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[Effects of menopause, pregnancies, breast feeding and hormonal contraceptives on the course of rheumatoid arthritis].


 Of 763 patients who were treated for rheumatoid arthritis (RA), 219 went through menopause, 114 were pregnant, 92 breast-fed children, and 29 used oral contraceptives. Of the 219 menopausal women, 5% experienced an improvement and 46.1% an adverse effect on the RA. It was found that those who experienced improvement during menopause more often had had RA for longer periods and tended to have developed RA before the 45th year of age. 59 patients first developed RA during the menopause, and a general adverse effect of menopause on RA was observed. Increased seronegativity and a reduction in rheumafactor levels were observed in this group, as well as a significantly higher BSG level. In the group which developed RA during menopause, increases in morphological stage II, in grade I of functional inefficiency, and in grip strength and the BFT were observed. There was also a significant increase in the incidence of long arthralgic periods before developing RA during menopause. The relationship between RA during menopause and various other factors, e.g. occupation, weight, prior therapy, is also discussed. Among the 114 pregnant patients, 42 reported a positive effect and 30 an adverse effect on RA. Among the 92 patients who breast-fed their children, 25 reported an adverse effect and 19 reported improvement of RA. Patients who had had RA for longer periods more often reported improvement during pregnancy and breast feeding. Adverse effects of pregnancy on RA usually continued during the breast feeding period. Of the 29 patients who had used oral contraceptives, 5 reported a positive effect on RA.
