — can go a long way.


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