Abstract

Menopausal arthritis, a form of osteoarthritis manifests as joint pain and inflammation, that occurs early in menopause and may continue to get worse as time goes on. It is well known that Estrogen helps to reduce inflammation in women and there exists a relationship between falling estrogen levels and arthritis though the exact mechanism is still not fully clear. During menopause when estrogen levels decline, Hot flashes, Night sweats, Mood swings, Fatigue, Weight gain and Vaginal dryness are common symptoms experienced. One of the lesser-known result is increase in inflammation, causing discomfort pain, swelling and stiffness of the joints and the condition is called ‘menopausal arthritis’. Early menopause has higher risk of all associated health problems. Menopause itself should set in around the age of 46-47 years in Indian women. We present a case of early menopause onset (as indicated by first delayed and irregular menses) accompanied by joint pains not responding to routine analgesics. A 44-year-old, housewife, reported with swelling and pain in both the ankles, toes and foot pain in November 2020, to a local practitioner. After physical examination and some basic investigations, he treated her with analgesics and anti- inflammatory drugs but with poor results in the remission of the pain. During the next menstrual cycle, which was delayed by 2 weeks (after 6 weeks instead of 4 weeks she was used to) the number of joints involved, and severity of the pain increased. This time they consulted a private Orthopedic specialist in the nearest town, who again after a battery of investigations including serological assessment of Rheumatoid Arthritis factor made provisional diagnosis of ‘Polyarthritis with seronegative RA- Menopausal Arthritis. She was put on a combination of corticosteroids, NSAIDs and anti-rheumatoid drugs since mid- May 2021. While the follow-up visit is due next week, she has nearly 50% relief by now.