Do flares of systemic lupus erythematosus decline after menopause?

Objective. To study whether dares of SLE decline after menopause. Method. 34 postmenopausal SLE patients with premenopausal disease onset wer e studied. The frequency and severity of flares before and after menopause was compared. 17 postmenopausal onset SLE patients were also included for c omparison. Result. Flares in postmenopausal SLE patients decreased significantly after menopause (total No. of flares/patient-year before and after menopause wer e 0.50+/-0.10 and 0.14+/-0.05, respectively, p=0.002). The frequency and pr oportion of severe dares also dropped significantly. The rate and magnitude of postmenopausal flares in these patients were similar to those of the po stmenopausal onset SLE patients, a subset known to run a more benign course . Conclusions. SLE flares less frequently and seriously after menopause. Whil e this may suggest a protective role of hypoestrogenemia against lupus dare s, the contribution of other factors like disease duration and effective tr eatment to this postmenopausal decline of flares cannot be separated from m enopause per se. Further studies are needed.