Unravelling the Connection Between Menstrual Cycle and Autoimmune Conditions

The menstrual cycle is a beautiful, complex process that influences hormonal levels and leads to physiological changes in menstruators.

Menstrual cycle signs and symptoms like headaches, cramps, fatigue, bloating, pain, and mood swings for some can be bothersome, yet are great signs that something else is going on.

Menstruators who also have autoimmune imbalances like lupus often can experience other signs or symptoms.

This can come with experiences such as fluctuations in cycle signs and symptoms that coincide with the menstrual cycle. This has led scientists to further explore the role of hormones, especially progesterone and oestrogen, in influencing autoimmune flare-ups.

In this article, explore with us the complex relationship between the menstrual cycle and autoimmune conditions, shedding light on the impact of hormonal changes on lupus and other systemic autoimmune diseases.

Key Takeaways

  • The menstrual cycle, marked by hormonal changes, may impact autoimmune flare-ups.
  • Progesterone and oestrogen play pivotal roles in shaping the course of autoimmune diseases.
  • Fluctuating hormone levels during the menstrual cycle can influence disease activity.
  • Specific phases, such as the luteal phase and ovulation, may be critical in triggering autoimmune responses.
  • Management strategies should consider the impact of the menstrual cycle on autoimmune conditions, offering personalised approaches for individuals.

Understanding the Menstrual Cycle

As mentioned earlier, the menstrual cycle is a beautifully orchestrated sequence of events that occurs in menstruators of reproductive age. Divided into four phases, it is characterised by fluctuations in hormone levels.

Phases of the Menstrual Cycle

  1. Menstrual Phase: The menstrual cycle kicks off with the menstrual phase. It usually runs from day 1 to day 5 but can differ from one person to another. During this time, the inner lining of the uterus, which had thickened to possibly support a pregnancy, is not needed anymore. So, it exits the body through the vagina, showing up as menstrual bleeding.
  2. Follicular Phase: During this phase, the body begins to prepare for ovulation by releasing hormones that stimulate the growth of follicles in the ovaries. Oestrogen levels start to rise, orchestrating the regeneration of the uterine lining.
  3. Ovulation: The peak of the menstrual cycle, sees a surge in luteinising hormone triggers ovulation. The time of ovulation is individual to each person and their specific cycle. However, for a 30 day healthy cycle this often would occur somewhere between cycle days 12-19. During this phase, an egg is released from a mature follicle, making its journey down the fallopian tube. Oestrogen peaks, creating an environment conducive for potential fertilisation.
  4. Luteal Phase: Following ovulation, the luteal phase takes over. The ruptured follicle transforms into a structure called the corpus luteum, secreting progesterone. This hormone prepares the uterine lining for a potential embryo implantation. If fertilisation does not occur, the corpus luteum degenerates, leading to a decline in both oestrogen and progesterone levels, triggering menstruation and signalling the beginning of a new cycle.

Hormonal Fluctuations and Their Crucial Role

Oestrogen, often referred to as the “female sex hormone,” plays a central role in shaping the first half of the menstrual cycle. Increased levels of oestrogen during the follicular phase stimulate the thickening of the uterine lining, promoting a nurturing environment for a potential embryo.

Oestrogen’s influence extends beyond the reproductive system, impacting various tissues and organs, including bones and the cardiovascular system.

Progesterone, on the other hand, takes the stage during the latter part of the menstrual cycle, particularly in the luteal phase. Produced by the corpus luteum, progesterone helps maintain the uterine lining, preparing it for embryo implantation.

This hormone also has immunosuppressive effects, modulating the immune response to prevent the body from rejecting a potential pregnancy.

The Connection With Autoimmune Conditions 

Although both oestrogen and progesterone play essential roles in regulating various biological functions, fluctuations in their levels during the menstrual cycle may contribute to autoimmune flare-ups.

Studies have shown that oestrogen has immunomodulatory effects, meaning it can regulate and modulate the body’s immunity. Changes in oestrogen levels during different phases of the menstrual cycle could impact the activity of immune cells.

During periods of elevated oestrogen, the immune system tends to become more responsive.

This heightened immune response can be a double-edged sword. Whilst it aids in combating infections, it may also lead to an overactive immune system that attacks the body’s own tissues — a characteristic feature of autoimmune diseases.

In the context of lupus, an autoimmune disease where the immune system mistakenly attacks various tissues and organs, the immune-stimulating effects of oestrogen become particularly relevant.

Fluctuations in oestrogen levels throughout the menstrual cycle can potentially contribute to lupus flares by promoting an inflammatory environment, triggering an immune response against self-antigens.

In contrast to oestrogen, progesterone assumes the role of an immune modulator. Progesterone is known for its immunosuppressive effects, designed to create an environment conducive to pregnancy.

During the luteal phase of the menstrual cycle is when progesterone levels peak. As a result, the immune system is not as active as it usually would be. This modulation is essential to prevent the body from rejecting a fertilised egg, allowing for potential conception and implantation.

In the context of autoimmune conditions like lupus, the immunosuppressive effects of progesterone can become problematic. Whilst it can help regulate the immune system, an excessive drop in progesterone levels could potentially remove this immunosuppressive influence, leading to a rebound effect and an increased risk of autoimmune flare-ups.

Meanwhile, the surge in progesterone levels during the luteal phase of the menstrual cycle may also have implications for autoimmune conditions, especially in the context of autoimmune progesterone dermatitis (APD)

This rare condition involves an allergic reaction to endogenous progesterone, which is manifested by a rash that usually develops 3-5 days prior to menstruation at the height of progesterone levels. As progesterone levels drop a few days following the start of menstruation, the rash often goes away, potentially only reappearing right before the next menstruation begins.

While there is variation in the form of rashes associated with autoimmune progesterone dermatitis, most initially exhibit:

  • Urticaria +/- angioedema and anaphylaxis
  • Dermatitis
  • Other multiple lesions on the skin

Impact of Menstrual Cycle on Rheumatic Diseases and Immune System Function

The menstrual cycle’s influence extends beyond triggering autoimmune flares in some menstruators. Research from the Hospital Special Surgery (HSS) found that exacerbated symptoms, such as joint pain and inflammation, are experienced by menstruators with rheumatic diseases prior to or at the start of their cycles.

The reasons behind this possible relationship are still to be completely understood. These results imply that inflammation and disease activity may be influenced by underlying alterations in hormone levels that occur during the menstrual cycle.

Moreover, studies have also shown that the menstrual cycle affects the overall function of the immune system. Hormonal changes during different phases of the menstrual cycle modulate the immune response, potentially influencing susceptibility to infections and other immune-related conditions.

Understanding how the menstrual cycle interacts with immune function provides valuable insights into disease management. For instance, certain phases of the menstrual cycle may be associated with increased immune activity, while others may involve a more subdued response.

Tailoring treatment approaches to align with these natural fluctuations is the key to optimise the management of autoimmune conditions and enhance overall immune health.

Nurturing Your Health as a Menstruator With an Autoimmune Condition

Being aware of the connection between the menstrual cycle and autoimmune conditions is essential to address the impact of hormonal changes on disease activity among menstruators.

If you are one of them, understanding how your hormones play into the mix is a game-changer for your overall well-being.

To further help you out in effectively managing the autoimmune mayhem that your menstrual cycle brings, here are a couple of tips you can follow

  • Team up with healthcare professionals to develop a tailored management plan that considers your fluctuating hormone levels during your menstrual cycle. It may involve adjusting medication regimens, monitoring symptoms more closely during specific phases, and providing targeted support to manage menstrual symptoms effectively.
  • Consider adding a Menstrual Cycle Coach to your support team. These coaches are specialists in navigating the twists, turns, and education of your menstrual cycle, offering personalised advice, and helping you sync your lifestyle with your unique needs.
  • Embrace your unique journey as both a menstruator and an autoimmune warrior. Face the challenges of your condition head-on and with confidence.


Navigating the intricacies of the menstrual cycle and autoimmune diseases requires an individualised and personalised approach. By understanding the roles hormones play, collaborating with healthcare professionals, and embracing your uniqueness, you empower yourself to stride through this complex journey with confidence and well-being.

To learn more about the menstrual cycle, and develop the knowledge and skills to guide other menstruators as a Menstrual Cycle Coach, join our growing community!

Frequently Asked Questions

The fluctuating hormone levels during the menstrual cycle may affect the immune system response and inflammatory reactions, potentially triggering flare-ups of autoimmune conditions in some individuals.

Hormone levels, particularly progesterone, can play a role in exacerbating autoimmune conditions and contributing to the manifestation of symptoms.

Fluctuating hormone levels around your period may lead to lupus flare-ups, impacting the severity of symptoms in people with lupus.

Autoimmune progesterone dermatitis is a condition where the body has an autoimmune response to progesterone, often exacerbated during the luteal phase of the menstrual cycle, resulting in skin manifestations and other symptoms.

Yes, menstruators with autoimmune diseases may experience increased flare-ups during the menstrual cycle due to the influence of hormone levels on the immune system.

The menstrual cycle can contribute to increasing symptoms and increased disease activity in menstruators with lupus and other autoimmune conditions, especially during phases where hormonal levels are high.

Heavy periods may be linked to certain autoimmune conditions, indicating an underlying health issue that requires evaluation and management

Fluctuating hormone levels may affect the immune system response and contribute to the development or exacerbation of autoimmune diseases in women.

The menstrual cycle can influence the systemic inflammatory response, potentially impacting disease activity and symptoms in menstruators with rheumatic diseases.

Some studies suggest that the hormonal changes associated with menopause may affect the immune system and contribute to the development or exacerbation of autoimmune diseases in menstruators. However, further research is needed to establish a definitive correlation.

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